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Ho E, Tran J, Fateri C, Sahagian C, Sarton K, Glavis-Bloom J, Houshyar R. Work-related musculoskeletal disorders affecting diagnostic radiologists and prophylactic physical therapy regimen. Curr Probl Diagn Radiol 2024; 53:527-532. [PMID: 38514284 DOI: 10.1067/j.cpradiol.2024.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 03/07/2024] [Indexed: 03/23/2024]
Abstract
The shift from film to PACS in reading rooms, coupled with escalating case volumes, exposes radiologists to the issues of the modern computer workstation including computer work posture and work-related musculoskeletal disorders (WMSD). Common WMSDs affecting the neck and upper extremities include cervical myofascial pain, shoulder tendonitis, lateral epicondylitis, carpal tunnel syndrome, and cubital tunnel syndrome. This review examines each pathology along with its pathogenesis, clinical features, physical exam findings, and potential risk factors. Furthermore, a comprehensive 11-part physical therapy regimen that is both prophylactic and therapeutic is illustrated and described in detail. One of the objectives of this review is to advocate for the inclusion of a physical therapy regimen in the working routine of diagnostic radiologists to prevent WMSDs. A brief daily commitment to this regimen can help radiologists remain healthy and productive in order to deliver optimal patient care throughout their careers.
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Affiliation(s)
- Erwin Ho
- University of California, Irvine School of Medicine, Irvine, CA, USA.
| | - Julia Tran
- University of California, Irvine School of Medicine, Irvine, CA, USA
| | - Cameron Fateri
- Department of Radiological Sciences, University of California, Irvine Medical Center, Orange, CA, USA; University of California, Irvine School of Medicine, Irvine, CA, USA
| | | | - Kyle Sarton
- Department of Physical Therapy, University of California, Irvine Medical Center, Orange, CA, USA
| | | | - Roozbeh Houshyar
- University of California, Irvine School of Medicine, Irvine, CA, USA
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Elahi A, Fennell N, Watson L. Certified Imaging Informatics Professionals (CIIP) Demonstrate Value to the Healthcare Industry and Focus on Quality Through the ABII 10-Year Requirements Practice Option. JOURNAL OF IMAGING INFORMATICS IN MEDICINE 2024; 37:909-914. [PMID: 38343211 PMCID: PMC11031500 DOI: 10.1007/s10278-023-00961-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 10/17/2023] [Accepted: 11/02/2023] [Indexed: 04/20/2024]
Abstract
Strengthening the field of imaging informatics by further defining standards and advocating for continuous education are the cornerstones of the American Board of Imaging Informatics (ABII). ABII is the non-profit organization that governs the Imaging Informatics Professional certification program. ABII is responsible for awarding the Certified Imaging Informatics Professional (CIIP) designation to candidates who meet specified educational and experience-based criteria and pass a qualifying exam (1). For this paper, we analyzed Quality Improvement (QI) projects submitted to ABII for satisfaction of the 10-year requirements in 2017-2021. The project reports demonstrated a variety of interventions undertaken to ultimately improve patient care. A retrospective review of these reports exemplifies the critical role the Certified Imaging Informatics Professionals have in delivery of high quality, safe healthcare and their vital contributions to the healthcare industry and practice of medicine.
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Affiliation(s)
- Ameena Elahi
- Department of Information Services, Penn Medicine, Philadelphia, PA, 19104, USA.
