McMenamy John, Kochkine Sergey, Bernstein Mark, Lucero Anthony, Miles Randy, Schwertner Adam, Thaker Ashesh, Naeger David M
Denver Health Medical Center, Denver, USA.
Stony Brook University Hospital, Stony Brook, USA.
Emerg Radiol. 2025 Feb;32(1):65-72. doi: 10.1007/s10140-024-02297-z. Epub 2024 Dec 11.
Increasing CT capacity to keep pace with rising ED demand is critical. The conventional process has inherent drawbacks. We evaluated an off-console automated AI enhanced workflow which moves all final series creation off-console. We hypothesized the off-console workflow would 1) decrease overall ED CT exam begin to end times and decrease length and variability of time CT is occupied at the individual exam level.
Study population was identified retrospectively and included all CT exams done on all ED adult patients. 3 months of data was collected using the conventional workflow and 3 months of data was collected after implementation of the off-console workflow. Exam begin and the exam end timestamps were collected from the EMR. Additionally, 4 subgroups from the above conventional and off-console workflows were identified retrospectively with an Emergency Severity Index level 1, undergoing one of the four most common CT exam set(s) performed on ESI level 1 patients.
6,795 ED adult patients underwent ED CT in the 3 months immediately prior to implementation of the off-console workflow and 6,708 adult ED patients underwent CT in the 3 months after complete implementation. The off-console workflow demonstrated a 36% decrease in median exam begin to end times (P < 0.001). 4 subgroups demonstrated 56-75% decreases in median CT occupied time (P < 0.001) and decreases in variability in ¾ subgroups.
This off-console workflow enables increased CT capacity to meet rising ED demand. Similar improvements could be expected across most exam sets and imaging settings if broadly implemented.
提高CT检查能力以跟上急诊科不断增长的需求至关重要。传统流程存在固有缺陷。我们评估了一种控制台外自动化人工智能增强工作流程,该流程将所有最终系列图像的创建转移到控制台外。我们假设控制台外工作流程将:1)减少急诊CT检查从开始到结束的总时间,并减少单个检查层面CT占用时间的长度和变异性。
回顾性确定研究人群,包括所有急诊科成年患者的CT检查。使用传统工作流程收集3个月的数据,并在实施控制台外工作流程后收集3个月的数据。从电子病历中收集检查开始和结束的时间戳。此外,回顾性确定上述传统和控制台外工作流程中的4个亚组,这些亚组的急诊严重程度指数为1级,接受对ESI 1级患者进行的四种最常见CT检查组合之一。
在实施控制台外工作流程前的3个月内,6795名急诊科成年患者接受了急诊CT检查,在完全实施后的3个月内,6708名成年急诊科患者接受了CT检查。控制台外工作流程显示,检查从开始到结束的中位时间减少了36%(P < 0.001)。4个亚组显示,CT占用时间的中位数减少了56 - 75%(P < 0.001),并且在四分之三的亚组中变异性降低。
这种控制台外工作流程能够提高CT检查能力,以满足不断增长的急诊科需求。如果广泛实施,在大多数检查组合和成像环境中预计会有类似的改善。