Patient Safety: Safety Check
By Rebecca Montz, EdD, MBA, CNMT, PET, RT(N)(CT), NMTCB RS
Radiology Today
Vol. 23 No. 5 P. 32

Three Departmental Challenges That Impact Patient Safety

In radiology—a fast-paced, high-stress, and technology-driven environment—creating a patient safety culture is vital to ensuring quality care. The World Health Organization defines patient safety as the absence of preventable harm to patients and prevention of unnecessary harm by health care professionals. All health care professionals and facilities have a responsibility to patients to deliver high-quality care and safety, which remains a global priority.

Radiology departments are unique in that they perform various diagnostic procedures and serve multiple patients while facing numerous workplace challenges. Some of the challenges departments face include ineffective communication due to staffing shortages, high patient volumes, and the use of technology. Additional challenges such as employee burnout and rapid technological advancements could also lead to potential medical errors and unsafe environments. These are a few identifying challenges that departments should be aware of and addressed as necessary to prevent undesired patient outcomes. Departmental challenges that may hinder patient safety can be addressed by improving the skills of radiological technologists by promoting effective communication, self-care, and advanced technological education and training to improve patient care and safety.

Effective Communication
Communication is an essential part of life. Through communication, relationships can flourish, connections can be made, and needs can be expressed. In health care, effective communication is vital, as it not only contributes to best and safe practices but also enhances patient experiences. In radiology, effective communication remains the key to overcoming departmental challenges that can lead to unsafe and undesirable patient outcomes. It consists of connecting, actively listening, and meeting the needs of patients and colleagues.

Effective communication ensures proper patient identification, procedure, drug or contrast media administration, and patient handoffs. Radiological technologists are responsible for patient interactions that involve educating patients of all ages about complex procedures and obtaining accurate medical history. These interactions occur when proper identification of the patient and procedure are determined, along with any contraindications. These interactions are especially important in gaining trust, confidence, and compliance from patients to ensure patient safety and quality images. However, due to the demands on technologists based on staffing, patient scheduling, and volume of studies, appropriate time for thorough and accurate patient interactions may be diminished.

Another challenge that could impede effective communication is the increased use of advanced of technology throughout radiology departments. Technology has decreased personal interactions due to the use of technologies such as EHRs, digital images, and e-mail. These advancements could lead to ineffective communication between radiologists and technologists, which presents additional patient safety concerns involving image quality, patient exposure, and drug or contrast media administration. Mutual respect between technologists and radiologists, to address procedural issues, patient contraindications, and exposure concerns, must be present to ensure a high level of patient safety. Radiology departments must strive to push beyond challenges that affect communication by being more flexible and creative, to ensure communication and patient safety is a top priority. A collaborative environment exhibits a good first impression and creates a positive start to the technologist-patient interaction. As stated by George Bernard Shaw, “The single biggest problem in communication is the illusion that it has taken place.” Therefore, it is vital, for both patients and technologists, to invest time into effective communication.

Employee Burnout
Fast pace, high stress, long hours, and demanding patient schedules are just a few of the many challenges radiological technologists face daily. Burnout affects not only technologists but also the department and, more importantly, patients. It can lead to fatigue and decreased productivity, which, in turn, can negatively affect patient safety by increasing the opportunity for medical errors.

Burnout is linked to multiple causes, such as lack of leadership, ineffective communication, long work hours with various shifts, high patient volumes, staff scheduling, and advancing technology. A study conducted by Philips in 2019 determined that 44% of radiological technologists reported moderate or severe levels of job stress. The findings also showed that imaging directors were underestimating the burnout felt by technologists, pointing to a “communication gap” between technologists and leadership. The results should encourage departments to be proactive in providing resources regarding self-care to enhance the mental, emotional, and physical well-being of radiological technologists. Leaders can also decrease technologists’ burnout by providing constructive feedback in an inclusive environment and focus on building positive relationships. The well-being of staff should be at the forefront of radiology departments to ensure a positive workplace that provides quality patient care in a safe environment.

Burnout is a problem that continues to affect health care professionals, and unaddressed burnout may lead to serious medical errors. Among radiological technologists, such errors may directly impact a patient’s safety and well-being. Radiological technologists need to be educated, understand the risk of burnout, and follow best practices to promote self-care. The goal should be to assist in preventing burnout in experienced technologists and promoting the profession to aspiring technologists so the field continues to thrive.

Rapid Technological Advancements
Radiology is a rapidly advancing, technology-driven environment that may hinder technologists’ skills and abilities, leading to an unsafe patient environment. Diagnostic imaging is continuously evolving and advancing, which makes it difficult for technologists to stay competent in operating new equipment or software. Radiological technologists may find it difficult to keep pace with learning and competently utilizing new technology, which, in turn, can impact patient safety, resulting in overexposure, duplicate procedures, and discomfort mentally and physically. New innovations in radiology, along with strenuous work environments, can lead to an increase in medical errors, which can affect overall patient well-being.

Another challenge in working in an environment that utilizes rapid technological advancements is the varying range of technology skills among technologists within a department. It’s a challenge to ensure that adequate training and education is provided. Leaders and technologists must be mindful of these limitations to ensure quality images are acquired with patient safety in mind. Adequate training is of utmost importance when new technology is introduced to a department, in conjunction with having a productive onboarding and reassessment program. Implementation of training programs will assist in identifying limitations and addressing areas of concerns to ensure that the proper training and resources are provided to keep patient safety at the forefront of daily operations.

Radiological technologists perform millions of diagnostic imaging procedures yearly in the United States within fast-paced and high-volume departments. Physicians and radiologists depend on qualified radiological technologists to obtain quality images to accurately diagnose and treat patients. However, patient safety and medical errors are issues that health care organizations must focus on. Patient safety will not be fully achieved until challenges such as effective communication between all levels in radiology, preventable employee burnout, and proper education and training to address rapid technological advancements are prioritized.

— Rebecca Montz, EdD, MBA, CNMT, PET, RT(N)(CT), NMTCB RS, is vice president of Advanced Health Education Center in Houston. She has worked at the Mayo Clinic Jacksonville and University of Texas MD Anderson Cancer Center in Houston as a nuclear medicine and PET technologist.