| | - Nikki Fennell
- Technology and Digital Solutions, Stanford Health Care, Stanford, CA, 94303, USA
| | - Liana Watson
- The American Registry of Radiologic Technologist, Saint Paul, MN, 55120, USA
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Sharpe RE, Huffman RI, McLaughlin CG, Blubaugh P, Strobel MJ, Palen T. Applying Implementation Science Principles to Systematize High-Quality Care for Potentially Significant Imaging Findings. J Am Coll Radiol 2023; 20:324-334. [PMID: 36922106 DOI: 10.1016/j.jacr.2022.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 10/29/2022] [Accepted: 11/16/2022] [Indexed: 03/14/2023]
Abstract
OBJECTIVE Use principles of implementation science to improve the diagnosis and management of potentially significant imaging findings. METHODS Multidisciplinary stakeholders codified the diagnosis and management of potentially significant imaging findings in eight organs and created a finding tracking management system that was embedded in radiologist workflows and IT systems. Radiologists were trained to use this system. An automated finding tracking management system was created to support consistent high-quality care through care pathway visualizations, increased awareness of specific findings in the electronic medical record, templated notifications, and creation of an electronic safety net. Primary outcome was the rate of quality reviews related to eight targeted imaging findings. Secondary outcome was radiologist use of the finding tracking management tool. RESULTS In the 4 years after implementation, the tool was used to track findings in 7,843 patients who received 10,015 ultrasound, CT, MRI, x-ray, and nuclear medicine examinations that were interpreted by all 34 radiologists. Use of the tool lead to a decrease in related quality reviews (from 8.0% to 0.0%, P < .007). Use of the system increased from 1.7% of examinations in the early implementation phase to 3.1% (+82%, P < .00001) in the postimplementation phase. Each radiologist used the tool on an average of 294.6 unique examinations (SD 404.8). Overall, radiologists currently use the tool approximately 4,000 times per year. DISCUSSION Radiologists frequently used a finding tracking management system to ensure effective communication and raise awareness of the importance of recommended future follow-up studies. Use of this system was associated with a decrease in the rate of quality review requests in this domain.
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Affiliation(s)
- Richard E Sharpe
- Division Chair of Breast Imaging and Radiologist, Mayo Clinic, Phoenix, Arizona; Member, ACR Peer Learning Committee; Member, ACR Appropriateness Panel for Breast Imaging; and Member, ACR Commission on Screening & Emerging Technology Committee.
| | - Ryan I Huffman
- Radiologist, Scripps Clinic Medical Group, La Jolla, California
| | - Christopher G McLaughlin
- Radiologist, Department Technical Lead, Radiology, Colorado Permanente Medical Group, Denver, Colorado
| | | | - Mary Jo Strobel
- Director, Clinical Quality Oversight, Quality, Risk, and Patient Safety, Kaiser Permanente Colorado, Denver, Colorado
| | - Ted Palen
- Internal Medicine Physician and Scientific Investigator, Colorado Permanente Medical Group, Denver, Colorado
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Camilleri S, Swainston K, MacGregor F. A qualitative exploration of the experiences of post-mortem forensic imaging in Malta: A psychological perspective. Radiography (Lond) 2023; 29:84-89. [PMID: 36327519 DOI: 10.1016/j.radi.2022.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/02/2022] [Accepted: 10/12/2022] [Indexed: 11/13/2022]
Abstract
INTRODUCTION This study aimed to qualitatively explore the experiences of post-mortem forensic imaging on theatre and trauma radiographers from a psychological perspective at a general hospital in Malta. METHODOLOGY The study utilised purposive sampling to recruit five radiographers undertaking forensic post-mortem imaging in a general hospital in Malta. Individual face-to-face semi-structured interviews were held. Interpretative phenomenological principles and reflexivity were applied throughout the transcription and analysis phases. RESULTS Four themes were developed from the interpretive phenomenological analysis of semi-structured interviews: 'The impact of the imaging process,' 'Psychological distancing,' 'Finding meaning in work,' and 'Resource needs,' the latter comprising three subordinate themes: 'Protocols,' 'Physical resources,' and 'Psychological training.' CONCLUSION Forensic radiography is a rewarding area of practice yet one that can be complex and have a lasting psychological impact. Many factors including working close to the cadaver, a lack of appropriate training and staffing levels and a lack of evidence-based protocols were identified by participants as contributing to potential psychological stress and emotional distress. IMPLICATIONS FOR PRACTICE Exploration and evaluation of the psychological experiences of radiographers undertaking post-mortem imaging will inform the development of appropriate psychological services and reinforce the need for the appropriate application of best practice guidelines and protocols to support radiographers working on traumatic cases within forensic and general radiographic practice.
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Affiliation(s)
- S Camilleri
- Senior Radiographer, Mater Dei Hospital, Triq Dun Karm, L-Imsida, MSD 2090, Malta
| | - K Swainston
- Senior Lecturer in Psychology, School of Psychology, Newcastle University, Newcastle NE2 4DR, UK
| | - F MacGregor
- Principal Lecturer, School of Health and Life Sciences, Teesside University, Middlesbrough, TS1 3BX, UK.
