J Am Coll Radiol. 2016 Feb;13(2):178-81. doi: 10.1016/j.jacr.2015.08.006. Epub 2015 Oct 23.
Rigual D1, Rove M2, Robison Z2, Nordenholz K3, Cumbler E3, Dodd G3, Borgstede J3.
The Problem: Long CT Turnaround Time in the Emergency Department
Emergency department (ED) utilization of radiologic services is growing in the setting of an expanding ED population 1 and 2. This growth has been attributed to changing standards of care in the setting of rapidly improving radiologic technology and an increasing severity of illness of the population of patients served by EDs nationwide 2 and 3.
More than 1,400 ED patients undergo CT scans at our institution monthly, with an ED length of stay (LOS) of approximately 1 to 3 hours. A collaborative inquiry by the radiology and emergency medicine departments identified slow CT scan turnaround time as a target for process improvement (PI) to reduce the length of ED patient stay. We conducted a “voice of the patient” survey on a cohort of ten ED patients, which validated the negative effects of long wait times for CT scans on patient satisfaction. Cost accounting analysis of our ED budget revealed an operating cost of $2.50 per minute for each patient. This translates to a potential annual savings of up to $420,000 with a 10-minute reduction of each CT scan if our ED remained at partial capacity. Alternatively, the economic implications of reduced CT turnaround time may be analyzed on the basis of the ability to handle increased patient throughput at times of maximum ED capacity. The average contribution of each ED patient to our hospital is $800 per visit. A 10-minute reduction in CT turnaround time would allow us to safely care for 1,789 additional patients per year, which could yield a potential increase of $1,431,200 if our ED remains at maximum capacity. Achieving our goal should result in financial gains between these estimates.