Same Day Access Program
The Same Day Access Program was launched in order to reduce emergency department referrals for medical imaging from primary care providers. (L to R): Sonographers from the Joint Department of Medical Imaging (JDMI), Rose Zhao, Rishma Jiwa, Run Zheng, Seving Huseynova, Olena Matviychuk, along with Dr. Jeff Bloom, Family Physician-in-Chief, TWH, and Kathy Hilario, TWH Clinical Manager, JDMI. (Photo: UHN)

Little did Paula know when she arrived at an appointment with her family physician last fall that before the day was over, she would undergo a key test in her diagnosis of cancer.

The then 45-year-old, who prefers to go by only her first name, booked an appointment with the Family Health Team at Toronto Western Hospital (TWH) after a mass had appeared on the side of her face. Upon examination, family physician, Dr. Sarah Reid decided that while the mass didn't appear to be an emergency case, it was significant enough to warrant a closer look with an ultrasound.

Deeming Paula a prime candidate for TWH's Same Day Access Program, Dr. Reid bypassed the typical ultrasound scheduling, which could take up to six weeks, and asked if Paula would be willing to wait at the hospital to have her ultrasound that same day.

"It was a very quick thing," Paula recalls, "and Dr. Reid called me that same day at 5:30 in the evening to tell me what they had seen."

New program reduces wait time for imaging services

In alignment with a primary care strategy from Toronto Central Local Health Integration Network and the Ontario Ministry of Health and Long-Term Care, the Same Day Access Program at TWH was launched in April 2016, and is the result of a collaboration between the Joint Department of Medical Imaging (JDMI) and the Family Health Team at TWH.

"We wanted to expand an existing same day access program we piloted at Women's College Hospital in an effort to reduce emergency department (ED) referrals from primary care providers," says Paul Cornacchione, Senior Director of Imaging Operations, JDMI.

"In many cases like Paula's, primary care physicians must choose to either send their patient to (ED), or book a non-urgent scan, but with the same day access program we provide a third option."

After an evaluation to ensure the program could be supported, Paul, along with Dr. Jeff Bloom, Family Physician-in-Chief, TWH, and Kathy Hilario, TWH Clinical Manager, JDMI, put the program into action.

Currently, the service is exclusive to Family Health patients at TWH, and after a year of operation, statistics show that 87 per cent of same day referrals were completed, with the majority of those unable to be completed being done the following day.

The program operates Monday to Friday from 8 a.m. to 4 p.m. and includes same day access to CT and ultrasound scans, with the exception of musculoskeletal ultrasound procedures such as shoulders and knees and vascular studies.

Immediate results lead to further testing and unexpected news

Paula's ultrasound suggested the mass on her face was a benign cyst. However, due to some suspicious particles inside the mass and further testing from a UHN Ear, Nose and Throat Specialist, the decision was made to have the mass removed. 

On December 23, 2016, Paula went into surgery and in January she received the call – it had been a low grade tumour.

Paula was referred to an oncologist at the Princess Margaret Cancer Centre who informed her that there was a 20 per cent to 40 per cent chance of the cancer returning and thus recommended radiation therapy. 

Six-and-a-half weeks and 33 treatments of radiation later, Paula was able to return to full-time work as a respiratory therapist.

Same Day Access means putting patient needs first

Despite the journey leading to her cancer diagnosis, Paula is thankful for the ultrasound that was offered to her within hours of her first appointment.

"Even though it didn't give us all the information, it certainly got things moving," she says.

Though not every patient's case is as serious as Paula's, the convenience of the Same Day Access Program means that patients are able to receive the right test at the right time and don't have to spend weeks anxiously awaiting their scan.

"In particular, this program is really focused on patient convenience," Dr. Bloom says, "being patient-centered and enhancing the patient experience." ​

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