A facility could save from 4 to 8 days per year per scanner by converting to prefilled-syringe use, depending on workloads and scheduling efficiency.

At Florida’s University of Miami Hospital and Clinics, as many as 15,000 outpatient CT studies are performed annually, and about 70% of them involve use of contrast.

Until 3 years ago, administering contrast in those studies entailed a time-consuming preparation process that cost the hospital money it had not planned to spend.

“The main problem was the time required to fill the syringes,” says Orlando Duran, RT, supervisor of the CT division. “We filled syringes at the end of each day to be ready for use the next. But that meant the technologist assigned that task would have to stay on 30, 45, even 60 minutes past the end of her shift.”

Consequently, the department found itself paying considerable sums in overtime compensation. Duran would not divulge the amount, but maintains it was hefty enough to be a growing source of concern among administrators.

The steps of the preparation process before prefilled syringes were several. First, the technologist assigned to fill the syringes needed to procure from inventory the correct number of bottles of contrast and containers of syringes for the volume of CT studies planned for the following day. After collecting those items, she then needed to transport them to the location where the contents of the bottles would be drawn into each syringe. But before filling could take place, the contrast bottle had to be placed in a warmer to elevate the temperature of its contents to the correct degree so as to sufficiently reduce its viscosity and permit drawing.

“The injectors we were using then were not as fancy as the ones we use now, with automatic drawback plungers,” says Duran. “Back then, the technologist would have to hold it, wait for the plunger to go all the way down, load the syringe, bring the plunger back up and then start filling from the bottle.”

The enterprise also took a financial hit in the form of wasted contrast. As each bottle emptied, there would always be a small amount of contrast that could not be taken up in the last draw and had to be thrown out with the depleted container.

“It wasn’t mucha few ccs worth,” says Duran. “But it really added up when you looked at all the bottles we were consuming in the course of even just a month.”

One way the hospital attempted to reduce the amount of labor involved in preparing syringes was to only draw up enough of them to accommodate the exact number of patients on the next day’s schedule. The deficiency of that approach was there would be no ready-made syringes available for add-ons.

“We had to stop what we were doing to draw up the extra syringes as needed,” says Duran.

Not only did this introduce steps into the technologist’s work flow, it also created a ripple effect across the CT division: others whose tasks were dependent on inputs from the syringe-filling technologist could not proceed with their work until he was no longer waylaid; meanwhile staff whose tasks were dependent on inputs from those others immediately affected by the brief sidelining of the preoccupied technologist likewise were temporarily nonproductive. The result was a slowdown in divisional throughput.

These problems vanished when the enterprise began using prefilled syringes instead.

“With the prefilled syringes, the technologist takes them off the shelf and is ready to go,” says Duran. “It saves time, it saves steps. If we work overtime at all now, it’s not because of the filling of syringes.

“There’s really no downside to using prefilled syringes. The staff loves themthese devices are well designed and constructed, they’re not cumbersome to handle, the tubing attaches to the nozzle in a simple fashion, the packaging itself is easy to open.”