#233 The effect of a private out-of-hours radiology service on patients time spend in the emergency department

<h3>Introduction</h3> The Emergency Department (ED) provides a 24-hour service. However, timely access to radiology, particulary CT scanning, can be a challenge in some departments, especially out of hours. The Emergency Medicine Program (EMP) recommends that a CT scanner should be available to the ED 24 hours a day, specifically for CT in head injury/stroke (CTB), pulmonary embolus (CTPA), major trauma (CT-T) and abdominal pain (CTAP or CT-aorta).¹ Availability of emergency CT for acute limb ischaemia is also advised.²In late 2022, Midland Regional Hospital Tullamore (MRHT) contracted a private out-of-hours radiology service for emergency CT imaging. We hypothesise that this shortens patient experience time (PET) and time to decision to discharge or refer (TtDecision). <h3>Methods</h3> We retrospectively reviewed all patients that had a CTB, CTPA, CT-T, CTAP, CT-aorta or CT angiogram (CT-A) requested by the Emergency Medicine (EM) team between 8pm to 8am in April 2022 and April 2023. Data was collected and analysed in SPSS 28.0, using descriptive analysis and the unpaired 2 sample t-test. <h3>Results</h3> April 2022: 45 CTs were requested by EM vs 84 in 2023, 33 and 80 were included respectively. The average age was 54 in 2022, vs 57 in 2023, p.0189. 2022, 63.3% were male, compared to 55% in 2023. The majority of patients were catergory 2 or 3 in both years and 78.8% and 75% had a CTB as initial CT. No significant differences were found. The mean PET for 2022 and 2023 were, respectively 16 hours and 7 minutes (SD 7hr42min) and 8hr51min (SD 4hr2min), p&lt;0.01 as per Levene’s test. The mean TtDecision is 11hr32minutes (SD 7hr16min) in 2022 and 6hr20minutes (SD 3hr31min) in 2023, p &lt;0.01. <h3>Conclusion</h3> The introduction of a private out-of-hours CT service resulted in significant improvement in PET and time to decision in MRHT ED.