Ontario, like much of Canada, is grappling with prolonged wait times for specialist consultations, surgeries and diagnostic imaging. The delay in diagnostic imaging is particularly concerning, as it hampers the timely diagnosis of critical, life-altering medical conditions.
CT scans, formally known as Computed Tomography scans, play a pivotal role in modern health care. They enable clinicians to diagnose a wide array of medical conditions, from cancers and strokes to vascular abnormalities. These scans detect abnormalities on detailed, three-dimensional images of a patient’s anatomy with minimal discomfort to the patient.
Troubling, though, the average wait time to get a CT scan in Ontario currently stands at a staggering 81 days. This can and must change.
In their efforts to address the CT scan backlog, hospitals have been incentivizing medical radiation technologists to work overtime by offering time-and-a-half pay for after-hour shifts. While well-intentioned, this approach has not significantly reduced the backlog, largely due to inefficiencies in how patients are scheduled.
Currently, hospitals allocate fixed time slots for CT scans, regardless of the complexity or duration of the procedure. For instance, a contrast-based scan that may take 10-15 minutes to complete is allotted the same time slot as a low-dose, non-contrast scan, which can be completed in as little as two minutes.
This one-size-fits-all scheduling model is inefficient and fails to maximize the capacity of available resources.
For example, in one, five-hour overtime shift, I might have 12 low-dose, non-contrast scans scheduled alongside two contrast-based scans. Altogether, the non-contrast scans would take about 45 minutes to perform. The two contrast-based scans could take an additional 15 minutes. Allocating five hours for this schedule is inefficient, as all of these scans could easily be completed in one hour.
This example underscores the need for a more strategic approach to scheduling.
What hospitals should do instead is dedicate five-hour overtime shifts exclusively to non-contrast scans. By focusing these shifts on non-contrast imaging, medical radiation technologists could potentially complete up to 50 scans in a single session.
Contrast-based scans, which are more time-intensive, could then be reserved for regular weekday shifts.
This targeted scheduling strategy would allow hospitals to significantly increase their throughput, making a substantial dent in the provincial wait list for CT scans.
If hospitals across Ontario adopted this model, the impact could be transformative.
Patients requiring non-contrast scans would experience drastically reduced wait times, enabling earlier detection of conditions such as cancers, where the timing of a diagnosis can make the difference between early intervention and advanced-stage treatment.
This approach would not only optimize the use of existing resources but also improve patient outcomes and alleviate the strain on the health-care system.
By rethinking how we allocate resources and prioritize patient needs, we can improve efficiency, reduce wait times and ultimately save lives.
Would this simply move the bottleneck to the radiologists who have to analyze the scans? Why or why not, and what could be changed to ensure that it didn’t?
This article highlights the importance of including the perspectives of the front line team in the planning of health care delivery. This is vitally important given the demand for resources. Over the past 3 decades, front like employees of all stripes have watched decision making be confined to administrative staff far removed from the reality of service delivery. Multiple layers of administration just make this more challenging to navigate. This results in less inefficient care and discourages front line employees from bothering to speak up, as good suggestions are lost while being bounced from one admin department to another. This is not meant to be a criticism of those individuals, it’s simply the nature of government-run services.