system utilizing 19. 4 technical FTEs. The
types of scanners include two 16 slice
workhorse systems, a 20 slice system (with
low dose) with wide bore aperture and
heavy table capacity to support the
bariatric patient population, a 64 slice
scanner for cardiac imaging, and one
portable scanner dedicated to the neuro
intensive care unit. The ED scanner is
dedicated for ED procedure volume and
utilizes a fixed staffing model of two technical FTEs and one transport aide from
noon to midnight daily. At all other times
one technologist and one transport aide
managed the ED CT scanning suite.
In response to NSUH’s executive director’s mandate to begin developing staffing
models that align staffing resources to meet
the needs of patients, radiology began evaluating service demands for inpatient CT
studies, as well as service changes that had
occurred during the previous 18–24 months
(September 2008 to January 2010). Realizing
that CT imaging is a high volume modality
in great demand, the review included evaluating the complexity of procedures and
room availability during the day.
During this timeframe, two significant
changes had occurred in the CT division.
First, the daily staffing and management
responsibility for the cardiac CT scanner
( 64 slice) was reassigned to radiology. Previously, two full time technologists from
cardiology shared a rotational assignment
on a daily basis to perform cardiac imaging
studies. The cardiology technical staff was
limited to scanning only cardiac studies.
Under the new restructuring, one of the
two full time positions was transferred to
the radiology CT pool of technologists and
one position was eliminated through attrition. By adding one position to the radiology pool of technologists, NSUH was able
to provide daily technical coverage and,
through flex scheduling practices, provided
vacation coverage without using overtime
hours. Cardiac CT volume has continuously declined during the last three years.
The cardiac schedule has been compressed
to three days a week and there are no operational issues related to procedure TAT.
The second major service change
occurred with the arrival of a portable CT
Through a collaborative effort with IT, a data repository was
established to capture turnaround data for all radiology
departments across the health system.
scanner. The system was designated to the
neurosurgical intensive care unit (ICU).
Early each morning (excluding Sunday)
technologists reported to the NSUH ICU
and performed CT studies utilizing the
portable scanner. Routinely, two technologists were deployed to complete the unit
run, which improves scan completion
times and provides additional resource
support to maneuver the equipment, position the patient, and process study images.
On average, six to eight patient exams
were completed each day. Images were
downloaded to PACS and the portable
unit was placed in a designated locked
location on the unit.
Utilizing raw data captured from the
departmental radiology information sys-
tem (RIS), management reports were cre-
ated and converted into an Excel pivot
table allowing CT procedure volume to be
analyzed by hour of the day (8:00 AM–
12:00 AM). See Figure 1. This hourly vol-
ume performed was charted and then
compared to existing technologist staffing
levels during those hours throughout the
day. The analysis revealed many peaks
and valleys with procedure volume with
staffing inconsistencies at shift start times,
during lunch periods, shift changes, and
Procedure turnaround data was used to
demonstrate to the staff where opportunities for improvement existed. The data was
a powerful driver in building staff consensus and buy-in. Through several working
sessions, departmental leadership outlined
the advantages of the new model which
DATA COLLECTION TOOL
Figure 1 • CT procedure volume analysis.
• Data collection period – Jan 2009 thru Apr 2009