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Gavahi SS, Hosseini SMH, Moheimani A. An application of quality function deployment and SERVQUAL approaches to enhance the service quality in radiology centres. BENCHMARKING-AN INTERNATIONAL JOURNAL 2022. [DOI: 10.1108/bij-07-2021-0411] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeMeeting the patients' requirements as customers of the health care sector is crucially important as a social responsibility. According to the resource constraints, only an efficient utilisation of health services can provide that purpose. This study aims to develop a quantitative assessment framework for radiology centres as a vital section in healthcare to translate the patients' requirements into service quality specifications. This would help to achieve quality improvement by emphasising the voice of customers.Design/methodology/approachA literature review is conducted to specify the service quality criteria and the patients' requirements related to healthcare and hospitals. Based on the experts' opinions, these criteria and requirements are later customised for the radiology centres. Moreover, the requirements are categorised into five dimensions of SERVQUAL. The interrelations between service elements are also determined through expert group consensus using Pearson correlation. Afterwards, by applying the QFD method, the relations between the requirements and criteria are explored. Additionally, a customer satisfaction survey is executed in Tehran public hospitals to prioritise these requirements and provide an importance-satisfaction analysis.FindingsBased on the result of the case study, service elements are prioritised for improvement, and practical suggestions are provided using the Delphi technique for quality improvement. In addition, a cause-and-effect diagram is presented to highlight the improvement area and provide enhancement suggestions.Originality/valueThis study is the first empirical attempt to benefit from the VOC in evaluating and enhancing the quality of service delivered to radiology patients. In doing so, the study applies a hybrid approach of QFD and SERVQUAL as well as other tools to highlight the improvement area and provide enhancement suggestions. The findings can be readily used by the practitioners.
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Marin-Garcia JA, Vidal-Carreras PI, Garcia-Sabater JJ. The Role of Value Stream Mapping in Healthcare Services: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18030951. [PMID: 33499116 PMCID: PMC7908358 DOI: 10.3390/ijerph18030951] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 01/04/2021] [Accepted: 01/15/2021] [Indexed: 12/16/2022]
Abstract
Lean healthcare aims to manage and improve the processes in the healthcare sector by eliminating everything that adds no value by improving quality of services, ensuring patient safety and facilitating health professionals’ work to achieve a flexible and reliable organization. Value Stream Mapping (VSM) is considered the starting point of any lean implementation. Some papers report applications of VSM in healthcare services, but there has been less attention paid to their contribution on sustainability indicators. The purpose of this work is to analyze the role of VSM in this context. To do so, a scoping review of works from recent years (2015 to 2019) was done. The results show that most applications of VSM reported are in the tertiary level of care, and the United States of America (USA) is the country which leads most of the applications published. In relation with the development of VSM, a heterogeneity in the maps and the sustainability indicators is remarkable. Moreover, only operational and social sustainability indicators are commonly included. We can conclude that more standardization is required in the development of the VSM in the healthcare sector, also including the environmental indicators.
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Bhatia N, Trivedi H, Safdar N, Heilbrun ME. Artificial Intelligence in Quality Improvement: Reviewing Uses of Artificial Intelligence in Noninterpretative Processes from Clinical Decision Support to Education and Feedback. J Am Coll Radiol 2020; 17:1382-1387. [DOI: 10.1016/j.jacr.2020.08.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 08/07/2020] [Indexed: 02/07/2023]
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Towbin AJ, O'Connor T, Perry LA, Moskovitz JA, Miñano GG, Regan J, Hulefeld D, Schwieterman E, Hater D, Smith RL. Using informatics to engage patients. Pediatr Radiol 2020; 50:1514-1524. [PMID: 32935243 DOI: 10.1007/s00247-020-04767-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 05/27/2020] [Accepted: 07/01/2020] [Indexed: 02/04/2023]
Abstract
As a specialty, radiology has spent much of the last two decades implementing information systems that improve departmental efficiency and the ordering provider's access to information. While our patients have realized benefits such as improved access to care and reduced turnaround times, there has been little focus on using these information systems to improve patient engagement. In the last decade, society has shifted. Now, consumers in every industry expect to be able to use technology to help them accomplish different tasks from scheduling to communicating. Medicine, in general, has been slow to respond to the concept of the patient as a consumer. In this manuscript we describe some of the informatics efforts we have employed in our department to improve patient engagement. We present these initiatives, corresponding to each aspect of the radiology value stream, from the patient's point of view.
