Kim M, Ford E, Smith W, Bowen SR, Geneser S, Meyer J. A system for equitable workload distribution in clinical medical physics.
J Appl Clin Med Phys 2021;
22:186-193. [PMID:
34697863 PMCID:
PMC8664136 DOI:
10.1002/acm2.13460]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 09/21/2021] [Accepted: 10/11/2021] [Indexed: 11/07/2022] Open
Abstract
Background
Clinical medical physics duties include routine tasks, special procedures, and development projects. It can be challenging to distribute the effort equitably across all team members, especially in large clinics or systems where physicists cover multiple sites. The purpose of this work is to study an equitable workload distribution system in radiotherapy physics that addresses the complex and dynamic nature of effort assignment.
Methods
We formed a working group that defined all relevant clinical tasks and estimated the total time spent per task. Estimates used data from the oncology information system, a survey of physicists, and group consensus. We introduced a quantitative workload unit, “equivalent workday” (eWD), as a common unit for effort. The sum of all eWD values adjusted for each physicist's clinical full‐time equivalent yields a “normalized total effort” (nTE) metric for each physicist, that is, the fraction of the total effort assigned to that physicist. We implemented this system in clinical operation. During a trial period of 9 months, we made adjustments to include tasks previously unaccounted for and refined the system. The workload distribution of eight physicists over 12 months was compared before and after implementation of the nTE system.
Results
Prior to implementation, differences in workload of up to 50% existed between individual physicists (nTE range of 10.0%–15.0%). During the trial period, additional categories were added to account for leave and clinical projects that had previously been assigned informally. In the 1‐year period after implementation, the individual workload differences were within 5% (nTE range of 12.3%–12.8%).
Conclusion
We developed a system to equitably distribute workload and demonstrated improvements in the equity of workload. A quantitative approach to workload distribution improves both transparency and accountability. While the system was motivated by the complexities within an academic medical center, it may be generally applicable for other clinics.
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