Audit of CT scans done at Chris Hani Baragwanath Academic Hospital in 2014

A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of Master of Medicine in Diagnostic Radiology, Johannesburg, 2018INTRODUCTION: In resource limited environments careful consideration should be made to ensure adequate patient referral and limitation of unnecessary radiation exposure to patients. By evaluation of the current practices and processes, insight can be gleaned so as to specifically target quality improvement initiatives. AIM: This study aimed to evaluate the computed tomography (CT) scans performed at Chris Hani Baragwanath Academic Hospital (CHBAH) in 2014 by means of an audit. The audit assessed referral patterns and workflow in the CT Department in order to identify possible areas that could be targeted to improve service delivery. METHOD: A retrospective descriptive study was performed using data from hand written logbooks of CT scans performed in the CT Department at CHBAH over a 6 month period. The referral patterns and the workflow (i.e. patient through put) was also observed. RESULTS: A total of 11181 CT scans were performed of which 54.2 % were CT brain scans. The 20-29 year age group constituted the greatest proportion (20%) of patients referred to the CT department. The majority (40.6%) of the CT scans performed were for patients from the wards, followed by urgent requests from the emergency departments (34%). It was vi noted that two-thirds of CT scans performed in the CT department were done after hours and there was a trough of productivity between 06h00-09h00 in the morning. Interestingly, the use of two operational CT scanners instead of one resulted in a smaller, than expected, increase in the total number of CT scans performed. CONCLUSIONS: The CT Department at CHBAH was not functioning optimally during the period of the study. There was suboptimal use of both equipment and human resources. Further in depth and detailed review of each step in the operational chain of the CT department at CHBAH is recommended to identify bottlenecks in the system in order to specifically target and monitor quality improvement efforts.XL201