Understanding Changes in Radiotherapy Practices Over a Decade: Integrating Treatment Data and Perspectives of Staff in Leadership Positions

Abstract Background Radiotherapy (RT) with the growing demand, has gone through many transitional challenges that tested RT departments’ coordination and adaptability. This study aims to understand how RT staff in leadership roles experienced changes in treatment availability, workflows, and operational dynamics over the last decade. Methods A total of 13 staff members with formal or informal leadership positions participated in the study. The interviews were conducted during 2024, and the participant group consisted of oncologists, oncology nurses/radiation therapists, and medical physicists with leadership roles within the studied time period between 2015 to 2024. We also extracted a quantitative dataset for the same period to investigate if these data coincided with the reported events. Results The thematic analysis based on Braun and Clarke’s approach, resulted in a total of 27 unique codes with 9 sub-themes and 3 overarching themes from all 13 interviews. More than half of the interviewees reported issues relating to resource conditions and operational dynamics. Quantitative data over the years suggested that departmental delays reduced from 12 weeks to 7 weeks, however, all interviewees still highlighted recurring issues with staffing organization during the same years. Conclusion Quantitative data reflected improvements from digitization and new treatment techniques, while qualitative findings highlighted the contribution of leadership initiatives for overall improvements in the RT workflow. The qualitative analysis provided additional insight into factors related to departmental challenges beyond those usually captured by quantitative metrics.