title: Optimizing computed tomography simulation wait times in a busy radiation medicine program.
abstract: OBJECTIVE
  An audit was conducted of patient schedules for computed tomography simulation (CT-Sim) scans within the Radiation Medicine Program at the Princess Margaret Cancer Centre to investigate opportunities for improved efficiencies, enhancing process, reducing rescanning rates, and decreasing wait times.
  
  
  METHODS
  A 3-phased approach was undertaken to evaluate the current practice in the CT-Sim facility with a view toward implementing improvements. The first phase involved a review and assessment of the validity of current guidelines and protocols associated with 16 different disease sites. The second phase incorporated the use of a patient record and verification program MOSAIQ to capture the duration of each appointment. The last phase allocated additional time for patient-centered care and staff engagement.
  
  
  RESULTS
  The audit revealed that efficiency could be achieved through staff training, updating protocols, and improving process coordination. With the exception of sarcoma, pediatric, and palliative patients who require unique management approaches, the duration for each CT-Sim appointment was successfully shortened for all disease sites by 22% to 33%, corresponding to a reduction of 10 to 15 minutes per appointment. Rescanning rates for patients requiring self-administered preparations before CT-Sim procedures were also significantly reduced by enhancing processes to increase patient compliance. Implementation of procedural changes resulted in an overall net gain of 3060 minutes, equivalent to 102 additional 30-minute CT-Sim appointment slots available for each month.
  
  
  CONCLUSIONS
  This retrospective evaluation, review, and optimization of CT-Sim guidelines and practices identified opportunities to shorten appointment timeslots, and reduce rescanning rates for CT-Sim procedures, thereby significantly shortening wait times and improving access to service for our patients.
authors.affiliation: Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.
authors.forename: Jerry
authors.initials: J
authors.lastname: Roussos
authors.affiliation: Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada; Ontario Cancer Institute, University Health Network, Toronto, Ontario, Canada.
authors.forename: Payam
authors.initials: P
authors.lastname: Zahedi
authors.affiliation: Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada; Ontario Cancer Institute, University Health Network, Toronto, Ontario, Canada.
authors.forename: Tara
authors.initials: T
authors.lastname: Spence
authors.affiliation: Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.
authors.forename: Lue-Ann
authors.initials: LA
authors.lastname: Swanson
authors.affiliation: Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.
authors.forename: Fionna
authors.initials: F
authors.lastname: Li-Cheung
authors.affiliation: Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.
authors.forename: Fred
authors.initials: F
authors.lastname: Cops
authors.affiliation: Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.
authors.forename: Patrick
authors.initials: P
authors.lastname: Darcy
authors.affiliation: Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.
authors.forename: Veng
authors.initials: V
authors.lastname: Chhin
authors.affiliation: Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.
authors.forename: Elen
authors.initials: E
authors.lastname: Moyo
authors.affiliation: Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada; Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Padraig
authors.initials: P
authors.lastname: Warde
authors.affiliation: Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.
authors.forename: Sophie
authors.initials: S
authors.lastname: Foxcroft
authors.affiliation: Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada; Ontario Cancer Institute, University Health Network, Toronto, Ontario, Canada; Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada. Electronic address: fei-fei.liu@rmp.uhn.on.ca.
authors.forename: Fei-Fei
authors.initials: FF
authors.lastname: Liu
mesh_terms: D001071:Appointments and Schedules; D006801:Humans; D008485:Medical Audit; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed