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Workplace and Staffing

Best practice: Medical imaging departments develop staffing policies and procedures that facilitate safe patient care. Because extended shifts, burnout and fatigue can compromise patient safety, managers should set realistic expectations for staffing that consider high-quality patient care as a priority. Staffing is particularly important when radiologic technologists are required to perform complicated procedures and in MR imaging, where radiologic technologists are responsible for controlling access to the equipment’s magnetic field. Failing to staff adequately can affect patient satisfaction, a critical factor in scores now assigned to providers by the Centers for Medicare and Medicaid Services (CMS), and thus in reimbursement. These policies should include staffing adequately to free time for training on new and upgraded imaging equipment and education about evolving technologies. A 2008 Joint Commission sentinel event alert that addressed safety issues when implementing health information and converging technologies stated that although the time and attention required to learn new technologies can strain already demanding schedules, hospital leadership should establish a training program for all clinical and operations staff who might use new technology. The alert also recommended that the orientation for new technology occur near the time of implementation and that refresher courses be held.

Best practice: Efforts focus on better facilitating radiologist/radiologic technologist collaboration on care, feedback and quality improvement. In The Joint Commission’s 2011 sentinel event alert regarding radiation risks in medical imaging, communication among clinicians, medical physicists, technologists and staff was cited as one of the contributing factors to avoidable radiation dosing. Traditionally, radio-logic technologists have learned from radiologists about improving radiographic technique, and radiologists ultimately are responsible for “mastery of technology and dedication to quality and safety” in their practices. In today’s digital imaging environment, collaboration between the technologist and radiologist does not occur as often as it did in the film-screen environment. This lack of interaction has resulted in fewer opportunities for the technologist to learn from radiologists and talk about the quality of their images.

Departments should adopt communication strategies and policies in the new digital environment to allow for and even encourage radiologist oversight, involvement and feedback on image technique, expo-sure and quality. Radiologic technologists usually have sole medical imaging department contact with patients and are the only professionals who might notice duplicate or inappropriate examinations before they occur. Technologists need radiologist input and cooperation to effectively communicate with patients and a departmental system in place in which they can report concerns regarding ordered examinations or technique questions and exposure issues.

Technology Gaps

Best practice: Medical imaging departments provide effective and efficient applications training for new and upgraded medical imaging equipment. Regular radiologist communication helps radiologic technologists improve basic and advanced technical skills and guidance for patient exposure and ALARA principles. When new and emerging technologies are introduced, radiologic technologists and radiologists must rely on a number of sources for professional development. Before new or upgraded equipment is installed, radiologic technologists should have a core knowledge of the basics in the modality. The basics of some modalities have changed considerably since radiologic

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