The Trilemma of CT Workflow

Working in a busy CT department requires a tight balancing act, but ultimately there will always be certain areas that need to be “sacrificed” in favour of others. There are three main factors that need to be balanced in order to have a smoothly operating CT department, with time being the overarching constant:

1. Quality - producing high quality images with minimal mistakes

2. Quantity - completing a high number of examinations

3. Patient care - ensuring patient’s needs are met and they are comfortable and safe

In a set time frame, without an increase in resources, it is impossible to favour all three of these factors. This can sometimes be referred to as a trilemma (triangle dilemma).

As we see in the above diagram:

1. If the focus was shifted towards patient care/comfort/safety and quality, then the number of examinations performed would decrease.

2. If the focus was shifted towards quality and quantity, then there would be less time and resources to focus on patient care.

3. Finally, if the focus was shifted towards patient care and quantity, then the quality of work may suffer.
   

Unfortunately there is no percentage or number that dictates what an appropriate balance would be. The CT department workflow needs to respond and adapt to the resources and requirements in each moment, for each patient.

The work needs to flow between all three factors to reach the most practical and desirable outcome for everyone - the patient, staff and department.

So next time you're moving through your worklist, stop and ask yourself if you are striking the balance for everyone. If one factor seems to be regularly favoured over the others, it may be time to review your workflow protocols and resources.