Case Studies: Optimizing Digital Radiography

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Central Baptist Hospital: Reducing Costs, Keeping Staff, and Pleasing Patients with DR

By Bill Broaddus, RT (ARRT), Director of Radiology Services, Central Baptist Hospital, Lexington, Ky.

Central Baptist Hospital is a 371-bed medical research and educational center located in Lexington, Ky. The hospital offers some of the most advanced medical facilities, technologies and capabilities available in the region including a respected heart program, a Cancer Care Center, and family-centered obstetrics, among others.

The radiology department, which supports many of the programs, performs approximately 100,000 procedures each year. However, the radiology umbrella that we have does not include mammography because we have made that a separate center, and it also does not include nuclear cardiology because the heart studies are performed at a center for heart exams. Of the exams, some 70,000 are diagnostic in nature. The hospital's radiology department is comprised of five radiologists with four general radiography rooms and three radiography and fluoroscopy rooms. Today we are totally digital and each of our modalities is connected through a radiology information system (RIS) and our images are available for viewing anytime, anywhere through a web-based PACS.

Pondering that move
After planning to make the move to a PACS since 2001, we went with Agfa IMPAX in November 2003 and at the same time installed Agfa ADC Compact and Solo CR (computed radiography) systems. The move from film to CR did make us more efficient in many respects, yet we were still lacking in productivity and efficiency because we were still using cassettes that require a technologist to go back and forth to a central processing area. Keeping an eye out for new technologies to improve our facility, it quickly became apparent to us that our next migration would be to a digital radiography (DR) system due to the efficiency of the systems from many perspectives as well as the patient-care benefits.

We put off replacing our diagnostic and fluoro equipment until we had the funding and administrative support so that any new room we installed would be DR-capable. We installed two Siemens AXIOM Aristos FX systems at one of our imaging centers in January 2004 and plan to install another of these systems at a new imaging center in October of this year. More recently, we installed the AXIOM MULTIX M in February of this year to replace an older CR system in our main hospital. For each system, the benefits that we projected have proven true in every instance.

Essential site visits
Taking highly inquisitive and straight-shooting personnel to do site visit evaluations of these types of system is absolutely essential and in our case, this included an in-house radiology engineer, a modality supervisor, and a general staff member. Our experience with the Aristos FX unit was very positive. Yet, the room we had to work with for our next install was not large enough to accommodate the advanced robotics of the FX. So, we considered the MULTIX M. We liked the single- plate design, which allows a technologist to take the cassette out of the table and put it in the motorized upright detector stand which saves the cost of buying a second plate. We also were wary of systems that have the plate built in to the table because when you go to do cross-table work you still have to use your CR cassettes, and we were looking to avoid multiple systems.

With the MULTIX M, you can do work in the table, on top of the table or take the plate out which can be placed in a holder on the side of the table. A grid attachment allows technologist's to do cross-table work. Also, the plate has enough cable on it that when patients come in on stretchers it can be placed under them just like you would a cassette, and the radiographs can be done just like they would be done with a CR cassette. The system produces images in four seconds for quick review which is much easier on patients, especially the elderly or those in a great deal of pain because follow-up images can be done right then without coming back and re-lifting the patient to get them repositioned for that exposure.

'You're done?'
The productivity in every room that we have put DR has increased and it has been well accepted all around. A common patient response after the exam is complete is 'you're done?' That's how fast the systems are.

As for daily hospital productivity, a four-day snap shot of work with the DR systems reveals that we perform an