title: Reducing the throughput time of the diagnostic track involving CT scanning with computer simulation.
abstract: BACKGROUND
  To examine the use of computer simulation to reduce the time between the CT request and the consult in which the CT report is discussed (diagnostic track) while restricting idle time and overtime.
  
  
  METHODS
  After a pre implementation analysis in our case study hospital, by computer simulation three scenarios were evaluated on access time, overtime and idle time of the CT; after implementation these same aspects were evaluated again. Effects on throughput time were measured for outpatient short-term and urgent requests only.
  
  
  CONCLUSIONS
  The pre implementation analysis showed an average CT access time of 9.8 operating days and an average diagnostic track of 14.5 operating days. Based on the outcomes of the simulation, management changed the capacity for the different patient groups to facilitate a diagnostic track of 10 operating days, with a CT access time of 7 days. After the implementation of changes, the average diagnostic track duration was 12.6 days with an average CT access time of 7.3 days. The fraction of patients with a total throughput time within 10 days increased from 29% to 44% while the utilization remained equal with 82%, the idle time increased by 11% and the overtime decreased by 82%. The fraction of patients that completed the diagnostic track within 10 days improved with 52%. Computer simulation proved useful for studying the effects of proposed scenarios in radiology management. Besides the tangible effects, the simulation increased the awareness that optimizing capacity allocation can reduce access times.
authors.affiliation: Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital (NKI-AVL), P.O. Box 90203, 1006 BE Amsterdam, The Netherlands. w.v.lent@nki.nl
authors.forename: Wineke A M
authors.initials: WA
authors.lastname: van Lent
authors.forename: Joost W
authors.initials: JW
authors.lastname: Deetman
authors.forename: H Jelle
authors.initials: HJ
authors.lastname: Teertstra
authors.forename: Sara H
authors.initials: SH
authors.lastname: Muller
authors.forename: Erwin W
authors.initials: EW
authors.lastname: Hans
authors.forename: Wim H
authors.initials: WH
authors.lastname: van Harten
mesh_terms: D003198:Computer Simulation; D008962:Models, Theoretical; D009426:Netherlands; D013996:Time and Motion Studies; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*; D014850:Waiting Lists; D016526:Workload / Q000706:statistics & numerical data*