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Published on: January 15, 2017
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Describing wait time bottlenecks for ED patients undergoing head CT.
Jonathan G Rogg1, Robert Huckman2, Michael Lev3
1Massachusetts General Hospital, Department of Emergency Medicine, Boston, MA 02114, United States.
The American Journal of Emergency Medicine
|May 11, 2017
Summary
Emergency departments (EDs) face bottlenecks in head CT scans, leading to significant patient wait times. Identifying these delays is crucial for improving efficiency and patient care.
Area of Science:
- Emergency Medicine
- Radiology
- Healthcare Operations
Background:
- Emergency departments (EDs) experience high patient volumes, leading to capacity and budget challenges.
- Understanding process flow and bottlenecks is essential for improving ED efficiency.
- Head CT scans are critical diagnostic tools with potential delays impacting patient care.
Purpose of the Study:
- To identify bottlenecks in the head CT acquisition process within an academic ED.
- To analyze the impact of these bottlenecks on patient waiting times.
Main Methods:
- Observational study of patients undergoing head CT from July 2013 to June 2014.
- Inclusion of over 100,000 annual ED visits.
- Primary outcome: total cycle time (patient arrival to preliminary CT report), analyzed in four workflow components.
Main Results:
- 8312 head CTs were analyzed.
- Median cycle time was 3 hours and 13 minutes.
- Bottlenecks contributed to a median of 39 minutes of waiting time, with delays occurring most frequently in CT ordering (30%), CT completion (27%), and report generation (42%).
Conclusions:
- A mismatch between demand and capacity for head CTs significantly impacts patient wait times.
- Future research should focus on the causes of delays in CT ordering, completion, and reporting.
- Improving these areas can enhance ED efficiency and reduce patient wait times.
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