Staffing Levels and Workload for Radiation Therapists in Canada

PURPOSE: The safe delivery of radiation therapy is dependent in part on the provision and organization of oncology professionals. General recommendations for staffing of radiation oncologists, medical physicists, and radiation therapists have been published, but most of these provide little detail, especially in the case of radiation therapists (RTs). In Canada, there are no guidelines or national standards for the staffing of RTs, and there is a paucity of Canadian data on the existing staffing levels of RTs and the models used to establish these levels. This project sought to identify and compare the staffing models used for Canadian RTs, and the staffing levels and workload resulting from these models. METHODS AND MATERIALS: In January 2016, a survey was sent to managers of the 46 radiation treatment centres in Canada. This survey sought information on a range of staffing and practice variables for the fiscal year 2014/2015. Respondents were requested to provide the staffing model used for RTs at each centre and enough additional information to calculate the staffing levels and workload resulting from their staffing model. The survey included further variables that had the potential to influence staffing levels and workload, and centres were compared to establish if these variables did indeed impact staffing. RESULTS: Of the 46 centres contacted, 37 centres responded, representing an 80.4% response rate. Survey results showed there are a variety of ways used to determine staffing across the country. Twenty of the 37 responding centres include some type of workload measurement in their staffing model, whereas 17 centres base staffing solely on historic levels or operating funds. There is a great deal of variation in the staffing levels and workload of RTs in Canada, with staff at some centres planning and treating twice the number of patients as RTs at other centres. Radiation therapist staffing levels at most radiation treatment centres in Canada are below the level recommended in recent publications. Differences in staffing levels or workload could not be accounted for by treatment complexity, number of specialty programs, use of relief staff, or number of RTs working in specialty nontreatment roles. CONCLUSIONS: A high degree of variability in staffing levels and workload exists for RTs in Canada, which is not explained by differences in patterns of practice. It is likely that workload for RTs exceed safe levels at some Canadian centres. It is recommended that treatment centres use an up-to-date staffing model for RTs and continue to review staffing levels at regular intervals.