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Affiliation(s)
- Alexander J Towbin
- Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., MLC 5031, Cincinnati, OH, 45229, USA. .,Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
| | - Timothy O'Connor
- Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., MLC 5031, Cincinnati, OH, 45229, USA
| | - Laurie A Perry
- Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., MLC 5031, Cincinnati, OH, 45229, USA
| | - Jay A Moskovitz
- Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., MLC 5031, Cincinnati, OH, 45229, USA
| | - Glenn G Miñano
- Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., MLC 5031, Cincinnati, OH, 45229, USA
| | - Jennifer Regan
- Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., MLC 5031, Cincinnati, OH, 45229, USA
| | - David Hulefeld
- Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., MLC 5031, Cincinnati, OH, 45229, USA
| | - Eric Schwieterman
- Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., MLC 5031, Cincinnati, OH, 45229, USA
| | - Dianne Hater
- Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., MLC 5031, Cincinnati, OH, 45229, USA
| | - Rachel L Smith
- Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., MLC 5031, Cincinnati, OH, 45229, USA
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Al Gadeeb M, Hassan A, Al Dandan O, Al Shammari M, Kalalah M, Zabeeri N, Farea A, Gari D, Alsaif HS. Physical exercise among radiologists in Saudi Arabia: a cross-sectional study. ACTA ACUST UNITED AC 2020; 78:73. [PMID: 32793346 PMCID: PMC7418417 DOI: 10.1186/s13690-020-00450-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 07/17/2020] [Indexed: 11/10/2022]
Abstract
Background The practice of clinical radiology has become more sedentary in the era of the Picture Archiving and Communication System. Physical inactivity is a well-known risk factor for various chronic diseases. This study aimed to determine the frequency and pattern of physical exercises among radiologists in the Eastern Province of Saudi Arabia and the association between physical exercises and the prevalence of work-related musculoskeletal symptoms. Methods An online survey was sent to radiologists in all hospitals (academic, public, and private) in the major cities of the Eastern Province of Saudi Arabia. It covered information about demographic characteristics and the frequency and pattern of physical exercises. It also included an evaluation of work-related musculoskeletal symptoms using the Nordic Musculoskeletal Questionnaire. This survey of 263 radiologists was conducted in April 2019. The study outcome was the presence of disabling musculoskeletal symptoms in any body region which restricted the performance of normal activities within the last 12 months. The study results were analyzed descriptively using the Chi-square test. Results The survey was completed by 198 participants (111 men and 87 women) with a response rate of 75.3%. Most participants (71.2%) were less than 40 years. Eighty-three men (74.8%) did a physical exercise at least weekly, compared to 45 (51.7%) women. Men were more likely to engage in various physical exercises than women. Overall, 60.9% of participants who did not do any physical exercise regularly (less than monthly) reported having disabling neck pain. This figure was found lower among participants who did physical exercises monthly (45.8%) or at least weekly (32.8%). A similar pattern was observed with shoulder pain, with 45.7% found in participants who did not exercise and only 25.8% in those engaging in physical activities at least weekly. Conclusions Physical inactivity is common among radiologists, especially female ones, in the Eastern Province of Saudi Arabia. The physical inactivity was significantly associated with work-related musculoskeletal symptoms. Gender-specific health promotion programs are needed to mitigate the negative health outcomes due to the sedentary nature of the radiology current practice.
