1
|
Courtier J, Hess CP. Does Pediatric Radiology Need Faster Horses? Rethinking Strategies to Workforce and Workflow. Acad Radiol 2023; 30:2046-2049. [PMID: 37394413 DOI: 10.1016/j.acra.2023.05.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 05/24/2023] [Accepted: 05/31/2023] [Indexed: 07/04/2023]
Affiliation(s)
- Jesse Courtier
- UCSF Department of Radiology and Biomedical Imaging, Pediatric Radiology UCSF Benioff Children's Hospital, 1975 4th Street, C1758 P, San Francisco, CA 94138.
| | - Christopher P Hess
- UCSF Department of Radiology and Biomedical Imaging, Pediatric Radiology UCSF Benioff Children's Hospital, 1975 4th Street, C1758 P, San Francisco, CA 94138
| |
Collapse
|
2
|
Structured coaching as a means to improve sonographic visualization of the appendix: a quality improvement initiative. Emerg Radiol 2023; 30:161-166. [PMID: 36598657 DOI: 10.1007/s10140-022-02106-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 11/28/2022] [Indexed: 01/05/2023]
Abstract
PURPOSE Ultrasound of the right lower quadrant for appendicitis requires specific training and practice. Improved visualization of the appendix can result in decreased utilization of computed tomography. Increasing the sensitivity of ultrasound for appendicitis thus decreases radiation exposure, reduces cost, and improves the patient healthcare experience in accordance with the three principles of the triple aim designated by the Institute for Healthcare Improvement. The purpose of this study was to examine the effect of a structured training program supplemented by technologist feedback on sonographic visualization of the appendix in a large pediatric health system. METHODS The baseline ultrasound visualization frequency was computed for 20 ultrasound technologists in a large pediatric health system. Following this, technologists were informed of their individual and relative performance. Those with visualization frequencies less than 75% were provided structured training by a designated sonographer with an appendix visualization frequency above 75% while those with greater than 75% visualization continued to be monitored and informed of their monthly frequency. Following this structured training, appendix visualization frequencies were monitored over the next 5 months. RESULTS There was no significant effect of sonographer career experience on the baseline appendix visualization frequency. Fourteen of 20 technologists demonstrated improved visualization frequencies post-intervention. The composite visualization frequency among these 20 technologists improved from 66.55 to 69.14%. This resulted in a potential savings of 38 CT scans during the post-intervention period. CONCLUSION An appendix visualization rate monitoring program coupled with structured training was successful in improving the appendix visualization rate throughout a large pediatric health system. This program demonstrates the positive effect that monitoring and targeted intervention can have on a quality improvement program. The program continues to be carried out as part of a plan-study-do-act cycle.
Collapse
|
3
|
Seghers MC, Seghers VJ, Sher AC, Jadhav SP, States LJ, Trout AT, Alazraki AL, Sammer MBK. Working from home during the COVID-19 pandemic: surveys of the Society for Pediatric Radiology and the Society of Chiefs of Radiology at Children's Hospitals. Pediatr Radiol 2022; 52:1242-1254. [PMID: 35229184 PMCID: PMC8885321 DOI: 10.1007/s00247-022-05299-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 12/19/2021] [Accepted: 01/23/2022] [Indexed: 12/25/2022]
Abstract
BACKGROUND Due to the COVID-19 pandemic, some pediatric radiologists have shifted to working from home; the long-term ramifications for pediatric radiologists and departments have not yet been defined. OBJECTIVE To characterize experiences of working from home associated with the COVID-19 pandemic and guide expectations after the pandemic is controlled, via separate surveys of Society for Pediatric Radiology (SPR) and Society of Chiefs of Radiology at Children's Hospitals (SCORCH) members. MATERIALS AND METHODS Two separate surveys were conducted. In the first, SPR members were surveyed Jan. 11 through Feb. 8, 2021. The response rate was 17.0% (255 of 1,501). Survey questions included demographics, information on the ability to work from home and subjective experiences ranked on a scale of 0 to 10. The survey enabled segregation and comparison of responses between those with and without home PACS. In the second survey, SCORCH members were surveyed Dec. 8, 2020, through Jan. 8, 2021. The response rate was 51.5% (51/99). Survey questions included the logistics of working from home, technical specifications and the expectations on clinical duties performed from home. The Wilcoxon rank test was used to determine statistical significance of compared variables between respondents with and without home PACS in SPR members, and expectations between SPR and SCORCH members. Descriptive statistics summarized demographic questions and free text responses. RESULTS The majority of member respondents (81.2%, 207/255) had a home PACS and most departments provided home PACS to faculty (94.1%, 48/51). Overall, radiologists who could work from home were satisfied with their ability to work from home (mean rating: 8.3/10) and were significantly more satisfied than predicted by those without home PACS (5.9/10, P<0.0001). Respondents overwhelmingly indicated they were less able to teach trainees (mean rating: 2.7/10) and had decreased emotional engagement (mean rating: 4.4/10), but had improved research productivity and cognitive ability for research when working from home (mean rating for both: 5.3/10). Regarding the expectations of the ability to work from home after no longer needing to address the pandemic, department chairs generally favored fewer rotations from home, with 97.9% (47/48) indicating working from home should be 60% or fewer assignments, compared with 84.1% (164/195) of individual radiologists (P=0.071). CONCLUSIONS Due to the COVID-19 pandemic, there has been a shift to working from home using PACS. Results of these SPR and SCORCH member surveys can help inform future decisions regarding pediatric radiologists working from home once the pandemic has been controlled.
