How AyniHealth credentials clinical workflows
Credential the task, not the title.
Every AyniHealth credentialling pack is built the same way: the workflow is broken into steps, each profession holds a defined role on each step, everyone climbs the same six tiers, and the credential responds when the workflow changes.
Why tasks, not titles
Job titles no longer predict who performs a clinical step. Adaptive radiotherapy, AI contouring and brachytherapy all spread one procedure across oncologists, physicists, therapists and nurses. So we credential each step, and record which profession anchors it, leads it or supports it.
Steps
Each pack breaks its workflow into units. Every unit belongs to one of eighteen universal workflow classes, so packs are comparable.
Roles
On every unit, each profession is Anchor, Lead, Support or Not involved. Leads work inside a written directive; Anchors carry accountability.
Six tiers, the same everywhere
Every unit in every pack uses the same ladder. Only the evidence depth changes.
- T0
Theory
Learn the theory. No hands-on work.
- T1
Observation and simulation
Watch it done. Practise on phantoms or simulations.
- T2
Supervised practice
Do it with a credentialled person beside you, signing each case.
- T3
Independent with retrospective check
Do it alone; every output is checked afterwards until you match the standard.
- T4
Credentialled
Practise independently within the directive. Audit only.
- T5
Assessor / trainer
Assess and train others. Keep the benchmark sets current.
T3 is what makes delegation safe. Working alone while every output is checked against a standard, until parity is reached, is the step between supervised and credentialled. It is required for any unit a profession leads.
Eighteen workflow classes
Any clinical workflow maps onto these. Every pack is a starting point: your site reviews each step and confirms it against local process before anyone is credentialled against it.
Set up
- W01 Governance, directive and scope
- W02 System readiness
Prepare
- W03 Patient preparation, selection and consent
- W04 Setup, positioning and procedure preparation
- W05 Data and image acquisition
- W06 Input assessment, registration and reconstruction
Decide and define
- W07 Clinical decision gate
- W08 Structure (OAR) definition and editing
- W09 Target definition and editing
Plan and verify
- W10 Plan generation and optimisation
- W11 Plan evaluation and selection
- W12 Independent verification and QA
- W13 Authorisation
Perform and care
- W14 Delivery and intra-procedure performance
- W15 Emergency and escalation response
- W16 Patient care and communication
Learn and assess
- W17 Documentation, audit and incident learning
- W18 Supervision and assessment
Who anchors, leads and supports
Four professional overlays: radiation oncologist (RO), medical physicist (MP), radiation therapist (RT), and nursing, theatre and anaesthetics (NC). Approval always anchors with the medical practitioner. A few typical examples:
| Step | RO | MP | RT | NC |
|---|---|---|---|---|
| Plan approval | A | S | S | N |
| Target contouring | A | N | L* | N |
| Independent plan check | S | A | S | N |
| OAR contouring | S | S | L | N |
| Care with device in situ | S | N | S | A |
| Emergency response | L | A | L | L |
A Anchor, L Lead, S Support, N Not involved* Lead only via an advanced-practice pathway.
How you move up
Evidence comes from eleven recognised methods. Thresholds such as case numbers and the parity target are set by your credentialling committee, not by us.
- KC Knowledge check
- CERT External certificate or registration
- GOV Governance artefact
- OBS Observed-case log
- SIM Simulation or phantom exercise
- SUP Supervised case log
- DOPS Direct observation of procedural skills
- BEN Benchmark parity
- AUD Retrospective audit
- CBD Case-based discussion
- MSF Multi-source feedback
- T0 to T1
- Knowledge check passed. Directive read and signed.
- T1 to T2
- Observation log and simulations complete.
- T2 to T3
- Supervised case minimum met. DOPS satisfactory.
- T3 to T4
- Benchmark parity reached (default 80 percent), or five audited cases with no major deviation. Committee award.
- Staying at T4
- Annual case minimum, refreshers and drills current, audit participation. Renewal every three years.
When the workflow changes
Competency is perishable. Each credential is tied to the version of the workflow, protocol, applicator or AI model it was assessed against. When that changes, the change is classified and the credential responds automatically.
Minor change
Vendor patch, cosmetic UI change, protocol wording, no change to decision rules or output behaviour.
No re-trigger. Record acknowledgement.
Moderate change
New AI model version with validated equivalent performance, new applicator of the same class, updated dose constraints within the same directive.
Affected units return to T3 for one audit cycle or a benchmark re-run; T4 retained pending result.
Major change
New workflow, new platform, new anatomical site, directive rewritten, AI model with changed behaviour, new procedure class.
Affected units return to T2. Directive re-issued. Benchmark set rebuilt where relevant.
AyniHealth Competency Mapping Protocol, version 1.0, September 2026. An implementation framework, not regulatory advice: delegation boundaries are jurisdiction-specific and are confirmed with your regulator and committee.