{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T23:53:31Z","timestamp":1790985211290,"version":"4.1.0"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T00:00:00Z","timestamp":1786060800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T00:00:00Z","timestamp":1786060800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Emerg Radiol"],"DOI":"10.1007\/s10140-026-02528-5","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T05:06:44Z","timestamp":1786079204000},"page":"1017-1028","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["From order to image: reducing CT order to exam start time through targeted quality improvement in the ED"],"prefix":"10.1007","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-6453-9739","authenticated-orcid":false,"given":"Obert","family":"Xu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morgan","family":"Black","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4603-4084","authenticated-orcid":false,"given":"Bryanna","family":"De Lima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith","family":"Cross","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louis","family":"Riccelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheven","family":"Thorson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-3895-9877","authenticated-orcid":false,"given":"Melinda","family":"Hartenstein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0217-6612","authenticated-orcid":false,"given":"Steven","family":"McGaughey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8509-5648","authenticated-orcid":false,"given":"John","family":"Organick-Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Skyler","family":"Kieran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5550-1302","authenticated-orcid":false,"given":"Beech","family":"Burns","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,7]]},"reference":[{"key":"2528_CR1","unstructured":"Emergency Medicine Practice Committee (2016) Emergency department crowding: High-impact solutions. American College of Emergency Physicians. https:\/\/www.acep.org\/siteassets\/sites\/acep\/media\/crowding\/empc_crowding-ip_092016.pdf Accessed 22 May 2026"},{"issue":"9","key":"2528_CR2","doi-asserted-by":"publisher","first-page":"1625","DOI":"10.3390\/healthcare10091625","volume":"10","author":"M Sartini","year":"2022","unstructured":"Sartini M, Carbone A, Demartini A et al (2022) Overcrowding in emergency department: Causes, consequences, and solutions\u2014a narrative review. Healthc (Basel) 10(9):1625. https:\/\/doi.org\/10.3390\/healthcare10091625","journal-title":"Healthc (Basel)"},{"key":"2528_CR3","doi-asserted-by":"publisher","unstructured":"Kelen GD, Wolfe R, D\u2019Onofrio G et al (2021) Emergency department crowding: The canary in the health care system. NEJM Catal 2(5). https:\/\/doi.org\/10.1056\/CAT.21.0217","DOI":"10.1056\/CAT.21.0217"},{"key":"2528_CR4","unstructured":"American College of Emergency Physicians. Policy solutions to emergency department boarding. https:\/\/www.acep.org\/administration\/crowding--boarding. Accessed 22 May 2026"},{"issue":"3","key":"2528_CR5","doi-asserted-by":"publisher","first-page":"189","DOI":"10.15441\/ceem.18.022","volume":"6","author":"P McKenna","year":"2019","unstructured":"McKenna P, Heslin SM, Viccellio P, Mallon WK, Hernandez C, Morley EJ (2019) Emergency department and hospital crowding: Causes, consequences, and cures. Clin Exp Emerg Med 6(3):189\u2013195. https:\/\/doi.org\/10.15441\/ceem.18.022","journal-title":"Clin Exp Emerg Med"},{"issue":"2","key":"2528_CR6","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1007\/s10140-026-02449-3","volume":"33","author":"O Xu","year":"2026","unstructured":"Xu