An operational key performance indicator framework and reference data from a multi-room pencil beam scanning proton therapy center

Purpose

Multi-room proton therapy centers face unique operational challenges related to shared beam delivery systems, extended treatment hours, and high clinical complexity. This study presents a structured framework of key performance indicators (KPIs) and reports longitudinal single-institution operational reference data from a multi-room proton therapy center to support operational assessment and continuous quality improvement. Methods and materials: Operational KPIs were retrospectively evaluated for calendar year 2024 at a three-room proton therapy center utilizing pencil beam scanning. KPIs were categorized into three areas: beam performance, treatment planning and pre-treatment workflow, and treatment room operations. Beam performance metrics included site- and room-specific uptime and beam pauses. Treatment planning metrics quantified CT simulation-to-patient scheduling timelines with attribution to physician, dosimetry, and physics components. Treatment room operations metrics included appointment variance, slot utilization, and waiting-for-beam (WFB) time. Data were collected automatically using a commercial analytics platform integrating radio-frequency identification tracking and oncology information system. Metrics were analyzed longitudinally and stratified by treatment room, disease site, and workflow component.