Dream Reading Rooms Require Team Effort

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Reading images, Terence Matalon, MD, chair of the Department of Radiology at Albert Einstein Medical Center  in Philadelphia, stands at his Biomorph interactive desk, while two colleagues sit at a Biomorph desk.Dynamic changes in radiology from film-based practice to PACS has necessitated transformational shifts in the reading environment. It started with big picture items: lighting, sound, overall room configuration and has now moved into the arena of individual workstation design that includes furniture and displays taking center stage.

The importance of these issues cannot be denied, because de-veloping an appropriate setting for reading electronic images impacts the efficiency and effectiveness of radiologists while protecting their health through ergonomic design.

The scarcity of radiologists combined with increased complexity of studies and exponential rise in workload added to the usual imperative for accuracy has placed overwhelming demands on stretched-thin radiology departments. Ergonomic research has revealed that repetitive stress injuries as well as fatigue are potential hazards to new workflow design unless departments are cognizant of necessary environmental changes. 

These issues were raised first in looking at the total environment of the reading room that includes issues of lighting, sound reduction, temperature regulation and utilization of workspace. Often the new radiology suite is located where film-based practice was previously conducted, and that fact alone may involve challenges that must be met.

The big picture

A trailblazer of ergonomic considerations in radiology reading rooms, Eliot Siegel, MD, professor and vice-chair of the Diagnostic Radiology Department at the University of Maryland School of Medicine and chief of imaging for the VA Maryland Healthcare System in Baltimore, describes the challenges they faced secondary to the physical location of their new reading room. On one side of the radiology department, an MR scanner was installed, another side features a busy corridor and a third involves a patient waiting room where public restrooms are currently being installed.

Obviously, sound reduction gained paramount importance as this convergence of circumstances impacted their re-designed reading room of the future that opened late last year. Siegel explains that, especially with the MR scanner next door, they needed to create an environment that is as quiet as possible because they are using speech recognition. Extraneous noises may be recognized as small words such as “ah” or “the” and placed in the report in error.

To meet this challenge, they added acoustic baffles to sound-absorbing material on the walls, ceilings and in the corners to minimize internal reflection of noise. They increased the insulation on the walls in a room that already featured noise-reducing materials on the floor, walls and ceiling. 

“One of the technologies we’re using is a system that generates background noise that is in a frequency range that approximates the sound of the human voice, which is similar to the noise that the MR scanner generates,” Siegel explains. “When you walk into the room, you don’t even notice it, or if you notice anything, it sounds like you are hearing a heating system or air system.”  He says it is quite effective in masking not only extraneous sound, but also the noise of radiologists dictating and does not interfere with the dictation system.

The entire reading room is 532 square feet, which is relatively small, but Siegel describes that with clever planning, partitioning and lighting, their interior design team was able to help the individual radiologists’ 10’X10’ work space seem larger. LCD glass partitions between the work spaces are activated with the same computer icon that controls individual lighting. The radiologist can make the glass surrounding the workstation transparent or opaque. They usually leave it clear if they don’t mind someone coming in to speak with them, but if they don’t want to be interrupted, they make it opaque.

In terms of overall lighting, this group recommends achieving a balance by matching ambient room light with monitor light as a means to reduce eye strain. One of their research projects revealed that without this critical balance, 80 percent of the cases they read were required to use window/level functionality. But when the room light matched the brightness of the monitors, they only had to window/level 40 percent of the time. Another study showed that the percentage of radiologists who complained of a high level of fatigue dropped from 50 percent to zero when the room light matched monitor brightness. The finding that concerned them most was the study