O, Cross K, Riccelli LP et al (2026) Breaking the bottleneck: A quality improvement initiative to reduce overnight CT turnaround times in the emergency department. Emerg Radiol 33(2):291\u2013303. https:\/\/doi.org\/10.1007\/s10140-026-02449-3","journal-title":"Emerg Radiol"},{"key":"2528_CR7","first-page":"897","volume":"2018","author":"R Perotte","year":"2018","unstructured":"Perotte R, Lewin GO, Tambe U et al (2018) Improving emergency department flow: Reducing turnaround time for emergent CT scans. AMIA Annu Symp Proc 2018:897\u2013906","journal-title":"AMIA Annu Symp Proc"},{"issue":"2","key":"2528_CR8","doi-asserted-by":"publisher","first-page":"226","DOI":"10.5811\/westjem.17831","volume":"25","author":"A Dhanik","year":"2024","unstructured":"Dhanik A, Stenson BA, Levenson RB, Antkowiak PS, Sanchez LD, Chiu DT (2024) Root cause analysis of delayed emergency department computed tomography scans. West J Emerg Med 25(2):226\u2013229. https:\/\/doi.org\/10.5811\/westjem.17831","journal-title":"West J Emerg Med"},{"issue":"1","key":"2528_CR9","doi-asserted-by":"publisher","first-page":"75","DOI":"10.3810\/pgm.2010.01.2101","volume":"122","author":"AM Mills","year":"2010","unstructured":"Mills AM, Baumann BM, Chen EH et al (2010) The impact of crowding on the time until abdominal CT interpretation in emergency department patients with acute abdominal pain. Postgrad Med 122(1):75\u201381. https:\/\/doi.org\/10.3810\/pgm.2010.01.2101","journal-title":"Postgrad Med"},{"issue":"5","key":"2528_CR10","doi-asserted-by":"publisher","first-page":"e010815","DOI":"10.1136\/bmjopen-2015-010815","volume":"6","author":"CJ Li","year":"2016","unstructured":"Li CJ, Syue YJ, Lin YR et al (2016) Influence of CT utilization on patient flow in the emergency department: A retrospective 1-year cohort study. BMJ Open 6(5):e010815. https:\/\/doi.org\/10.1136\/bmjopen-2015-010815","journal-title":"BMJ Open"},{"issue":"4","key":"2528_CR11","first-page":"105","volume":"106","author":"A Ryan","year":"2013","unstructured":"Ryan A, Hunter K, Cunningham K et al (2013) Lean thinking, theory of constraints, and identifying bottlenecks in an emergency department. Ir Med J 106(4):105\u2013107","journal-title":"Ir Med J"},{"issue":"3","key":"2528_CR12","doi-asserted-by":"publisher","first-page":"410","DOI":"10.5811\/westjem.2016.12.32457","volume":"18","author":"BA White","year":"2017","unstructured":"White BA, Yun BJ, Lev MH, Raja AS (2017) Applying systems engineering reduces radiology transport cycle times in the emergency department. West J Emerg Med 18(3):410\u2013418. https:\/\/doi.org\/10.5811\/westjem.2016.12.32457","journal-title":"West J Emerg Med"},{"issue":"3","key":"2528_CR13","doi-asserted-by":"publisher","first-page":"E81","DOI":"10.1148\/rg.2021200107","volume":"41","author":"P Rachh","year":"2021","unstructured":"Rachh P, Pendley AM, Duong PT, Hanna TN, Heilbrun ME (2021) Decreasing CT acquisition time in the emergency department through lean management principles. Radiographics 41(3):E81\u2013E89. https:\/\/doi.org\/10.1148\/rg.2021200107","journal-title":"Radiographics"},{"issue":"1","key":"2528_CR14","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1016\/j.jacr.2016.06.032","volume":"14","author":"D Klein","year":"2017","unstructured":"Klein D, Khan V (2017) Utilizing Six Sigma lean strategies to expedite emergency department CT scan throughput in a tertiary care facility. J Am Coll Radiol 14(1):78\u201381. https:\/\/doi.org\/10.1016\/j.jacr.2016.06.032","journal-title":"J Am Coll Radiol"},{"issue":"7","key":"2528_CR15","doi-asserted-by":"publisher","first-page":"796","DOI":"10.1111\/acem.12988","volume":"23","author":"MY Yiadom","year":"2016","unstructured":"Yiadom