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Affiliation(s)
- Mohammed Al Gadeeb
- Department of Radiology, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Al-Khobar, Saudi Arabia
| | - Ali Hassan
- Department of Radiology, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Al-Khobar, Saudi Arabia
| | - Omran Al Dandan
- Department of Radiology, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Al-Khobar, Saudi Arabia
| | - Malak Al Shammari
- Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Mawaheb Kalalah
- Department of Radiology, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Al-Khobar, Saudi Arabia
| | - Najwa Zabeeri
- Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Abdulaziz Farea
- Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Danya Gari
- Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Hind S Alsaif
- Department of Radiology, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Al-Khobar, Saudi Arabia
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Using Quality Improvement Methodology to Reduce Costs while Improving Efficiency and Provider Satisfaction in a Busy, Academic Musculoskeletal Radiology Division. J Med Syst 2020; 44:104. [PMID: 32318828 DOI: 10.1007/s10916-020-01569-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 03/31/2020] [Indexed: 10/24/2022]
Abstract
Within an everchanging healthcare system, continuous evaluation of standard operating procedures must be performed to ensure optimization of system level organization, communication, and efficiency. Using the Lean management approach, our institution introduced modifications to our musculoskeletal (MSK) radiology workflow in order to facilitate beneficial change that improved clinical workflow efficiency, reduced moonlighting costs, and improved radiologist satisfaction without sacrificing quality of care. The scope of our study included the MSK division of adult inpatient and outpatient populations at three hospitals in a single academic medical center. A root cause analysis was executed to determine the causative factors contributing to clinical inefficiency. Five main factors were identified, and appropriate countermeasures were introduced. Efficiency was measured via the turnaround time (TAT) for radiographic examinations, measured from exam completion to final report submission. Moonlighting expenses were monitored for the fiscal year in which the modifications were implemented. Surveys were administered to MSK radiologists before and after the countermeasures were introduced to determine subjective ratings of efficiency and satisfaction. The average TAT within our MSK division decreased from 40 h to 12 h after introducing changes to our workflow. During one fiscal year, moonlighting expenses decreased from $26,000 to $5000. Post-study survey results indicated increased efficiency of and satisfaction with our implemented modifications to the scheduling and clinical workflow. Optimization of our radiology department's workflow led to increased productivity, efficiency, and radiologist satisfaction, as well as a reduction in moonlighting costs. This project leveraged Lean management principles to combat clinical inefficiency, waste time, and high costs.
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Cochon L, Lacson R, Wang A, Kapoor N, Ip IK, Desai S, Kachalia A, Dennerlein J, Benneyan J, Khorasani R. Assessing information sources to elucidate diagnostic process errors in radiologic imaging - a human factors framework. J Am Med Inform Assoc 2019; 25:1507-1515. [PMID: 30124890 DOI: 10.1093/jamia/ocy103] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 07/10/2018] [Indexed: 01/01/2023] Open
Abstract
Objective To assess information sources that may elucidate errors related to radiologic diagnostic imaging, quantify the incidence of potential safety events from each source, and quantify the number of steps involved from diagnostic imaging chain and socio-technical factors. Materials and Methods This retrospective, Institutional Review Board-approved study was conducted at the ambulatory healthcare facilities associated with a large academic hospital. Five information sources were evaluated: an electronic safety reporting system (ESRS), alert notification for critical result (ANCR) system, picture archive and communication system (PACS)-based quality assurance (QA) tool, imaging peer-review system, and an imaging computerized physician order entry (CPOE) and scheduling system. Data from these sources (January-December 2015 for ESRS, ANCR, QA tool, and the peer-review system; January-October 2016 for the imaging ordering system) were collected to quantify the incidence of potential safety events. Reviewers classified events by the step(s) in the diagnostic process they could elucidate, and their socio-technical factors contributors per the Systems Engineering Initiative for Patient Safety (SEIPS) framework. Results Potential safety events ranged from 0.5% to 62.1% of events collected from each source. Each of the information sources contributed to elucidating diagnostic process errors in various steps of the diagnostic imaging chain and contributing socio-technical factors, primarily Person, Tasks, and Tools and Technology. Discussion Various information sources can differentially inform understanding diagnostic process errors related to radiologic diagnostic imaging. Conclusion Information sources elucidate errors in various steps within the diagnostic imaging workflow and can provide insight into socio-technical factors that impact patient safety in the diagnostic process.
