Emergency departments equipped with CT scanners show improved workflow

Reducing the physical distance between emergency departments (EDs) and CT scanners accelerates imaging requisition and completion times and expedites final patient disposition, according to a study published in the Journal of the American College of Radiology. Prior research suggests the physical distance between the ED and available CT technology is the single most important factor in improving workflow and overall imaging times. One study that focused on the use of portable CT scanners within EDs showed that reductions in patient transfers can save nearly 15 minutes between the initial study request and the completion and interpretation of imaging results.  The research team, led by Wilfred Dang, BHSc, of the University of Ottawa, set out to determine if the strategic placement of a full-service CT scanner within the confines of an ED can significantly increase the timeliness of imaging studies and improve the overall efficiency of the diagnostic process. To do this, the researchers retrospectively reviewed 2,142 consecutive imaging requests for acute thoracic and abdomino-pelvic studies from the EDs of two hospitals affiliated with the University of Ottawa over a three-month period. One hospital’s ED was equipped with its own CT scanner; the other had a physical distance of 300 meters, or about a two-minute walk, between the ED and the radiology department where its CT scanner was located. The results gave the edge to the CT-equipped ED, which consistently registered significant time reductions, including an average of 16 minutes saved between initial receipt of the imaging request and initiation of the CT scan; 15 minutes between the scan initiation and interpretation by a radiology resident or staff radiologist; and 19 minutes between initial CT requisition and final patient disposition. The results could have a major impact on facilities that must report ED waiting times publically and/or compete for funding through time-based targets and favorable patient outcomes. “This finding is important for hospitals that are trying to meet benchmarks or improve efficiency in the ED, as the presence of an ED CT scanner department could help meet these goals,” wrote Dang and colleagues. “Future work should include evaluation of the degree of utilization and overutilization, and the frequency of adherence to published imaging guidelines, when a CT scanner is more readily available.”