Internal Benchmarking Improves Nurse Workflow, Staffing in Radiation Oncology

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For the study, current practices were recorded assess whether these were appropriate benchmarks for determining staffing decisions.
For the study, current practices were recorded assess whether these were appropriate benchmarks for determining staffing decisions.
The following article features coverage from the 2018 Oncology Nursing Society's Annual Conference in Washington, DC. Click here to read more of Oncology Nurse Advisor's conference coverage. 

WASHINGTON, DC — Based on internal benchmarks established in this project, investigators were able to implement effective radiation oncology nurse scheduling and staffing, according to an oral presentation given at the 2018 Oncology Nursing Society (ONS) Annual Congress.

The American Society for Radiation Oncology (ASTRO) and American College of Radiation Oncology (ACRO) have established guidelines for appropriate staffing decisions. However, these guidelines are not based adequately on the nature of care, type of patient, or the full scope of radiation oncology nursing duties.

For this study, Amanda Choflet, DNP, RN, director of Nursing Radiation Oncology of Johns Hopkins Medical Center aimed to record current practices and assess whether these were appropriate benchmarks upon which to determine nurse staffing decisions.  

Choflet and her team evaluated nursing activities for each type of clinic visit, projected nursing workload hours for these activities as well as additional “out-of-clinic” time — defined as care coordination activities that are not completed while patients are in-clinic (eg, telephone triage) — and compared these projections to actual times in clinic practice. 

The nursing workload was properly defined per each clinic visit type, and comparisons with actual scheduled nurse assignments revealed that staffing at the majority of clinics was appropriate according to the benchmark tool. 

Choflet was able to successfully adjust the projected over- and under-staffing by reassigning nurses to different sites when necessary. “Because we now have this ability to really project with some real granularity around our staffing needs,” she said, “now we can share staff in a way that makes sense and place resources exactly where the patients are.”

She concluded that “benchmarking of nursing workload based on nursing activity times should be tested in additional clinics to validate assumptions and test for usefulness.”


Choflet A. Internal benchmarking for optimal staffing in an integrated radiation oncology practice. Oral presentation at: ONS 43rd Annual Congress; May 17-20, 2018; Washington, DC.

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