Staffing Model for Radiation Therapists in Ontario.

Purpose: The Cancer Care Ontario's (CCO) Radiation Program Leadership tasked the Radiation Therapy Professional Advisory Committee (RTPAC) to develop a radiation therapist (RT) staffing model to support current radiation therapy practice.

Background: A 1999 RT staffing model was outdated. Limitations included: (1) the inability to keep pace with advanced treatment planning and/or delivery techniques, (2) the exclusion of staffing for brachytherapy and orthovoltage, and (3) the omission of vital patient safety activities that are required to support clinical practices.

Methods: The RTPAC used a comprehensive scientific methodology to develop the new staffing model. A thorough literature review was completed, and an evidence-based model was developed. A unique creativity tool, the simplex process, was used to identify all the RTs' domains of practice that are integral for professional practice. All domains identified were included in the recommended staffing model.

Results: The staffing model recommends basing the number of RTs on equipment and associated clinical activities. The following staffing numbers are recommended: (1) linear accelerators: 4 full-time equivalent (FTEs) RTs per 10-hour day, (2) brachytherapy: 3 FTEs/8-hour day, (3) orthovoltage: 3 FTEs/8-hour day, (4) CT simulator: 3 FTEs/8-hour day and 4 FTEs/10-hour day, (5) dosimetry: 1 FTE/325 courses per year, (6) radiation oncology systems support and technology development implementation: 1 FTE/4 linear accelerator, (7) administration and education: 1 manager, 1 FTE supervisor/30 staff, 1 FTE professional practice leader/8 linear accelerators, 1 FTE staff educator/8 linear accelerators, 1 FTE undergraduate educator/8-10 students, and (8) additional 20% FTEs of the total for vacation, sick time, maternity leaves, and other leaves.

Conclusions: The recommended staffing model is now more suitable for today's radiation therapy profession by addressing the domains of practice and clinical activities. Further research includes monitoring performance indicators annually to ensure that the staffing model is current. These indicators include wait times, access to care, radiation incidents, technological advances, and the quality of work-life of RTs.