Category: Uncategorized

29 Oct 2019

Reduce Fatigue in Radiology

Each year, more than 1,100 new radiologists complete their diagnostic training and take jobs in hospitals, medical clinics, and diagnostic laboratories. These new doctors specializing in radiology understand the demands of their new jobs, but they may not fully understand just how much fatigue plays a factor.

It’s likely that as a radiology resident, these medical professionals learned about working 10- to 12-hour days and how that can cause stress and physical fatigue. In addition to working long hours, causes include the time of day a person works, the time spent on a task, and environmental issues like working in a loud office space.

But constant work reviewing radiology images — day after day, year after year — does more than just make one want to take a nap. There is such a thing as visual fatigue that differs from simply being tired, and it can start to take a toll on radiology professionals anywhere from halfway to two-thirds of the way through their workdays.

Visual fatigue is also more than just eyestrain. It encompasses a lack of focus and a reduction in the doctor’s ability to use visual search patterns that can help with accurate diagnoses. At Emory University in Atlanta, Dr. Elizabeth Krupinski is studying the part that visual fatigue plays in a radiologist’s typical day. Her research team found a statistically significant drop in accuracy of 4 percent when comparing the work of both faculty and residents at the beginning of the day and after 8 hours. That means that fatigue may be contributing to diagnostic errors.

Another study conducted by Dr. Richard Gunderman from the Indiana University School of Medicine in 2016 and published in the Journal of the American College of Radiology connects radiologists and a lack of happiness or satisfaction with their work. Dr. Gunderman points to a lack of control in their environments, a need for increased interpersonal relationships in the workplace, and the need to feel they’re making a difference as factors that cause this unhappiness in radiology professionals. The first issue — a lack of control — comes from long workdays and, quite possibly, from the associated physical and visual fatigue that comes from reviewing images all day.

How Can Radiologists Reduce Fatigue in the Workplace?


It’s clear that professionals need to be empowered to take steps that will reduce fatigue in radiology and, ultimately, increase job satisfaction. Medscape’s 2015 report on physician burnout found that radiologists are most likely of all the medical professions to burn out, and that needs to change in order to improve the lives of current radiologists and attract new professionals to the field. Those who feel burn out are more likely to make mistakes, have less motivation, and become more easily bothered by interactions with patients and colleagues.

Fortunately, there are three main changes to make to reduce fatigue in radiology.

  1. Technology.
    Computer assisted detection, or CAD, as well as high-resolution image analysis tools can help to highlight inconsistencies in radiologic images so doctors can focus quickly on the problem. Better interoperative tools guide better overall patient outcomes, so the benefit isn’t just for radiologists.

    Especially important to reducing visual fatigue in radiology: High-quality, medical-grade monitors. Radiologists literally spend hours each day staring at screens, and these need to be the top of the line, with high contrast, high resolution, and features like glare reduction, filtering of ambient light, and automatic calibration for accuracy.

  1. Ergonomics.
    Ergonomics play a direct role in radiology fatigue, as each workstation must be customized to the individual’s needs based on his or her size and preferences. No longer can one generic workstation be used by whichever radiologist got there first; instead, workstation furniture must be carefully adjusted to the radiologist to prevent ergonomic fatigue from setting in.

    The display must be positioned at the right place in conjunction with the viewer’s eyeline. As well, viewing conditions need to be optimized to reduce problems with glare and ambient light that can’t be eliminated by the choice of a high-end monitor. Chairs must fit the user to avoid neck and back strain and encourage proper posture. Ideally, the ergonomic workstation should be adjustable to reduce radiology fatigue by encouraging natural, healthy movement. The workstation could be converted from sitting to standing every half-hour to hour to prevent the user from getting strains associated from not moving  or from hunching over a keyboard.

  1. Awareness.
    Radiologists should be better taught about the impacts of fatigue. Management and colleagues should work to create a clinic or hospital culture that promotes regular breaks and scheduled viewing times. Especially because regular breaks are shown to improve diagnostic accuracy, it may be helpful to integrate monitoring tools that help to check visual fatigue. Timers can encourage radiologists to reduce their fatigue by following the 20-20-20 rule that every 20 minutes, a computer user should look at something 20 feet away for 20 seconds to reduce visual strain.


Why Does Reducing Fatigue Matter?


Professionals used to working long hours and staring at diagnostic images may not fully understand the need for regular breaks, software tools, and ergonomic chairs to reduce radiology fatigue. But reducing fatigue is more than just giving perks to hard-working doctors. The right medical grade displays can help radiologists work faster with fewer mistakes, and the right ergonomic workstation can prevent muscle strain and discomfort that distracts from full focus.

In addition, radiologists who take more control over their working conditions and their schedules may work longer in the profession with a greater degree of job satisfaction, a factor that can influence the entire culture of a clinic or hospital. Increasing awareness of the importance of the quality and resolution of the tools used, and the need for regular breaks to reduce eye strain, are important to improving the work and accuracy of radiologists — a goal that every medical facility should strive for.

