Wilfred Dang BS, Presenter: Nothing to Disclose

Ania Zofia Kielar MD, Abstract Co-Author: Nothing to Disclose

Angel Yi Nam Fu BSC, Abstract Co-Author: Nothing to Disclose

Suzanne T. Chong MD, Abstract Co-Author: Nothing to Disclose

Matthew Donald Fernand McInnes MD, FRCPC, Abstract Co-Author: Nothing to Disclose

To evaluate whether the presence of a CT scanner in the emergency department (ED) improves ED workflow by decreasing the time between imaging requisition and completion, as well as potentially impacting patient outcomes by shortening time to final disposition.

IRB approval was obtained for this retrospective study conducted on 2,142 consecutive, acute thoracic, abdominal and pelvic imaging requests from two affiliated academic EDs from August 1 to October 31, 2012. At one institution, the CT scanner is in the ED; in the other it is located in the radiology department 300m away from the ED. Patients were stratified based on acutity of CT indication, interpreting radiologist training level, and the time of day of scanning. Three time points were compared between hospitals: 1) The time the CT requisition was received to the time the CT scan was initiated (ΔTime 1), 2) the time from CT scan initiation to the time the CT was reported preliminarily by a resident/fellow, or verbally reported by staff to the ED (ΔTime 2), and 3) the time the CT requisition was received to the time of final patient disposition (ΔTime 3). 

Decreases in time, favouring the institution with the ED CT scanner, are 16 (P<0.0001), 15 (P<0.0001), and 19 minutes (P<0.04). Significant differences were also seen in morning and overnight shifts (P<0.0001, P<0.0001, P=0.002, and P<0.0001, P=0.04, P=0.001) and for CT reporting times in higher radiology levels of training (P=0.04 and 0.0001 for Staff and PGY 5, respectively). No significant differences were seen for hyperacute patients.

The presence of an ED CT scanner is associated with decreases time to CT scan completion, radiological interpretation and patient disposition.

A CT scanner in the Emergency department reduces: time from request to scan initiation, time from CT request reception to interpretation, and time of patient disposition for acute-care patients.  

Dang, W, Kielar, A, Fu, A, Chong, S, McInnes, M, Does Distance Matter? Effect of Having a Dedicated CT Scanner in the Emergency Department on Completion of CT Imaging and Final Patient Disposition Times.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14045596.html