St. Joe’s seeks to add CT scanner to its emergency department to reduce wait times, code zeros

Dr. Greg Rutledge, chief of emergency medicine, and Dr. Colm Boylan, chief of diagnostic imaging, say a new CT scanner suite in St. Joseph's emergency department would help cut down on ambulance offloading delays, among other things. St. Joseph's Healthcare Foundation

St. Joseph’s Healthcare Hamilton is hoping to raise $1.4 million to bring a CT scanner into its emergency department.

Adding a CT suite to the department would help address a massive wait-list for diagnostic imaging and cut down on ambulance shortages but isn’t something that’s funded by the province, according to the St. Joseph’s Healthcare Foundation.

The demand for emergency CT scans at St. Joe’s has jumped by 13 per cent over the past year, according to chief of emergency medicine Dr. Greg Rutledge.

He said patients who currently show up in emergency and need a scan need to be transported to the diagnostic imaging department — which puts them at risk if something goes wrong during the transfer.

“So that’s taking an unstable patient and transferring them away from the nurses, away from the physicians … away from all the resources we have if something were to go awry,” he said.

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“But if we’re successful in this, we can roll the patient 50 yards down the hallway and they’re in and out very quickly. And then if they’re unstable, we’ve got everybody right there that can respond to them getting further unwell.”

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It would also reduce ambulance offloading times — with patients who need CT scans getting admitted and discharged more quickly — and free up paramedics to respond to other emergency calls.

Hamilton’s emergency and community services committee heard last month that there has been a dramatic increase in code zero events, which happen when the number of available ambulances in the city is at one or zero.

Michael Sanderson, the city’s chief of paramedic services, said at the Nov. 4 meeting that there were 41 code zeros from August to October of this year, compared with four in that same time period in 2020, 13 in 2019 and 20 in 2018.

“From a patient perspective, patients are experiencing delays and transfer of care as long as 12 hours,” he said at that time. “We’ve had four- to six-hour delays, which are not uncommon.”

Rutledge said those offloading delays could be reduced with more bed space and that a CT scanner directly in the emergency department would help.

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“If it takes six hours now to get a scan done, read, completed and a decision made to discharge, if we can shorten that to four hours, over the course of several patients you’ve saved, at the end of the day, 20, 24 hours of bed time, collectively, for patients,” he said.

“So without creating any more physical beds, we’re creating more turnaround, which is allowing us to offload ambulances quicker.”

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It’s already the standard in new hospitals across Canada to build a CT suite directly into the emergency department, but no Hamilton hospital currently has that feature.

It would also help the nearly 4,000 outpatients who were on the wait-list for a non-emergency CT scan, as of the end of November.

Dr. Colm Boylan, chief of diagnostic imaging, said St. Joe’s has one of the highest wait-lists for semi-urgent and non-urgent CT scans in the region, with wait times of about 20 days for semi-urgent patients and 60 days for non-urgent patients.

He said that’s double what the province expects the wait time for a CT scan to be.

“And that is despite the fact that our team has been working 24/7 for many months trying to catch up on that.

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The hospital already has the funding to purchase the actual scanner, but the $1.4 million is needed to build a miniature department within the emergency department to house it.

Anyone who is interested in contributing to the project can visit the St. Joseph’s Healthcare Foundation’s website.

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