Double Black Imaging provides high-resolution medical grade monitors for use in a variety of diagnostic settings. We also offer a line of ergonomic furniture designed specifically for the needs of radiologists. Our experts can help design and install workstations for radiologists that improve comfort, reduce the impacts of fatigue in radiology, and help radiologists with focus and accuracy.

Contact the medical imaging experts today to learn more about our full line of medical displays and ergonomic workstations.

29 Sep 2019

Improving Ergonomics in the Workplace for Modern Radiology Suites

As a radiologist, you’ve been able to make huge strides in efficiency in the past few years. Filmless digital images that can be viewed anywhere let you work wherever you wish. PACS permits you to send images to referring physicians in seconds. Smart radiology tools can do amazing things automatically, such as identifying subtle changes over time.

What you probably haven’t paid as much attention to: Your reading room design.

While monitors have gotten slimmer, brighter, and higher in resolution, and software has been getting more robust, the radiology community simply hasn’t been focused on improving ergonomics in the workplace. A poorly set-up radiology workstation can have noticeable impacts on your overall health and well-being, as well as your efficiency.

When you say that any old desk, chair, or monitor will do, you’re essentially agreeing to decreased productivity from not being in the ideal position to view images. You’re also putting yourself at risk for repetitive stress injuries, eye strain, neck and shoulder pain, and backache. Here’s how haphazard medical workstation organization could be costing you, and what you can do to improve your ergonomics for safety and functionality:

Ergonomics and Safety

Your Head: Poor Position Can Lead to Eye Strain and Neck Compression

The Problem: You need to look at many different areas, from monitor to keyboard, to reference materials, or to worklist or dictation programs, that are to the side of your primary screen.

The Physical Issue: Straining your neck to properly view all your materials, both on-screen and off, can cause tension in your neck muscles and lead to headaches. Eventually, you could develop compressed neck vertebrae.

The Change: If you’re using a workstation for more than 2 hours, it should be organized so your primary monitor and keyboard are directly in front of you.

The Ideal: Your neck is in a neutral position, and you’re using a document holder positioned right next to your screen so you don’t need to swivel your neck constantly.

Your Hands: Wrong Keyboard Placement Costs You from Elbows to Fingertips

The Problem: Poor positioning of your keyboard results in your shoulders being hunched, your elbows being bent awkwardly, and your wrists at the wrong angle.

The Physical Issue: Your posture can suffer as your shoulders roll forward for long periods of time. The strain on your hands can lead to carpal tunnel problems and issues with tendons and ligaments in your elbows.

The Change: You’ll want to make sure your keyboard is positioned where your arms fall in a position immediately in front of you at a relaxed 90° angle.

The Ideal: You sit relaxed in front of your workstation, with your upper arms relaxed and your elbows comfortably close to your body.

Your Back: Misaligned Chairs Force Your Back into Unnatural Postures

The Problem: Your chair is too high, has too much (or not enough) cushioning, and lacks a suitable backrest for lumbar support.

The Physical Issue: Your slumped shoulders lead your back into incorrect posture and place strain on the muscles of your upper and lower back.

The Change: You should improve your ergonomics by adjusting your workplace chair to fit your body and allowing your feet to rest comfortably on the floor in front of you. You also need to be seated in a chair with moderate cushioning and lumbar support for your lower back.

The Ideal: Your posture is correct, with spine straight and shoulders in place. Your feet don’t strain to reach the floor.

Your Environment: Problematic Airflow, Sound, and Lighting All Reduce Efficiency

Three main problems can crop up in your workstation environment, leading to problems with productivity due to compromised focus.

Temperature and Ventilation. For desk work, you’ll want to be sitting in a room that’s between 68°F and 75°F, with humidity between 40% and 60%. Unfortunately, computer equipment, monitors, and other electronics lead to warmer temps and drier air, so you’ll want to be sure you can adjust as needed. Air conditioning that responds rapidly to changes should be available.

Sound. High levels of unnecessary background noise — even white noise, like that caused by air conditioning systems or computer fans — can decrease your attention span and increase fatigue. In a busy medical office or hospital, you’re probably also listening to paging systems, phone calls, and noise from nearby colleagues. Remove noise equipment from radiology workstations and install acoustic dampening materials such as carpeting and paneling that can reduce outside sounds.

Ambient Lighting. Light boxes and windows can add glare and unwanted light when you’re reviewing images on a high-resolution monitor. Without control over these outside sources of light, viewing the screen can be challenging. Task lighting can give you more control over how much light you use for reading off paper or working on a screen, and dimmer switches should permit exact adjustment of lighting. In fact, ergonomics play a role in eye safety, as lighting has a huge impact on overall eye health.