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Affiliation(s)
- Laila Cochon
- Center for Evidence-Based Imaging, Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Ronilda Lacson
- Center for Evidence-Based Imaging, Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Aijia Wang
- Center for Evidence-Based Imaging, Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Neena Kapoor
- Center for Evidence-Based Imaging, Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Ivan K Ip
- Center for Evidence-Based Imaging, Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Sonali Desai
- Harvard Medical School, Boston, Massachusetts, USA.,Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Allen Kachalia
- Harvard Medical School, Boston, Massachusetts, USA.,Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Jack Dennerlein
- Center for Work, Health, and Wellbeing, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - James Benneyan
- Healthcare Systems Engineering Institute, Northeastern University, Boston, Massachusetts, USA
| | - Ramin Khorasani
- Center for Evidence-Based Imaging, Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
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Al Shammari M, Hassan A, Al Dandan O, Al Gadeeb M, Bubshait D. Musculoskeletal symptoms among radiologists in Saudi Arabia: a multi-center cross-sectional study. BMC Musculoskelet Disord 2019; 20:541. [PMID: 31727049 PMCID: PMC6857232 DOI: 10.1186/s12891-019-2933-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 11/01/2019] [Indexed: 02/08/2023] Open
Abstract
Background Musculoskeletal symptoms account for the majority of work-related illnesses resulting in a significant economic burden on society. Computer users are subject to unique repetitive strains that predispose them to musculoskeletal symptoms. In the digitalized field of radiology, radiologists spend long hours interpreting medical images on computers. This study aimed to determine the prevalence of musculoskeletal symptoms among radiologists in Saudi Arabia and their contributing factors. Methods An online survey was sent to radiologists in all hospitals (academic, public and private) in the major cities of the Eastern Province of Saudi Arabia covering demographic characteristics, workload (e.g. the time spent at a computer workstation), and workstation environments including the number of monitors as well as the adjustability of the height of the workstation and the viewing distance. This survey of 263 radiologists was conducted in April 2019. It included an evaluation of musculoskeletal symptoms using the Nordic Musculoskeletal Questionnaire. The study outcome was the presence of disabling musculoskeletal symptoms in any body region, which restricted the performance of normal activities in the last 12 months. Results were analyzed descriptively using a Chi-square test and logistic regression analysis to estimate the odd ratio of experiencing disabling musculoskeletal symptoms in the last 12 months. Results The survey was completed by 198 participants (111 men and 87 women) with a response rate of 75.3%. Most participants (71.2%) were aged below 40 years. A multivariate logistic regression analysis revealed being a female radiologist (OR = 2.7; 95% CI: 1.2–6.5), aged 30–39 years (OR = 4.1; 95% CI: 1.1–15.3), and predominantly reviewing computed tomography (CT) images (OR = 4.1; 95% CI: 1.4–12.3) or ultrasound scans (OR = 5.9; 95% CI: 1.4–25.3) were associated with higher prevalence of disabling musculoskeletal symptoms, compared to those aged below 30 years and those who reviewed various imaging modalities, respectively. Conclusions Musculoskeletal symptoms are common among radiologists with lower back and neck pain being the most frequent complaints. Being a female radiologist, aged 30–39 years, and reviewing CT or ultrasound scans were associated with higher rates of disabling musculoskeletal symptoms.
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Affiliation(s)
- Malak Al Shammari
- Department of Family and Community Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Ali Hassan
- Department of Radiology, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Al-Khobar, Saudi Arabia
| | - Omran Al Dandan
- Department of Radiology, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Al-Khobar, Saudi Arabia.
