Applying Lean Six Sigma Methodologies Reduces Lead Time for Emergency Department CT Scans by 32%

The goal was to reduce delay in patient care by decreasing patient wait times for a CT exam from requested time to start time in the emergency department. Process defects were identified as CT exams that a patient was not ready for and point of care testing not being used on patients who required pre-CT lab testing. Key improvements included: (1) assigning a radiology technologist assistant to the emergency department CT modality between the hours of 11:00 and 19:30; and (2) implementing pre-check point of care testing for creatinine and pregnancy for CT exams that require pre-labs.

Lead time for CT exams in the emergency department that required labs were reduced from an average of 80.75 minutes between August 1 and 14, 2014, to 72.56 minutes between August 15 and September 7, 2014, representing a 10.15 percent reduction from requested time to start time. Lead times for CT exams in the emergency department between the hours of 11:00 and 19:30 were reduced from an average of 96.81 minutes in September 2014 to 70.60 minutes between November 1 and December 14, 2014, representing a 27 percent reduction in wait time from ordered to start. This was further reduced to 65.41 minutes in February 2015, representing a 32 decrease decrease overall.

This case study is part of the Illinois Health and Hospital Association's annual Quality Excellence Achievement Awards. Each year, IHA recognizes and celebrates the achievements of Illinois hospitals and health systems in continually improving and transforming health care in the state. These organizations are improving health by striving to achieve the Triple Aim—improving the patient experience of care (including quality and satisfaction), improving the health of populations, and reducing the per capita cost of health care—and the Institute of Medicine's six aims for improvement—safe, effective, patient centered, timely, efficient, and equitable. To learn more, visit https://www.ihaqualityawards.org/javascript-ui/IHAQualityAward/