Why Improving your Ergonomic Desk Setup Really Matters

The bottom line is that the way you position your body makes a big difference in how productive you are. The right radiology workstation that merges ergonomics with safety, and is adjusted specifically to you, can help you reduce fatigue, muscle strain, and the risk of repetitive motion injury.

Contact the experts at Double Black Imaging for more information on improving ergonomics in your workplace!

29 Aug 2019

Do Your Diagnostic LCD Monitors Meet the Guidelines?

As diagnostic medicine moved from film to the computer screen, medical professionals found that reasonable guidelines were needed to control how diagnostic monitors display images. Consistent output ensures that medical professionals around the globe are able to view images and make accurate diagnoses.

To establish consistency for diagnostic LCD monitor requirements, the American College of Radiology developed the ACR Technical Standard for Electronic Practice of Medical Imaging. The standard was first set forth in 1994 and is updated regularly. Today, it is also endorsed by and revised in conjunction with the American Association of Physicists in Medicine (AAPM) and the Society for Imaging Informatics in Medicine (SIIM).

This standard covers not only how images are displayed, but how they are captured and stored. Section IV-D of the ACR standard details the minimum display settings for image quality and resolution. Monitor performance characteristics that define image quality include:

  • Luminance:

    the amount of photon energy that reaches the eye. Ranges for the values of the lowest gray value are 1.2 candelas per meter squared (cd/m2) for mammogram interpretation and 1.0 cd/m2 for other diagnostic interpretation. For the highest gray value, some medical-quality monitors can produce as much as 1200 candelas per meter squared (cd/m2), but the minimum for monitors that are used for mammograms is 420 cd/m2, and all other medical monitors at 350 cd/m2.

  • Contrast:

    the ratio of luminance difference between the darkest black and the brightest white that can be viewed on the screen at one time. The higher the contrast ratio, the more shades of gray (on a monochrome monitor) or colors (on a color monitor) can be viewed. It is ideal for all monitors in a medical facility to have similar ratios to ensure correct interpretation between monitors.  However, an excessively large contrast ratio is not recommended as it exceeds what the human eye can process.

  • Ambient light:

    light in the environment that hits the screen, reducing how its luminance is viewed by the observer.  To minimize eye fatigue, the ambient lighting (ambient illuminance) should be set to 25-50 lux.

  • Matrix size:

    how many pixels are in each mm of screen space. ACR recommends at least 2.5 lp/mm, which translates to at least a 3MP Display. For Mammography, FDA Cleared 5MP or 8MP Displays are recommended.

  • Other standards for diagnostic monitor displays establish guidelines for bit depth or the number of bits displayed per pixel; noise or luminance variation; and response time for a pixel to change from white to black and back again. For full standards, see ACR’s practice parameters for mammography and for other diagnostic interpretation.


Evaluating Medical LCD Display Monitors for Adherence to the ACR Standard

Diagnostic monitor guidelines change as new technology becomes available in the marketplace; for example, CRT screens are no longer used in favor of flat-screen LCDs that provide a less distorted image. The ACR updates its guidelines on a regular basis, and medical practitioners must ensure their diagnostic LCD monitors and other displays adhere to the latest requirements.

A qualified medical display provider can help radiology departments keep up with changes and remove outdated equipment. This provider works with an on-site Imaging Informatics Professional or IT staff to meet the need for maintenance and calibration of displays.

Call to Set Up your On-Site Survey!

The ability to ensure that monitors are properly calibrated is especially important for all diagnostic monitors. Displays that incorporate front sensors can automatically calibrate for the DICOM 3.14 radiologic standard. Without front sensors and auto-calibrating software, each display must be manually calibrated. A medical display provider can and should explain the importance of calibration and assist a medical practice with determining the best solution for calibrating to standard on a regular and consistent schedule.

Choosing the Right Display Provider

Any medical display provider you select to provide displays, whether it be one or hundreds, should be up-to-date with current diagnostic monitors and their guidelines and be able to recommend the best solution for monitors that adhere to the standards and fit your environment and budget. Providers can also assess your existing medical-grade displays.

In addition, your provider should be able to provide quality assurance software that proves adherence to the ACR standard. This software must be able to both control performance and identify any issues that may cause a display to fall out of standard. Software should be updated regularly, and new versions or updates should be installed when available.

The right display provider will also support products as needed. This includes training and follow-up to check that monitors and software tools are being correctly utilized. If you are unable to check display performance, your provider should have trained personnel who can assist you with scheduled calibration checks and maintenance.

Double Black Imaging performs these services from setup to configuration to ongoing training and support. Our calibration software and productivity tools are made in the U.S., and we are current on the established standards for conformance and calibration of medical imaging displays. Contact us for more information about medical monitor and calibration training for your staff or ongoing monitoring and maintenance of your medical-grade displays.