| | - Mohammed Al Gadeeb
- Department of Radiology, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Al-Khobar, Saudi Arabia
| | - Dalal Bubshait
- Department of Orthopedic Surgery, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Al-Khobar, Saudi Arabia
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Makeeva V, Gichoya J, Hawkins CM, Towbin AJ, Heilbrun M, Prater A. The Application of Machine Learning to Quality Improvement Through the Lens of the Radiology Value Network. J Am Coll Radiol 2019; 16:1254-1258. [DOI: 10.1016/j.jacr.2019.05.039] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 05/22/2019] [Indexed: 12/18/2022]
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Effect of Analytics-Driven Worklists on Musculoskeletal MRI Interpretation Times in an Academic Setting. AJR Am J Roentgenol 2019; 212:1091-1095. [PMID: 30807228 DOI: 10.2214/ajr.18.20434] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE. The objective of this study was to determine how use of analytics-driven worklists for MRI based on relative individual interpretation time affects the overall group interpretation time in an academic musculoskeletal practice. SUBJECTS AND METHODS. In this prospective study, interpretation times for all MRI studies signed by three musculoskeletal fellowship-trained radiologists during 2016 were calculated from initial study view and report signing times. Custom worklists were made for each radiologist with body parts ordered from the fastest to the slowest based on relative interpretation time. These worklists were then used for a trial period of 7 consecutive days. The difference in mean interpretation times between the trial period and baseline and the differences in volume distribution were calculated. Changes in individual interpretation time were assessed by z-score with statistical significance set at ≤ 0.05. RESULTS. Across all readers, total interpretation time decreased by a mean of 29.5 minutes per day during the trial period. Only two types of studies were read with an individual interpretation time significantly different from baseline (wrist studies for reader 1 were 10 minutes slower [p = 0.01] and cervical spine studies for reader 3 were 9 minutes faster [p < 0.01]). Volume distributions changed across various body parts (-3% to 4% for reader 1, -13% to 14% for reader 2, and -24% to 10% for reader 3). CONCLUSION. Analytics-driven worklists for MRI may decrease overall group interpretation time without significant alteration in individual speed, though a change in volume distribution is required.
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Possible Bias From Prepopulated Impressions in Structured Radiology Reports. J Am Coll Radiol 2019; 16:724-727. [DOI: 10.1016/j.jacr.2018.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 10/31/2018] [Accepted: 11/09/2018] [Indexed: 11/23/2022]
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Shea LAG, Towbin AJ. The state of structured reporting: the nuance of standardized language. Pediatr Radiol 2019; 49:500-508. [PMID: 30923882 DOI: 10.1007/s00247-019-04345-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 12/04/2018] [Accepted: 01/11/2019] [Indexed: 12/26/2022]
Abstract
Radiology reports are the principal form of communication with the referring provider. Unfortunately, they can be a form of communication riddled with errors and inscrutable statements burying the intended meaning, failing to achieve the main task for which it was made: communicating key imaging findings as they pertain to the clinical question being posed. Structured reporting is a multifaceted and modular solution to problematic reports, with variable iterations and benefits. Structured reports have been adapted across departments and even national societies, with standardized format, content and language. Newer developments include contextual reporting and common data elements. Herein, we discuss the various forms and levels of structured reporting and the latest advancements, as well as the general acceptance within radiology. We also discuss some areas for improvement as the practice of structured reporting matures.
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Affiliation(s)
- Lindsey A G Shea
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Alexander J Towbin
- Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., MLC 5031, Cincinnati, OH, 45229, USA. .,Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
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Lacson R, Cochon L, Ip I, Desai S, Kachalia A, Dennerlein J, Benneyan J, Khorasani R. Classifying Safety Events Related to Diagnostic Imaging From a Safety Reporting System Using a Human Factors Framework. J Am Coll Radiol 2018; 16:282-288. [PMID: 30528933 PMCID: PMC7537148 DOI: 10.1016/j.jacr.2018.10.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 10/12/2018] [Accepted: 10/17/2018] [Indexed: 11/30/2022]
Abstract
Purpose: To measure diagnostic imaging safety events reported to an electronic safety reporting system (ESRS) and assess steps where they occurred within the diagnostic imaging workflow and contributing socio-technical factors. Methods: We evaluated all ESRS safety reports related to diagnostic imaging during calendar 2015 at an academic medical center with 50,000 admissions, 950,000 ambulatory visits, and performing 680,000 diagnostic imaging studies annually. Each report was assigned a 0-4 harm score by the reporter; we classified scores of 2 (minor harm) to 4 (death) as “potential harm”. Two reviewers manually classified reports into steps involved in the diagnostic imaging chain and socio-technical factors per the Systems Engineering Initiative for Patient Safety (SEIPS) framework. Kappa measured inter-reviewer agreement on 10% of reports. The percentage of reports that could cause “potential harm” was compared for each step and socio-technical factor using chi-square analysis. Results: Of 11,570 safety reports submitted in 2015, 854 (7%) were related to diagnostic imaging. Although the most common step was Imaging Procedure (54% of reports), potential harm occurred more in Report Communication (Odds Ratio=2.36, p=0.05). Person factors most commonly contributed to safety reports (71%). Potential harm occurred more in safety reports that were related to Task compared to Person factors (OR=5.03, p<0.0001). Kappa was 0.79. Conclusion: Safety events were related to diagnostic imaging in 7% of reports and potential harm occurred primarily during Imaging Procedure and Report Communication. Safety events were attributed to multifactorial socio-technical factors. Further work is necessary to decrease safety events related to diagnostic imaging.
