Challenge
To provide increased access to rapid CT scanning for stroke patient admissions. From the inception of the stroke service, immediate access to CT scan was available by dedicated CT radiographers from 8am to 8pm, Monday to Friday. However as Fairfield’s stroke service expanded, it became apparent in order to extend this level of service, a more efficient and cost effective approach was necessary.

Solution

• Develop training programmes for general radiographers who were already on site working a 24/7 shift rota to ensure all staff were competent in performing CT scans;
• Include radiographers within stroke team to help them to understand about the importance and impact of rapid scanning in stroke;
• Introduce a number of process improvements to streamline patient flow; e.g. redesigned CT forms to include time of onset and arrival; requests for CT scan sent ahead of the patient’s arrival to speed up processes;
• Promote teamwork, and a culture of openness to change/improvement.

Impact
By improving access and timeliness to urgent brain scanning, we have set the stage for better care early on in the stroke care pathway and this will ultimately improve patient outcomes. Improvements in SSNAP performance at Fairfield General Hospital:

Percentage of patients scanned within 1 hour:
In 2013/2014: 36.4%
In 2016/2017: 80.6%

Median time from arrival to scan:
In 2013/2014: 99 minutes
In 2016/2017: 18 minutes

Reflection
The secret to our success has been the close working relationship between the radiographers and the stroke team which fostered excellent communication and co-operation between the two teams. The improvement in stroke imaging established a culture of pride in the part we play within the service, and ensured continued dedication to maintain our high quality service. The fact that these improvements were reflected in SSNAP results reinforced our belief that this project was having a real impact on many stroke patients under our care.

Patient Quote
“When I arrived at the A&E department at Fairfield General there were around 30 people waiting. However I was triaged and seen by the stroke team immediately. After being assessed by a doctor I was transferred for a CT scan, all within about 10 minutes. Everything flowed really quickly from A&E to being admitted to Ward 5, the dedicated stroke unit, where an excellent service was provided” - Gerald, 81, stroke patient at Fairfield General Hospital.

This case study was written Andrea Maxwell (CT lead radiographer) and Michele Mayes (Department Manager) at Fairfield General Hospital, Pennine Acute Hospitals NHS Trust.


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