S2908
RTT- RTT operational practice and workflow innovations
ESTRO 2026
Material/Methods: An action research approach was used to monitor and refine the implementation of an in-house developed automated plan check script built into the Eclipse Treatment Planning system using ESAPI scripting functionality. Prior to the implementation, a pilot group of 8 RTTs and physicians designed and validated the initial workflow; this was scaled and evaluated department wide with a user group consisting of 100 RTTs. Results: Key focus areas included training, user adoption, usage frequency, and time efficiency. Within a six- month time-frame, the implementation of the automatic plan check was systematically monitored. Qualitative information was extracted from interviews conducted at baseline, three-, and six-month post- implementation. Quantitative data collection included script usage rates, repeated use per patient (and changes in the plan between the runs), e-learning engagement, and user interpretation. Results: Initial assumptions included the need for simultaneous technical and contextual training, maintaining both manual and automated checks to support patient safety, and concerns about over-reliance on automation. Despite (repeated) management encouragement, only 50% of RTTs completed the mandatory e-learning module. Additional information was provided by a Standard Operation Procedure (SOP), which 82% considered to be sufficient. Script usage was initially low (37%) but increased to >90% after integration into the standard workflow and removal of duplicate manual checks from the old existing checklist template (figure1). After introduction and initial adoption, users started to drift from intended use: RTTs applied the script to unapproved indications which amounted up to 10 unapproved indication checks per week, being unaware of associated safety risks using outside the intended use. Lack of background knowledge was the most frequent reason for this inappropriate use, which was resolved through targeted training of the RTTs. Over 28 weeks, script usage remained consistent, with in total 1228 evaluated plans. The script detected errors in 33% of the plans, which were then corrected before plan approval. A qualitative survey among 28 RTTs showed that automated checks saved an average of 27% in time compared to manual checks (figure2).
over two years, with four recruited in the first month.A total of 33 discrete research tasks were identified per study, equating to 1,170 minutes (19.5 hours) of staff activity per patient. The mean task duration was 35 minutes (median 30). Most activity involved documentation (72%), followed by clinic interactions (13%), emails (8%), and meetings or calls (8%). Research RTTs undertook majority ofthe tasks (87%), with multidisciplinary input contributing to 25%, averaging 43 minutes per task.These findings show that administrative and documentation work dominates research workload, underscoring the need for dedicated RTT time and process streamlining to support efficient study delivery. Conclusion: RTTs play a key role in integrating research within the ECIP programme, contributing across screening, planning, and follow-up. The time audit indicated that each patient required ≈ 19.5 hours of study activity, with 72% spent on documentation and administrative tasks. This substantial hidden workload highlightsthe need for dedicated RTT capacity. By aligning study requirements with standard care, RTTs ensure protocol adherence, maintain patient safety, and minimise workflow disruption. Their involvement has been central to identifyinginefficiencies, assessing feasibility, and embedding research within clinical delivery, providing a strong foundationfor future PBT studies. Keywords: PBT, Radiation Therapist, Evaluative Commissioning Mini-Oral 1389 Implementing an Automated Plan Check in a High- Volume Radiotherapy Department: Adoption, Integration, and Impact. Steffie Schouenberg, Wouter van Elmpt, Peter Fick, Jan Kubica, Richard Canters, Dominique Reijtenbagh, Maud de Rooy, Desiree Willems, Michel Ollers, Denis Eyssen, Moniek Verstegen, Erik Roelofs, Sanne Hurkmans, Cissy Stultiens, Frederique Geuns, Ans Swinnen, Karo Limpens, Marta Bogowicz Department of Radiation Oncology (Maastro), GROW Research Institute for Oncology and Reproduction, Maastricht University Medical Centre+,, ., Maastricht, Netherlands Purpose/Objective: To provide a structured overview of the implementation and adoption process of an automated treatment plan check script in a high- volume radiotherapy department.
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