MY, Scheulen J, McWade CM, Augustine JJ (2016) Implementing data definition consistency for emergency department operations, benchmarking, and research. Acad Emerg Med 23(7):796\u2013802. https:\/\/doi.org\/10.1111\/acem.12988","journal-title":"Acad Emerg Med"},{"key":"2528_CR16","unstructured":"Emergency Department Benchmarking Alliance (2024) A New Normal: 2023 ED Performance Measures Report. Emergency Department Benchmarking Alliance. https:\/\/www.edbenchmarking.org Accessed 30 Aug 2025"},{"issue":"1","key":"2528_CR17","doi-asserted-by":"publisher","first-page":"283","DOI":"10.1186\/s12880-024-01457-4","volume":"24","author":"F Kempter","year":"2024","unstructured":"Kempter F, Heye T, Vosshenrich J, Ceresa B, J\u00e4schke D (2024) Trends in CT examination utilization in the emergency department during and after the COVID-19 pandemic. BMC Med Imaging 24(1):283. https:\/\/doi.org\/10.1186\/s12880-024-01457-4","journal-title":"BMC Med Imaging"},{"issue":"5","key":"2528_CR18","doi-asserted-by":"publisher","first-page":"486","DOI":"10.1016\/j.annemergmed.2013.02.018","volume":"62","author":"CT Berdahl","year":"2013","unstructured":"Berdahl CT, Vermeulen MJ, Larson DB, Schull MJ (2013) Emergency department computed tomography utilization in the United States and Canada. Ann Emerg Med 62(5):486\u2013494e3. https:\/\/doi.org\/10.1016\/j.annemergmed.2013.02.018","journal-title":"Ann Emerg Med"},{"issue":"5","key":"2528_CR19","doi-asserted-by":"publisher","first-page":"835","DOI":"10.5811\/westjem.2017.5.34152","volume":"18","author":"MF Bellolio","year":"2017","unstructured":"Bellolio MF, Heien HC, Sangaralingham LR et al (2017) Increased computed tomography utilization in the emergency department and its association with hospital admission. West J Emerg Med 18(5):835\u2013845. https:\/\/doi.org\/10.5811\/westjem.2017.5.34152","journal-title":"West J Emerg Med"},{"issue":"7","key":"2528_CR20","doi-asserted-by":"publisher","first-page":"205846011986040","DOI":"10.1177\/2058460119860404","volume":"8","author":"G Juliusson","year":"2019","unstructured":"Juliusson G, Thorvaldsdottir B, Kristjansson JM, Hannesson P (2019) Diagnostic imaging trends in the emergency department: An extensive single-center experience. Acta Radiol Open 8(7):2058460119860404. https:\/\/doi.org\/10.1177\/2058460119860404","journal-title":"Acta Radiol Open"},{"issue":"12","key":"2528_CR21","doi-asserted-by":"publisher","first-page":"986","DOI":"10.1136\/bmjqs-2015-004411","volume":"25","author":"G Ogrinc","year":"2016","unstructured":"Ogrinc G, Davies L, Goodman D et al (2016) SQUIRE 2.0 (Standards for QUality Improvement Reporting Excellence): revised publication guidelines from a detailed consensus process. BMJ Qual Saf 25(12):986\u2013992. https:\/\/doi.org\/10.1136\/bmjqs-2015-004411","journal-title":"BMJ Qual Saf"},{"key":"2528_CR22","volume-title":"The improvement guide: a practical approach to enhancing organizational performance","author":"GL Langley","year":"2009","unstructured":"Langley GL, Moen RD, Nolan KM, Nolan TW, Norman CL, Provost LP (2009) The improvement guide: a practical approach to enhancing organizational performance, 2nd edn. Jossey-Bass, San Francisco, CA","edition":"2"},{"key":"2528_CR23","unstructured":"American College of Radiology (2024) ACR Manual on Contrast Media. American College of Radiology. https:\/\/edge.sitecorecloud.io\/americancoldf5f-acrorgf92a-productioncb02-3650\/media\/ACR\/Files\/Clinical\/Contrast-Manual\/ACR-Manual-on-Contrast-Media.pdf Accessed 1 Jun 2026"},{"issue":"1","key":"2528_CR24","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1148\/radiol.1212146","volume":"267","author":"JS McDonald","year":"2013","unstructured":"McDonald