Additions that CountHow adding advanced knee coils can improve workflows significantly 

MRI knee imaging at the William Osler Health System, Canada

January, 9 2013 | If buying a new magnetic resonance system is out of the question, adding advanced knee coils can improve workflows significantly. By purchasing two 15-channel knee coils, William Osler Health System in Ontario, Canada, increased patient throughput by a third.


Text: Martin Suter
Fotos: Lana Slezic

Joe-Anne McCue, Administrative Director of Diagnostic Imaging
Joe-Anne McCue, Administrative Director of Diagnostic Imaging

Even hospital administrators can sometimes become philosophical. “There are good times, and there are bad times– this is not a good time,” muses Joe-Anne McCue, Administrative Director of Diagnostic Imaging at William Osler Health System, on the financial condition of public healthcare in Canada. “Healthcare is experiencing challenging times,” McCue says.

Easing the Bottlenecks
Still, dire circumstances foster creativity. With the medical chief of diagnostic imaging as a partner, McCue was able to find a cost-effective way to ease the bottlenecks in magnetic resonance imaging (MRI) at William Osler. The imaging team purchased two advanced TX/RX 15-channel knee coils from Siemens for their MAGNETOM® Avanto 1.5T MRI systems, which are used in two of the system’s three hospitals. Faster and better imaging results along with workflow acceleration have been eye-openers, according to McCue. Exam times per patient have shrunk by a third with the use of these knee coils. In a system where the government funds a fixed number of hours of MR imaging, this gives the hospital welcomed flexibility: “We’ve been able to eliminate one full eight-hour shift at each hospital and maintain volumes,” she says.

Imaging at William Osler Health System, Canada
The new knee coil increased patient throughput by a third.

A Variety of Healthcare Services in Canada
William Osler Health System services a diverse and fast-growing community outside Toronto. Its two main hospitals, Brampton Civic and Etobicoke General, provide about 1,000 inpatient beds and perform 450,000-plus diagnostic imaging exams annually. William Osler’s third site – the Peel Memorial Urgent Care Facility – due to open in late 2016 will provide computed tomography (CT), X-ray, ultrasound, bone density scans, and mammography, while the two larger hospitals run the whole gamut, including nuclear medicine and MRI.

Versatile MRI Solutions
At Brampton Civic, an expansive, modern-looking facility, the importance of diagnostic imaging is reflected in the fact that its offices are not located in a basement, but are easily accessible on the ground floor close to the main entrance. The hospital operates three Siemens 1.5-tesla MRI systems, two MAGNETOM Avanto purchased in 2007, and one MAGNETOM Espree 1.5T scanner with a 70-centimeter Open Bore purchased in 2009, whose dimensions are easier on claustrophobic patients.
Between exams, the MRI room is quiet except for the rhythmic whooshing of a compressor. Once a patient has been positioned in the MAGNETOM Avanto, the powerful gradient coil inside the superconducting magnet start emitting their loud clicking noise. Even though their ears are protected by headphones, MRI patients appreciate shorter exam times.


Improved MRI Image Quality at William Osler Health System in Ontario, Canada

Love Is in the Air
In the adjacent control room, technician Norman Toy is excited about the new 15-channel knee coil. “I love this coil,” he exclaims. “It’s faster, and the images are so beautiful.” Supervising the MRI procedure through a glass window, Toy shows knee images acquired by the knee coil on a flat-screen computer monitor. “They are crisp black and white, there’s no noise around the edge.”
The knee coil is a soft-edged white cylinder comprising two halves that fit snugly around the knee. Compared to the old single-channel coil, it is smaller and lighter, says Toy. “For us, it’s easier to carry around.”

Time Needed for Knee Imaging Reduced by Half
Diagnostic radiologist Joshua Mamelak, MD, a radiologist from the Etobicoke hospital is also full of praise for the new accessory. “The image quality is excellent. We are able to make the same diagnoses and get the patients through much quicker,” he says. The powerful knee coil can enable image acquisition in 15 minutes, which used to take 30 minutes with the single-channel knee coil. “Multichannel coils image portions of a structure rather than the whole structure, and put it together later via computer,” Mamelak explains. In addition, shorter exam times improve images because after a while all patients start to move. From experience, the doctor knows: “The shorter the time they are in there, the better the images.” This is often due to less patient movement.

Brampton Civic Hospital in Ontario, Canada
Brampton Civic Hospital

What’s in it for the Patients and the Hospital
For administrator Joe-Anne McCue, buying the two multichannel coils “was absolutely worth it.” A performance improvement plan had already reduced average wait times for non-urgent MRI exams at William Osler Health System from 131 to 31 days, she says. The new equipment provides an option to shorten the waiting list even further.
In Canada, all diagnostic imaging investments have to be approved by the government in Ottawa. Purchasing entire new MRI systems is currently out of the question. “Hospitals have to find a way to get around that, and so upgrade options from the vendor is helpful,” McCue says. For her planning, she appreciates the utilization report Siemens provides every month. “It gives us all kinds of information, what body parts we do most, how many we do in an hour. We can look at our productivity and improve our workflow.”

A Sound Investment in MRI
Both William Osler sites have a heavy orthopedic workflow, and upgrading the knee coil would have the greatest effect and made the most sense. In the fall of 2012, the Etobicoke radiology team received their 15-channel coil. Once they saw how well it worked, the other hospital saw the benefits of having one, as well. Brampton Civic received its 15-channel coil in May 2013.
In all, McCue is very satisfied with the efficiency gains made possible with the knee coil purchase. “This is a good coil,” she says. “It was a sound investment.”