Reduce fluctuations in capacity to improve the accessibility of radiotherapy treatment cost-effectively

P.E. Joustra, R. Kolfin, N.M. van Dijk, C.C.E. Koning, P.J.M Bakker

Research output: Contribution to journalArticleAcademicpeer-review

4 Citations (Scopus)
22 Downloads (Pure)


This paper is motivated by a case study to reduce the throughput times for radiotherapy treatment. The goal is to find a cost-effective way to meet future throughput targets. A combination of queuing theory and computer simulation was used. First, computer simulation to detect the bottleneck(s) in a multi-step radiotherapy process. Despite, the investment in an additional linear accelerator, the main bottleneck turned out to be the outpatient department (OPD). Next, based on queuing theory, waiting times were improved by reducing the fluctuations in the OPD capacity. Computer simulation was used again to quantify the effect on the total throughput time of a radiotherapy patient. The results showed a reduction in both access times as well as waiting times prior to the consecutive steps: the preparation phase and actual treatment. The paper concludes with practical suggestions on how to reduce the fluctuations in capacity, and seems of interest for other radiotherapy departments or other multi-step situations in a hospital.
Original languageEnglish
Pages (from-to)448-464
Number of pages17
JournalFlexible services and manufacturing journal
Issue number4
Publication statusPublished - 2012


  • Discrete event simulation
  • Queuing theory
  • Variability
  • Waiting lists
  • Radiotherapy department


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