JS, McDonald RJ, Comin J et al (2013) Frequency of acute kidney injury following intravenous contrast medium administration: A systematic review and meta-analysis. Radiology 267(1):119\u2013128. https:\/\/doi.org\/10.1148\/radiol.1212146","journal-title":"Radiology"},{"issue":"5","key":"2528_CR25","doi-asserted-by":"publisher","first-page":"1162","DOI":"10.1097\/01.ta.0000194694.71607.0c","volume":"59","author":"LN Tremblay","year":"2005","unstructured":"Tremblay LN, Tien H, Hamilton P et al (2005) Risk and benefit of intravenous contrast in trauma patients with an elevated serum creatinine. J Trauma 59(5):1162\u20131167. https:\/\/doi.org\/10.1097\/01.ta.0000194694.71607.0c","journal-title":"J Trauma"},{"issue":"7","key":"2528_CR26","doi-asserted-by":"publisher","first-page":"2393","DOI":"10.1161\/STROKEAHA.108.546127","volume":"40","author":"A Oleinik","year":"2009","unstructured":"Oleinik A, Romero JM, Schwab K et al (2009) CT angiography for intracerebral hemorrhage does not increase the risk of acute nephropathy. Stroke 40(7):2393\u20132397. https:\/\/doi.org\/10.1161\/STROKEAHA.108.546127","journal-title":"Stroke"},{"key":"2528_CR27","unstructured":"Kidney Disease: Improving Global Outcomes (KDIGO). KDIGO clinical practice guideline for acute kidney injury. Published March 2012. https:\/\/kdigo.org\/wp-content\/uploads\/2016\/10\/KDIGO-2012-AKI-Guideline-English.pdf. Accessed 12 Jun 2026"},{"issue":"7","key":"2528_CR28","doi-asserted-by":"publisher","first-page":"722","DOI":"10.1016\/j.jacr.2025.04.028","volume":"22","author":"HP Patel","year":"2025","unstructured":"Patel HP, Chebaane M, Gerena RG et al (2025) Electronic health record improvements to reduce emergency department CT prescan times at a safety-net hospital. J Am Coll Radiol 22(7):722\u2013728. https:\/\/doi.org\/10.1016\/j.jacr.2025.04.028","journal-title":"J Am Coll Radiol"},{"issue":"3","key":"2528_CR29","doi-asserted-by":"publisher","first-page":"e000969","DOI":"10.1136\/bmjoq-2020-000969","volume":"9","author":"R Bhayana","year":"2020","unstructured":"Bhayana R, Wang CD, Menezes RJ, Bartlett ES, Choi J (2020) Optimising after-hours workflow of computed tomography orders in the emergency department. BMJ Open Qual 9(3):e000969. https:\/\/doi.org\/10.1136\/bmjoq-2020-000969","journal-title":"BMJ Open Qual"}],"container-title":["Emergency Radiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10140-026-02528-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10140-026-02528-5","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10140-026-02528-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T23:02:53Z","timestamp":1790982173000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10140-026-02528-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,7]]},"references-count":29,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,10]]}},"alternative-id":["2528"],"URL":"https:\/\/doi.org\/10.1007\/s10140-026-02528-5","relation":{},"ISSN":["1438-1435"],"issn-type":[{"value":"1438-1435","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,7]]},"assertion":[{"value":"21 June 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 July 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 August 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"None.","order":1,"name":"Ethics","label":"Presentations","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was deemed exempt by the Oregon Health and Science University Institutional Review Board: STUDY00027751.","order":2,"name":"Ethics","label":"IRB","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no potential conflicts of interest.","order":3,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}}]}}