Abstract

Flood R, Wright L. Measuring Utilisation of CT Scanners within an Acute Trust. Journal of Improvement Science 2022: 93; 1-19.

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Following a successful improvement project looking at CT Colonoscopy services [1], the trainee Healthcare System Engineer (HCSE), supported by a Diagnostic Specialist Advisor and accredited HCSE, was asked to look at the elective CT flow across Maidstone and Tunbridge Wells NHS Foundation Trust. The Getting It Right First Time (GIRFT) in Radiology report [2] recommended that Radiology departments look at opportunities to increase capacity from within existing resources and examine ways that Trusts may be able to manage demand more effectively, to improve its service to patients. The need for improvement within diagnostics was expressed by Prof Sir Michael Richards in his service review [3]. In order to do this, is it essential that service managers understand how their service operates and are able to identify and diagnose areas for improvement. The CT Radiology team, including radiographers and booking staff were engaged across both sites to measure patient flow through all four CT scanners. This multidisciplinary team met weekly and were shown how to measure patient flow and how to correctly interrogate the Radiology Information System (RIS) to see and understand the demand, activity, work in progress (WIP) and individual patient turnaround times.

The main findings were:
1. The utilisation of the available CT scanner time was between 38% and 91% because:

• Appointment slots were longer than the measured cycle-times.
• Patients were booked at 2 weeks or 6 weeks even if there was an appointment available sooner.
• The first patients were booked to arrive well after the scanner was open.
• There were delays waiting for porters to bring patients from the wards.

2. The Trust was unnecessarily outsourcing CT scans to the private sector.

This project also confirmed the need for healthcare systems thinking and training for Radiology and managerial staff. A further four staff are now taking part in the HCSE training programme across the Kent & Medway Imaging Network (KMIN).

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6M Design (6M); Activity; Backlog; Carveout; Computed Tomography (CT); Demand; Efficiency; Flow Capacity; Getting It Right First Time (GIRFT); Healthcare; Imaging Network; Improvement; Lead Time; Multi-Disciplinary Team (MDT); Productivity; Radiology; Radiology Information System (RIS); Richards Review; Systems Engineering; Time Trap; Utilisation; Vitals Chart; Work In Progress (WIP)