Temporal evaluation of computed tomographic scans at a Level 1 trauma department in a central South African hospital

Tony Tiemesmann,Coert De Vries,Jacques Raubenheimer

doi:10.4102/sajr.v20i1.836

Tony Tiemesmann, Coert De Vries + Show 1 more

Open Access

https://doi.org/10.4102/sajr.v20i1.836

Copy DOI

Abstract

Background: Time is a precious commodity, especially in the trauma setting, which requires continuous evaluation to ensure streamlined service delivery, quality patient care and employee efficiency.Objectives: The present study analyses the authors’ institution’s multi-detector computed tomography (MDCT) scan process as part of the imaging turnaround time of trauma patients. It is intended to serve as a baseline for the institution, to offer a comparison with institutions worldwide and to improve service delivery.Method: Relevant categorical data were collected from the trauma patient register and radiological information system (RIS) from 01 February 2013 to 31 January 2014. A population of 1107 trauma patients who received a MDCT scan was included in the study. Temporal data were analysed as a continuum with reference to triage priority, time of day, type of CT scan and admission status. Results: The median trauma arrival to MDCT scan time (TTS) and reporting turnaround time (RTAT) were 69 (39–126) and 86 (53–146) minutes respectively. TTS was subdivided into the time when the patient arrived at trauma to the radiology referral (TTRef) and submission of the radiology request, to the arrival at the MDCT (RefTS) location. TTRef was statistically significantly longer than RefTS (p < 0.0001). RTAT was subdivided into the arrival at the MDCT to the start of the radiology report (STR) and time taken to complete the report (RT). STR was statistically significantly longer than RT (p < 0.0001). Conclusion: The time to scan (TTS) was comparable to, but unfortunately the report turnaround time (RTAT) lagged behind, the findings of some first-world institutions.

Highlights

Productivity, cost, quality and time are the main concerns in every workplace
We evaluated the trauma-radiology timeline in a non-trauma departmentlocated multi-detector computed tomography (MDCT) scanner with the use of advanced trauma life support (ATLS) protocols to establish an institutional baseline and improve productivity and patient care
A total of 4977 patients were seen in the trauma department, 1144 of whom underwent a MDCT scan

Summary

Introduction

Productivity, cost, quality and time are the main concerns in every workplace. Improved productivity can be achieved by addressing all these factors. ATLS focuses on a specific sequence of procedures and interventions to be performed in dealing with an injured patient.[4] Several studies have shown that a CT scanner located within the trauma department can reduce the time taken to obtain a definite diagnosis.[5] An emergency MDCT scan requires expert evaluation by a qualified radiologist. It is through an approved radiology report that the radiologist adds the most value to patient care.[6]. Time is a precious commodity, especially in the trauma setting, which requires continuous evaluation to ensure streamlined service delivery, quality patient care and employee efficiency

Objectives

Results

Conclusion