From the November 2020 issue of HealthCare Business News magazine

Forming a team of proceduralists, technologists, nurses and administrators — with an administrator who had Six Sigma training leading the effort — Emory broke down and mapped out the entire process for admitting a patient into the CT room and beginning the procedure.

The team then performed a root cause analysis (RCA) of the various steps in the process. Most variability and lengthy times were found in nursing preparation of patients and coordination between nurses and CT technologists of when to let the patient enter the CT suite.


Emory orchestrated 14 different “tests of change” to address these issues, including equipping all nurses with access to the point-of-care INR testing device. Three changes received the most positive feedback:

1. Instituting daily morning huddles at 8:10am, with representatives from each procedural staff role.
2. Eliminating phone calls between nurses and CT techs used to assess readiness for accepting the patient.
3. Setting arrival time to 90 minutes prior to that first 8:30 a.m. appointment instead of an hour beforehand.

With the changes, mean turnaround time dropped from 71.5 minutes to 15.9, a gain of close to 78%. Exams starting on time — defined as within 15 minutes of an appointment — went from 11% to 82%, excluding outliers such as late arrivals.

CT X-ray cutting technique retains image quality at reduced dose
Researchers in London developed a technique for cutting a full X-ray beam during CT scans into thin beamlets, with the aim of reducing radiation exposure to the patient while retaining image quality.

"This new method fixes two problems,” said professor Sandro Olivo of University College London Medical Physics & Biomedical Engineering, senior author of a study on the technique, in a statement. “It can be used to reduce the dose, but if deployed at the same dose it can increase the resolution of the image.”

The method utilizes a mask with tiny slits that is placed over an X-ray beam. The slits allow for the beam to be divided into beamlets. Olivo and his colleagues tested their approach by imaging an object that was moved in a cycloidal motion to ensure quick and complete irradiation. The cycloidal method adds a simultaneous backward and forward motion to the rotation.

They then compared the outcomes to those of conventional CT scanning methods, in which a sample rotates as a full beam is directed on to it. Image quality was retained at a reduced dose, and image resolution was also found to be sharper, due to the part of the scanner that “reads” the information from the X-ray now being able to locate where the information came from more precisely. The sharpness can be easily adjusted using masks with different-sized apertures, freeing the resolution from the constraints of the scanner’s hardware.

November 2020 Magazine

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