Table 1.
Data Collection from 10 Benchmarking Telephone Interviews.
| Site | Out-patient model | Out-patient hours of operation | Days | Dedicated ER unit | Shifts (in hours) | On call | Stagger breaks | TA | Number of XR rooms | Digital or CR | Waiting room model | Dedicated DI porter | Dedicated ER porter | Community centre option | Reqs flagged for discharge | Critical indicators, Targets collected | Wait times displayed |
Strategies for bulges | Recent changes for patient flow |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | Walk-Ins | 0730–1730 | M-F | Y(1) | 4, 8, 12 | N/A | Y | Y | 5(1 FL) | Mix | Small | Y (1) | Y (2) | N | Y | N | Y | Casual called in for 4 h shift over Lunch time | Waiting rooms broken into small areas outside of each exam room |
| 2 | Booked | 0800–1600 | M-F | N | 8 | 2400–0800 | Y | Y | 4 (1 FL, 1 chest) | Small | - | - | N | - | N | - | - | - | |
| 3 | Walk-Insa | 0900–1600 | M-F | N | 8 and 12 | 2000–0645 | Y | N | 7 (2 FL, 1 chest) | Mix | Small | N | N | Y (limited) | Y | N | N | - | Now book out-patient exams with prep from 0700 to 0900 |
| 4 | Walk-Ins | 0730–1530 | M-F | N | 8 | 2330–0800 | Y | N | 2(1 FL) | Digital | Large | N | N | N | - | N | - | Techs work 2 to a room, created culture where efficiency is high priority | All new equipment (digital), switched from booked to walk-ins which has resulted in busier periods around lunch time |
| 5 | Walk-Ins | 0600–1800 | M-F | Y (1) | 8 | N/A | Y | N | 5(1 FL, 1 ER, 1 Clinic) | – | Large | Y (2) | N | N | - | N | - | Techs will go to clinic or ER units and image walk-ins | New dedicated Clinic and ER units have shown improvements on wait times |
| 6 | Walk-Ins | 0800–1600 | M-F | N | 8 | N/A | Y | N | 3(1 FL) | Digital | Large | N | N | N | N | N | N | - | Moved reception areas closer to DI, kiosks for check-in at hospital entrance so there is less to do at registration desk |
| 7 | Walk-Ins | 0800–1530 | M-F | N | 8 and 12 | N/A | Y | N | 5 (2 FL, 1 Clinic) | Digital | Small | N (but use to have) | N | N | - | Y,N | - | Techs work through lunches (must be pre-approved) or, more commonly, casual called in for 4 h shift over lunch time | Utilizing a number system for registration, since moving to digital, less rooms but same number of staff as during CR times so lots of staff available to increase flow when needed, loss of DI porter has increased wait times for in-patients and ER |
| 8 | Walk-Insb | 0700–1600 | M–Fc | N | 8 | N/A | Y | N (denied funding) | 4(1 FL) | Digital | Large | N (trying to get budget for one) | N | Y | - | Y,N | Y | Double up on techs during clinic days, O.R. tech assists on floor when not needed in O.R., charge tech will come onto floor, registration will tell patient their expected wait time and give them an option to come back another day, students perform TA duties such as changing patients, etc. | New ER is attached to DI, added a Saturday shift from 0900 to 1600 for walk-ins to accommodate working population, hospital uses a LEAN model where staff feedback is taken seriously, new digital equipment has made imaging more efficient, added second tech to overnight shift because single tech found workload overwhelming |
| 9 | Bookedd | 0800–1600e | M-F | N | 8 | 2100–0800 | N (shut down for lunch) | N | 1 (FL and gen capabilities) | CR | Large | N | N | N | - | N | N | Numerous multi-modality techs so sonographer or mgmt. will go to floor to do XR, if out-patient wait time is > 2 weeks, department will temporarily extend hours | E-referrals and online wait times arc on horizon |
| 10 | Walk-Ins | 0700–1800 | M-F | N | 8 | N/A | Y | N (position just cut) | 4(1 FL) | CR | Large | N | N | Y (2) | Unsure | N | Unsure | Lots of cross training between XR and CT so CT tech can float to XR when needed, charge tech ensures breaks/lunches being staggered at appropriate times to maximize flow, students perform TA duties such as changing patients, etc. | Loss of TA has causcd increased stress for techs as they have had to absorb TA duties which has increased burnout and decreased morale, improved privacy during the registration process |
| 11 | Walk-Ins | 0800–1800 | M-F | N | 8 | 0100–0600 | Y | N | 3(1 FL) | CR | Large | N | N | N | N | Y | N | Techs will assign all short exams to one room and more complcx exams to another room to complete as many short exams as efficiently as possible | - |
“-” means question was not answered during interview.
FL = fluoroscopy.
a
Majority are walk-ins but some out-patient exams with prep are booked between 0700 and 0900.
b
Any exams that require prep or take longer than 30 min are booked.
c
Added walk-in shift on Saturdays from 0900 to 1600.
d
All out-patient X-Rays are booked but won't turn a walk-in away.
e
Out-patient walk-ins accepted from 0800 to 1600 but 0900-1000 blocked off for ER/in-patients only (no out-patients imaged during that hour).