Collapse
Affiliation(s)
- Matthew C. Seghers
- grid.89336.370000 0004 1936 9924Dell Medical School, The University of Texas at Austin, Austin, TX USA
| | - Victor J. Seghers
- grid.416975.80000 0001 2200 2638Edward B. Singleton Department of Radiology, Texas Children’s Hospital, 6701 Fannin Street, Suite 470, 77030 Houston, TX USA ,grid.39382.330000 0001 2160 926XDepartment of Radiology, Baylor College of Medicine, Houston, TX USA
| | - Andrew C. Sher
- grid.416975.80000 0001 2200 2638Edward B. Singleton Department of Radiology, Texas Children’s Hospital, 6701 Fannin Street, Suite 470, 77030 Houston, TX USA ,grid.39382.330000 0001 2160 926XDepartment of Radiology, Baylor College of Medicine, Houston, TX USA
| | - Siddharth P. Jadhav
- grid.416975.80000 0001 2200 2638Edward B. Singleton Department of Radiology, Texas Children’s Hospital, 6701 Fannin Street, Suite 470, 77030 Houston, TX USA ,grid.39382.330000 0001 2160 926XDepartment of Radiology, Baylor College of Medicine, Houston, TX USA
| | - Lisa J. States
- grid.239552.a0000 0001 0680 8770Department of Radiology, The Children’s Hospital of Philadelphia, Philadelphia, PA USA ,grid.25879.310000 0004 1936 8972Department of Radiology, University of Pennsylvania, Philadelphia, PA USA
| | - Andrew T. Trout
- grid.239573.90000 0000 9025 8099Department of Radiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH USA ,grid.24827.3b0000 0001 2179 9593Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH USA
| | - Adina L. Alazraki
- grid.428158.20000 0004 0371 6071Department of Radiology, Children’s Healthcare of Atlanta, Atlanta, GA USA ,grid.189967.80000 0001 0941 6502Department of Radiology, Emory University, Atlanta, GA USA
| | - Marla B. K. Sammer
- grid.416975.80000 0001 2200 2638Edward B. Singleton Department of Radiology, Texas Children’s Hospital, 6701 Fannin Street, Suite 470, 77030 Houston, TX USA ,grid.39382.330000 0001 2160 926XDepartment of Radiology, Baylor College of Medicine, Houston, TX USA
| |
Collapse
|
4
|
Pfeifer CM, Reddy N, Burton KR, Griffith B, Bazylewicz MP, Pakkal MV, Milburn JM. The Evolving Status of Fellowships and Mini-Fellowships in Diagnostic Radiology: A Survey of Program Directors and Chief Residents. Acad Radiol 2021; 28:1264-1271. [PMID: 33775517 DOI: 10.1016/j.acra.2021.03.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 02/20/2021] [Accepted: 03/03/2021] [Indexed: 11/29/2022]
Abstract
RATIONALE AND OBJECTIVES Recent changes in radiology fellowships include musculoskeletal radiology adopting a match system, interventional radiology transitioning away from diagnostic radiology to offer direct-entry programs, and a common fellowship application timeline created by the Society for Chairs of Academic Radiology Departments (SCARD). The concept of mini-fellowships has also emerged with the elimination of the oral American Board of Radiology examinations that had been administered in the final year of residency training prior to 2014. This paper seeks to assess the opinions of fellowship program directors, residency program directors, and chief residents regarding these recent changes. MATERIALS AND METHODS This is a cross-sectional study using a web-based survey posed to fellowship program directors, residency program directors, and chief residents in 2020. Questions sought to explore current attitudes toward the following topics: (1) a common fellowship application timeline; (2) a common fellowship match; and (3) the status of mini-fellowships in diagnostic radiology. In addition, the number of fellowship positions for each subspecialty was estimated using subspecialty society directories, Accreditation Council for Graduate Medical Education (ACGME) data, and individual program websites. RESULTS Deidentified responses were collected electronically and aggregated. The three respondent groups preferred a common fellowship application timeline at rates of 67% among fellowship program directors, 80% residency program directors, and 74% residents. A common match system across all subspecialties was preferred at rates of 50% fellowship program directors, 74% residency program directors, and 26% chief residents. There was widespread reported compliance with the SCARD fellowship timeline policy. Subspecialty programs using the match system reported interviewing greater numbers of applicants per position. Fellowship directors and chief residents reported that the most common duration of mini-fellowship experiences was 2 to 3 months. CONCLUSION There is a division between chief residents and program directors regarding the preference for a common radiology match. Adopting a radiology-wide fellowship match would increase the number of interviews required. The SCARD fellowship timeline policy has been successful, and there is support across stakeholders regarding the common timeline. Mini-fellowships are highly variable in length and structure.
Collapse
Affiliation(s)
- Cory M Pfeifer
- Department of Radiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390.
| | - Nisha Reddy
- Department of Radiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390
| | - Kirsteen R Burton
- Department of Radiology & Biomedical Imaging, University of California-San Francisco, San Francisco, CA
| | - Brent Griffith
- Department of Radiology, Henry Ford Health System, Detroit, MI
| | - Michael P Bazylewicz
- Department of Radiology, Department of Radiology, University of Vermont Medical Center, Burlington, VT
| | - Mini V Pakkal
- Joint Department of Medical Imaging, University of Toronto, Toronto, ON
| | - James M Milburn
- Department of Radiology, Ochsner Clinic Foundation, New Orleans, LA
| |
Collapse
|