Improving CT Delivery & Access Across Island Health
Island-Wide Standards - A Foundation for Improvement
Computed Tomography (CT) is provided regionally at eight
Vancouver Island sites. In 2011, Island Health approved an
island-wide improvement initiative to address variation in
booking and scanning processes and the fact that CT clinical
protocols and wait-time benchmarks were not standardized.
Key concerns were that physician ordering practices, patient
wait times, and delivered procedures varied by where pa-
tients lived. There were also concerns about patient radiation
Establish foundation for Island-wide CT improvement by
March 2013 by:
Improving patient access to CT services
Increasing CT scan workflow efficiency
Improving safety by reducing radiation exposure
Improving Patient, Physician and Staff satisfaction
Increasing team capacity for continuous improvement
Patient acuity and CT exam complexity are increasing and
contribute to the time to complete some exams.
The scan process is already efficient but Technologists
are doing some non-technical work that modality aides,
porters, and clerical staff could support.
There is a real opportunity to reduce the length of time
from scan to final report and improve patient care.
The biggest gains were from improving communication
between services that touched the patient CT scan jour-
ney: Medical Imaging and unit nurses, emergency staff,
physicians and porters.
Work was launched late in the fiscal year which rushed plan-
ning and impacted our ability to build a strong coalition for
change with some stakeholders and proactively address
some misconceptions about ‘Lean’ and staffing.
Sponsor changes during the project impacted our ability to
get timely decisions at key strategic points.
One Year Later ...
Standard guidelines remain in place for clerks to process
outpatient CT requests (now booked within 24 hours) and
ensure backlogs are dealt with quickly.
The Modality Excellence team ensures standard CT Pro-
tocols and Procedures stay current. A new CT/Radiology
Team Lead has improved communication among sites.
A Modality Aide position is being posted in Nanaimo which
will make it possible to book more outpatient scans. This
is a direct result of evidence from the PDSA trial.
Voice recognition has been rolled out at all sites,
significantly reducing CT report turnaround time.
Wait times are monitored corporately but it is an ongoing
challenge to sustain a culture of continuous improvement
at all levels from front-line to executive.
Questions/Comments Contact Jeff Stevens or Heather Nash
c/o email@example.com 250.519.3500 Ext.32651
Collected baseline metrics inform mapping.
Site visits and current state mapping with people who rep-
resented all roles in the process. They identified & prioritized
issues. We included CT supervisors from other sites to share
expertise and solutions.
Plan Do Study Act cycles to test ideas for improvement.
For example, a trial to have a Modality Aide prep patients
and switch over the room between scans.
Visual Management Boards to share
ideas and progress.
CT Scan Room 5S Improved Access to Supplies
Modality Aide Trial Increased Outpatient CT Scan Capacity
By 5 per Day (1300 more Scans Per Year) in Nanaimo
3.2 % Island-Wide Increase in CT Exams Performed
(Emergency & Inpatients)
Implementing Priority Guidelines Enabled
Standard Booking Processes & Wait Time Comparisons
Collected Voice of the Customer ideas
for improvement through surveys of
Patients, Referring Physicians and Staff
Standardizing Scan Protocols reduced radiation exposure
by 31% (50% at sites with dose reduction software)