Emory Healthcare has decreased CT acquisition times while saving its radiologic technologists hundreds of hours, leaders reported Monday in RadioGraphics.
The noted Atlanta-based hospital system had grappled with increased advanced imaging volumes in its emergency department, creating a significant patient throughput challenge. Hoping to quash this bottleneck, Emory utilized Lean management principles to pinpoint process gaps and waste.
After implementing several changes, Quality Program Manager Pratik Rachh, MD, MBA, and colleagues recorded some notable gains. The number of emergency CT exams completed within two hours leapt 10 percentage points, up to 71%, and the system saved six weeks of annualized rad tech time.
“The challenge of ED CT image acquisition is not unique to our organization, and the countermeasures we instituted are applicable to other hospital systems,” Rachh and co-authors wrote May 3. “The lessons we learned using these Lean management tools may benefit other organizations facing similar challenges,” they added later.
To tackle this patient flow problem, Emory formed a multidisciplinary team comprised of physicians, nurses, technologists, administrators and a patient family advisor. They began tracking process metrics, such as the percentage of CT exams completed in 120 minutes or less, along with monthly median turnaround times. The ED included in the project has 39 beds, eight hallway stretchers during peak times, and is equipped with one CT scanner while three others in various locations serve as backups.
Rachh and colleagues tackled four projects to help move the needle. Those included creating a patient flow worksheet, revising the CT patient screening form, developing an “ideal” staffing model with enough manpower during surges, and better prioritizing examinations. Emory conducted a phased rollout of the changes over half a year and saw turnaround times improve, yet these gains only persisted for six weeks, the authors noted. Meanwhile, eliminating inefficiencies helped decrease median turnaround times from between 90-109 minutes down to 82-106 minutes, and rad techs saved roughly 268 hours of annualized time.
Speculating on reasons for the backslide, the authors emphasized that staffing considerations were “critical.” Rachh said several staffers departing on family and medical leave may have prompted the decline, and staffing constraints made it tough to adjust to demand surges when the ED experienced an influx.
“Sustaining improvements has been challenging. However, the lessons learned established a collaborative ED and radiology department partnership that continues to work on this complex challenge of optimizing ED CT [turnaround times],” the authors concluded.
You can read the rest of the study in the Radiological Society of North America’s RadioGraphics journal here.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.