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The number of patients that hospitals expect to see over the coming years for cardiac MRI is increasing. Incidents of Coronary Heart Disease, the UK’s biggest killer, continue to rise fuelled by soaring obesity rates and other lifestyle influences. The need for fast and accurate cardiac scanning facilities is high, to identify conditions early and minimise the impact on the long-term health economy.
The efficient utilisation of equipment such as MRI and CT scanners is the first step in ensuring that you are receiving a solid return on capital investment. But once the service is at full capacity, what more can be gained?
The Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust took an inquisitive approach towards addressing this question in partnership with Siemens Healthcare. Although its MRI scanner was working at maximum capacity, which ticked the box on utilisation, it recognised that there was the scope to make image gathering more efficient in order to cope with increasing patient numbers. A day optimising throughput (Dot) software engine was added to the existing system to accelerate the power and increase productivity.
“The increased scanning speed has raised patient throughput by 50 per cent allowing six patients to be scanned in a four hour session rather than only four before. Now we can scan over 1,000 cardiac patients a year using only 10 per cent of our total scanning capacity,” states Dr. Russell Bull, consultant radiologist MRCP, FRCR.
Siemens’ Dot optimises the patient examination strategy, automating the steps needed to get a high quality scan and adapting to the patient’s condition. It guides radiology staff through each step required, even in the most complicated examinations. This speeds up standard scans with fewer errors or the need for repeats, plus it intelligently advises in more complicated cases.
“Our patient population is almost exclusively adult and Cardiac Magnetic Resonance (CMR) is carried out frequently to provide structural and functional information, particularly for planning revascularisation strategies in patients with known coronary artery disease. This information is then used for planning ways to restore blood flow. The complexity of procedures and the lack of familiarity with cardiac anatomy presented major issues in staff resource allocation and training,” states Dr. Bull.
“Using the Dot software the most difficult MR examination has become much more straightforward and even relatively inexperienced staff members are now able to scan cardiac patients quickly and efficiently. Today, all 16 of our scanning staff perform cardiac examinations compared with just three people before.”
This ensures better utilisation of every member of staff in the department to perform at the same standard. It also means that historically difficult cardiac examinations can be incorporated into the general workload of a busy general hospital rather than having to have dedicated slots when the necessary skilled staff members are available. Traditionally this approach slowed down the number of patients that could be seen and the resulting diagnosis and treatment planning.
Better quality assurance
“The automation of the imaging process by the Dot workflow engine makes it easier to obtain high quality scans and streamlines the diagnostic process from patient preparation to viewing the acquired images. Results are now much more robust and the quality is consistently high,” continues Dr. Bull. “Furthermore, with scan images at a better level of quality, consultants have quick and accurate information to make diagnostic decisions and prescribe the course of treatment.”
The intelligent software engine also offers an intuitive and built in training tool to reduce the need for external training sessions. This delivers greater cost returns as no future outlay is required and provides an ongoing resource for all members of staff to engage in or refresh on functionality on a frequent basis. This keeps departmental knowledge high at all times and ensures that new staff can learn quickly.
The patient’s choice
Departmental objectives of keeping the number of patients seen each day at an optimum level must also be driven in line with the experience received. Dr. Bull states: “Although our throughput is now much swifter, the patient also gains a more positive experience spending less time in the scanner undergoing an examination. MRI scanning can be a claustrophobic experience for some so a reduced amount of time to achieve results removes associated anxiety. This could become an added advantage if hospital income linked to patient satisfaction comes to life later this year.”
He continues: “The number of referrals from cardiologists to the hospital has also increased due to the speed at which we can scan patients. Patients given the choice would rather be in and out the door in half an hour than a more lengthy procedure at alternative facilities. This is a positive reflection on the Trust’s reputation and positions the hospital’s imaging service as highly competitive.”
Whilst the decision to automate and simplify the cardiac MRI was via clinical leadership, the benefits are also delivered to satisfy Trust objectives and the wider NHS agenda. An increase in CMR capacity delivered by a cost effective technology upgrade to the existing scanner means that more patients can be seen during the working day. This exciting technology has the potential to be a source of additional revenue for the Trust.
Staff resources are also better utilised by the automation of clinical procedures guaranteeing a better result first time. This leads to improved efficiency and financial performance. Finally, and at the heart of clinical decision making, the patient experience is enhanced with shorter scanning times and a better result first time.
MAGNETOM® Avanto 1.5 Tesla MRI system from Siemens Healthcare was upgraded with ‘day optimising throughput’ (Dot) software engine.
The Royal Bournemouth Hospital
The Royal Bournemouth Hospital is part of The Royal Bournemouth & Christchurch Hospitals Foundation Trust, which provides healthcare for over 550,000 residents of Bournemouth, Christchurch, East Dorset and parts of the New Forest.
It offers a comprehensive range of outpatient and inpatient healthcare services, including a large regional cardiac unit, the Dorset Heart Centre, which performs over 2,500 procedures per year.