Diagnostic imaging waiting times in Nova Scotia

Abstract

Wait times for medical procedures have been increasing for many years. This trend has attracted much media attention, which has helped to focus efforts to reduce these waiting times. The Nova Scotia Department of Health recently began a project to reduce wait times for Diagnostic Imaging (DI) procedures in Nova Scotia. Diagnostic Imaging is the use of medical imaging procedures (e.g. CT Scans, X-Rays, Ultrasounds, etc.) to diagnose, and sometimes treat, diseases and conditions. DI is a critical component of many patients’ medical treatment; yet it is usually a significant source of delay in the treatment process. The delay in procedure varies greatly between the District Health Authorities (DHA). For example, in the Annapolis Valley DHA, the wait time for an Ultrasound can be as low as 14 days, while in the Cumberland DHA it can be as high as 164 days. (Ultrasound, 2007) Each type of procedure, referred to as modality, has a similar variation in wait time throughout Nova Scotia. The Nova Scotia Department of Health has secured funding for a pilot project to help increase timely and appropriate access to DI procedures. The focuses of this paper are the appropriateness and efficiency components of the project. Four specific intervention types have been chosen for implementation in the province’s DI clinics. These interventions are: a reminder system to decrease the number of patients not arriving for their appointment, or arriving ill prepared; a triaging system to determine the appropriate modality for each patient; changes to when and how patient appointments are booked; and a change to the appointment schedule based on machine cycle and preparation times. To assist in achieving the goals of these project components, and to ensure that the most effective interventions are performed at each clinic, a decision support tool is being created. This tool will allow decision makers to determine the most effective intervention(s) before it(they) are implemented.