Evaluation of a dual-room sliding gantry CT concept for workflow optimisation in polytrauma and regular in- and outpatient management

Highlights

• A sliding gantry trauma room CT solution facilitates significantly faster polytrauma management.

• Faster and more efficient resumption of regularly scheduled patients due to a two room solution is supported.

• Sliding gantry CT achieves the same patient throughput as two separate conventional CT devices.

Abstract

Objectives

To reveal the impact on workflow from introducing a dual-room sliding gantry CT to the trauma room for polytrauma and regularly scheduled in- outpatients with regard to efficiency and degree of capacity utilisation.

Materials and methods

Time analysis was performed for 30 polytrauma patients each in 2 different trauma room settings, the new trauma room comprising a sliding gantry CT, the old one a stationary single-room CT. Complete trauma room and diagnostic workup times were manually measured and compared for both groups. In a third scenario, the number of CT scans performed with one single sliding gantry CT and the two-room concept was compared to the number of CT scans performed on two separate regular CT units in a 5 days clinical routine sample.

Results

Patients demographics and type of CT examinations were comparable for all patient groups. The median time from patient arrival in the trauma room until beginning of CT scanning was 6 min shorter for the sliding gantry CT group (21 vs.15 min). Sliding gantry CT embedded in a two-room solution achieved 252 CT scans in 5 working days, compared to 250 CT scans on two separate regular CT units with the same man power.

Conclusions

Sliding gantry CT in the trauma room allows for significant time saving in the diagnostic workup of polytrauma patients and faster resumption of the regular in- outpatient's CT schedule is possible. With the same man power, the dual-room solution is able to generate the same throughput as two separate CT units.

Introduction

With the importance of CT diagnostic in trauma patients ever-increasing, efforts have recently been made so as to provide for around the clock CT accessibility for trauma patients and to shorten the time from patient arrival to CT scanning while still allowing for the utmost CT efficiency.

Trauma accounts for a significant amount of death in younger people [1], [2], [3], [4]. The consistently improving trauma care has made it possible to pull patients with ever-increasing severity of injuries through. Whole body CT scanning has become an essential part of trauma room diagnostics. Several studies have already suggested its potential benefits on polytrauma patient survival [5], [6], [7]. Providing for early CT scan in polytrauma patients has also been suggested to potentially be crucial for the patients’ outcome, especially for unstable, severely injured patients [8]. However, literature has not reached a consensus yet as beneficial influence of whole body CT on polytrauma patient survival has not been ultimately proven [9], [10], [11], [12], [13].

Nevertheless, providing for early trauma care CT scans often cause problems [14] due to additional transports as the CT is often not located in the trauma room itself but in the radiology department. This is both time consuming in polytrauma management and can do further harm to the patient due to additional transfers.

We introduced a trauma room workflow concept by installing a double room solution embedded with a sliding gantry CT into the trauma room. Recent studies have already shown a new trauma workflow concept using a sliding gantry CT in the trauma room [15], [16], mostly within one room solutions and thus lacking the possibility of increasing efficacy by using the sliding gantry not only for trauma but also for regularly scheduled, non-trauma in- and outpatients.

This study was conducted in order to reveal the impact on workflow from introducing a sliding gantry CT in a dual-room concept with the trauma room being directly adjacent to the CT suite. The focus of interest was if and how this concept can improve the diagnostic work-up of polytrauma patients and what the impact on care of regularly scheduled out- inpatients is with regard to throughput efficiency and degree of capacity utilisation.