Reducing emergency department length-of-stay (ED LOS) has become increasingly important as our ED volume continues to rise by approximately 4% each year. In an effort to meet this goal, decreasing the delay between the time a CT is requested to the time the scan is performed, or “order-to-scan time,” has become a major quality improvement effort in our emergency radiology division. To meet this goal, we assembled a multidisciplinary team including ED radiology staff and trainees, CT technologists and managers, ED physician staff and trainees,...

Baseline Data Collection: To better understand the source of these delays, we conducted a survey of technologists inquiring about the reasons for CT exam delays. A pareto chart of survey responses showed that75% of delays were related to patient readiness, including waiting for labs to result and for an IV to be placed (Figure 1). Baseline Data Collection: Timestamps of “exam ordered” and “exam begun” were extracted from the electronic medical record, subtracted from each other (OtB or “order-to-scan” time), and averaged daily.These were turned...

Our interventions resulted in an immediate, significant decrease inOtB time from 92 minutes to 67 minutes for I- C-spine CTs, and from 90 minutes to 74 minutes for I- Stone protocol CTs, as shown in the updated SPC charts (Figure 7).We also observed decreases in variation in system performance, as evidenced by narrowing of the 3-sigma control limits. Updated data analysis has shown that these improvements have been sustained over time.As of 10/1/2017 91% of C-spine CTs and 72% of I- Stone protocol CTs are...

Using classic process improvement tools and interventions focused on automation, standardization, and communication, we decreased exam ordered-to-scan time for unenhanced C-spine CTs and Stone protocol CTs for non-trauma patients in our emergency department.

Corresponding author: Kristine S. Burk, MD [email protected]

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