Imaging Ergonomics: If You Build It, They Will Come (Back)
By Dave Yeager
Vol. 23 No. 2 P. 26
What would you say if someone offered to buy you a brand new house?
Sounds like a good deal, right? But what if they built it without taking any input from you? You may find that it’s not as good of a deal as it first seemed.
The radiology department at West Virginia University Medicine-Ruby Memorial Hospital found itself in a similar situation when the hospital’s decision makers decided that they needed to make room for a new IR suite. To create space, the radiology department was relocated to a new room that didn’t quite meet the needs of its radiologists.
The new reading room had 25 work spaces, just as the old reading room, but the similarities ended there. Because neither the radiologists nor anyone from the radiology department was consulted on the room’s design, it was lacking many necessary features.
“It was kind of like a call center,” says Ben Parker, BA, RT, (R)(N), assistant director of radiology at Ruby Memorial. “The radiologists moved there and, immediately, they were distracted and couldn’t read well, so they all started going to their offices to read. As a result, there was no one in the reading room when referring physicians would come by for a consult to review the images. The teachers weren’t next to their students, so the residency program started to suffer. And people became disengaged.”
Immediately following the move, turnaround times and quality began to suffer. The disengagement quickly became evident throughout the hospital.
Like many hospitals, Ruby Memorial conducts an employee engagement survey every few years to determine how effectively different sections of the hospital are working together. A significant sign of trouble, according to Parker, was that the radiology department had the lowest response rate.
“That’s a pretty good indication that your faculty aren’t engaged at all,” he says. “They’re not even willing to take a survey.”
The survey showed a steep decline in the engagement of radiologists and others in the radiology department, but the sharpest decline was on the most important question: the rest of the hospital’s overall view of radiology services.
“The least engaged faculty is usually the lowest-performing faculty,” Parker says.
Ruby Memorial’s radiology director, Parker’s supervisor, used the survey as ammunition for a new reading room. Hospital administration was reluctant, at first, since they had recently spent money on a reading room, But survey scores helped convince leaders that change was necessary.
With the administration’s approval, the radiology department located space that could be used for a new reading room and found some additional funding beyond what the hospital allocated. One thing they didn’t want to do was re-create the suboptimal reading room in a new space. To better serve the needs of the department, they created a reading room steering committee.
The steering committee included the leader of each radiology section, as well as Parker, who was the representative for radiology administration. All of the stakeholders who had an interest in the room were represented on the team.
“At our very first meeting, we developed a value statement of what we wanted in the room,” Parker says. “We did this because we wanted to make sure that the decisions we were making supported our goals. We didn’t want to start going down rabbit holes with extraneous features because you can’t have everything. So we wanted to make sure the decisions we were making were supporting our values. It was a way to keep the project on task.”
All subsequent decisions were evaluated by whether they supported the project charter. Once the committee was formed and the value statement was in place, a new design team was hired. Redrick was chosen because of its experience designing reading rooms.
“We wanted a space that gave people privacy and minimized distractions, but it still needed to facilitate collaboration and teaching,” Parker says. “Our faculty didn’t want to be like a telerad group; we wanted to be a valued member of the entire care team. We wanted to welcome collaboration and interaction with referring physicians and residents but also allow for productivity and privacy.”
Flipping the Script
Initially, the steering committee was unsure about which specific items in the previous reading room were the most problematic. It was believed they might need 60 workstations, but it turns out that only 35 were required. They thought perhaps the spaces just needed to be bigger. In reality, there were other considerations that were more important, such as the ability to adjust lighting, room for movement, and areas for collaboration and privacy during consultations with referring physicians and residents.
There was give and take throughout the design process. The faculty knew what the budget and space constraints were, and the vendor knew how to determine the optimal amount of space vs the optimal number of stations. In the end, everyone was pleased with the result.
“So what had been one of our weaknesses became one of our strengths,” Parker says. “Now, when we have a recruit, we take them to the reading room, and they’ve never seen a better reading room than the one we have to offer. And we’re also able to say, ‘This shows you the commitment our organization has to giving you the tools you need to be successful.’”
The process of redesigning the reading room reengaged the radiology faculty, and that attitude extended to other parts of the hospital. The radiology department used the grand opening of the new reading room to reconnect with referring physicians.
When the next engagement survey was sent out, there was notable improvement in radiology’s scores. “And we targeted the reading room to help increase those scores,” Parker says. “On the question of engagement, our faculty are now some of the most engaged. We had the most faculty we’ve ever had respond to the survey. And the question that previously saw the sharpest decline, our department’s overall value, saw the biggest increase of any question on the entire survey.”
— Dave Yeager is the editor of Radiology Today.