APRT Integration and Impact in an Inpatient Palliative Radiation Therapy Service: Effects on Throughput and Physician Burnout
Inpatient palliative radiation therapy (PRT) is time-sensitive yet vulnerable to delays from communication gaps, documentation burden, and competing clinical demands. This webinar presents two complementary evaluations of an Advanced Practice Radiation Therapist (APRT) embedded within an inpatient PRT service at a U.S. academic center. First, a 24-month, single-center prospective observational study (OWBR-supported) assessed clinician experience (Mini-Z 2.0) and departmental metrics at 6, 12, 18, and 24 months after APRT integration. Burnout decreased over time, job satisfaction and stress were stable, supportive climate improved, and simulation/treatment completion metrics increased. Second, a retrospective cohort analysis using IPTW compared APRT-supported care with standard care, showing higher completion of simulation and treatment verification among inpatients referred for urgent RT. Findings are correlational and should not be interpreted as causal. Practical implications for scope, governance, documentation, and scaling are outlined
Learning Objectives
By the end of this session, participants will be able to:
- Describe the four pillars of advanced practice in radiation therapy and their relevance to inpatient oncology care.
- Evaluate the effect of an APRT intervention on inpatient throughput, including simulation and treatment verification completion rates.
- Analyze the impact of APRT integration on physician workload, burnout, and continuity of care.
- Discuss the potential for broader adoption of APRT roles within U.S. radiation oncology, including cost-effectiveness and scalability considerations.
This webinar is pending approval by ASRT for 1 category A credit.
Presenters
Clodagh Starrs, MSc.Pgc RT(T)
Advanced Practitioner – Radiation Oncology – Mount Sinai Medical Center, New York, USA
Clodagh Starrs received her Bachelor of Science degree in Therapeutic
Radiography in 2001 from University of Ulster in Jordanstown, Northern
Ireland, and has worked at The Mount Sinai Hospital since 2006. She has
managed the daily treatment and simulation operations since 2010.
Through multidisciplinary collaboration, she has led many clinical
initiatives—notably liver breath hold techniques; sensitive practice for
breast patients; and advancing the use of Image Guided Radiation Therapy
for central nervous system malignancies. She has been invited to share her
work at national conferences, has been an ASRT keynote speaker twice,
and serves as a preceptor and admissions committee member for the
Mount Sinai Center for Radiation Sciences Education.
In August of 2022, she completed her Master of Science degree in
Advanced Clinical Practice, Radiation Oncology, at the University of Sheffield in Sheffield, United Kingdom.
Clodagh was promoted to Advanced Practitioner, Radiation Oncology at The Mount Sinai Hospital. She participates in the National Advanced Practice Radiation Therapy Working Group and the International Community of Practice, and she established national leadership in advancing the clinical and technical role of the radiation therapist.
In her new position at The Mount Sinai Hospital, she was the first radiation therapy professional in the United States to hold an Advanced Practice role. At Mount Sinai Radiation Oncology, this includes leading
the Department toward improved inpatient radiation treatment services, developing new treatment techniques, and leading research that contributes to radiation medicine, improving patient care, and
elevating the knowledge of radiation therapy.
Danielle McDonagh, DHSc, MS, RT(T)
Program Director for Radiation Sciences Education & Research- Mount Sinai Medical Center, New York, USA
Dr. Danielle McDonagh serves as the Program Director of the Radiation Therapy Program at the Mount Sinai Center for Radiation Sciences Education. With over 17 years of clinical experience and a strong commitment to academic leadership, she has developed and led competency-based curricula that supports student progression from entry-level training to professional practice. Her doctoral research investigated gaps in competency-based education (CBE) across multiple radiation science disciplines, including radiation therapy, medical dosimetry, and medical imaging. In her research, Dr. McDonagh has identified and is working towards implementing scalable solutions such as structured goal-setting frameworks and AI-assisted tools that enable learners to document, track, and standardize skill-based learning. Dr. McDonagh has authored peer-reviewed publications and regularly presents her work nationally.
