title: Does distance matter? Effect of having a dedicated CT scanner in the emergency department on completion of CT imaging and final patient disposition times.
abstract: OBJECTIVE
  To evaluate whether presence of a CT scanner in the emergency department (ED) improves ED workflow by decreasing time between imaging requisition and completion, and time to final patient disposition.
  
  
  METHODS
  Institutional review board approval was obtained for this retrospective study conducted on 2,142 consecutive, acute thoracic, abdomino- pelvic imaging requests from 2 ED hospital campuses affiliated with the same academic institution, August 1 to October 31, 2012. Of these patients, only 1,696 had complete records and were used for analysis. One hospital had a CT scanner in the ED; the other was in the radiology department, 300 meters from the ED. Patients were stratified based on acuity of CT indication, interpreting radiologist training level, and time of day. Time points were compared between hospitals: (1) time of CT requisition receipt to time of scan initiation (2) time from scan initiation to time of preliminary report by resident or fellow, or verbally by staff to the ED; and (3) time of CT requisition receipt to time of final patient disposition.
  
  
  RESULTS
  Decreases in time, favoring the institution with the ED CT scanner, are 16 min (P < .0001); 15 minutes (P < .0001); and 19 minutes (P < .04) for the 3 times, respectively. Significant differences were seen in morning and overnight shifts and for CT reporting times with higher radiology levels of training (20 min, P = .04; and 18 min, P < .0001 for staff and postgraduate year-5 residents, respectively).
  
  
  CONCLUSIONS
  Presence of an ED CT scanner is associated with decreases in time to CT scan completion, radiologic interpretation, and patient disposition.
authors: Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
authors: Wilfred
authors: W
authors: Dang
authors: Department of Medical Imaging, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada. Electronic address: aniakielar@gmail.com.
authors: Ania Z
authors: AZ
authors: Kielar
authors: Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
authors: Angel Y N
authors: AY
authors: Fu
authors: Department of Radiology, University of Michigan, Ann Arbor, Michigan.
authors: Suzanne T
authors: ST
authors: Chong
authors: Department of Medical Imaging, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
authors: Matthew D
authors: MD
authors: McInnes
mesh_terms: D004282:Documentation / Q000706:statistics & numerical data; D017598:Efficiency, Organizational / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D016347:Medical Records Systems, Computerized / Q000706:statistics & numerical data; D009864:Ontario / Q000453:epidemiology; D063886:Patient Discharge Summaries / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*; D057188:Workflow
keywords: CT scanner location; emergency department efficiency; patient disposition times