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Affiliation(s)
- Ronilda Lacson
- Center for Evidence-Based Imaging, Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
| | - Laila Cochon
- Center for Evidence-Based Imaging, Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Ivan Ip
- Center for Evidence-Based Imaging, Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - Sonali Desai
- Harvard Medical School, Boston, Massachusetts; Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | - Allen Kachalia
- Harvard Medical School, Boston, Massachusetts; Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | - Jack Dennerlein
- Center for Work, Health, and Wellbeing, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - James Benneyan
- Healthcare Systems Engineering Institute, Northeastern University, Boston, Massachusetts
| | - Ramin Khorasani
- Center for Evidence-Based Imaging, Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
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Parikh JR, Bender C, Bluth E. Musculoskeletal Injuries Affecting Radiologists According to the 2017 ACR Human Resources Commission Workforce Survey. J Am Coll Radiol 2018; 15:803-808. [DOI: 10.1016/j.jacr.2018.01.033] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 01/20/2018] [Accepted: 01/23/2018] [Indexed: 12/12/2022]
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Olthof AW, Borstlap J, Roeloffzen WW, Callenbach PMC, van Ooijen PMA. Improvement of radiology reporting in a clinical cancer network: impact of an optimised multidisciplinary workflow. Eur Radiol 2018; 28:4274-4280. [PMID: 29679214 DOI: 10.1007/s00330-018-5427-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 03/02/2018] [Accepted: 03/15/2018] [Indexed: 12/19/2022]
Abstract
PURPOSE To assess the effectiveness of implementing a quality improvement project in a clinical cancer network directed at the response assessment of oncology patients according to RECIST-criteria. METHODS Requests and reports of computed tomography (CT) studies from before (n = 103) and after (n = 112) implementation of interventions were compared. The interventions consisted of: a multidisciplinary working agreement with a clearly described workflow; subspecialisation of radiologists; adaptation of the Picture Archiving and Communication System (PACS); structured reporting. RESULTS The essential information included in the requests and the reports improved significantly after implementation of the interventions. In the requests, mentioning start date increased from 2% to 49%; date of baseline CT from 7% to 64%; nadir date from 1% to 41%. In the reports, structured layout increased from 14% to 86%; mentioning target lesions from 18% to 80% and non-target lesions from 11% to 80%; measurements stored in PACS increased from 76% to 97%; labelled key images from 38% to 95%; all p values < 0.001. CONCLUSION The combination of implementation of an optimised workflow, subspecialisation and structured reporting led to significantly better quality radiology reporting for oncology patients receiving chemotherapy. The applied multifactorial approach can be used within other radiology subspeciality areas as well. KEY POINTS • Undeveloped subspecialisation makes adherence to RECIST guidelines difficult in general hospitals. • A clinical cancer network provides opportunities to improve healthcare. • Optimised workflow, subspecialisation and structured reporting substantially improve request and report quality. • Good interdisciplinary communication between oncologists, radiologists and others contributes to quality improvement.
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Affiliation(s)
- A W Olthof
- Department of Radiology, Treant Health Care Group, Dr. G.H. Amshoffweg 1, Hoogeveen, The Netherlands.
| | - J Borstlap
- Department of Radiology, Treant Health Care Group, Dr. G.H. Amshoffweg 1, Hoogeveen, The Netherlands
| | - W W Roeloffzen
- Department of Oncology, Treant Health Care Group, Dr. G.H. Amshoffweg 1, Hoogeveen, The Netherlands
| | - P M C Callenbach
- Research Bureau, Treant Health Care Group, Dr. G.H. Amshoffweg 1, Hoogeveen, The Netherlands
| | - P M A van Ooijen
- Department of Radiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, Groningen, The Netherlands.,Center for Medical Imaging North East Netherlands (CMI-NEN), University of Groningen, University Medical Center Groningen, Hanzeplein 1, Groningen, The Netherlands
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