"Architecture is the learned game, correct and magnificent, of forms assembled in the light.” The turn of the century, Swiss-born architect Le Corbusier seems to understand the considerations of radiology reading room design, especially its dependence on proper lighting constructs.
As with most construction projects, starting from scratch is usually the best and easiest way. But most often when it comes to radiology reading rooms, renovations are in the plan for hospitals and radiology practices requiring providers to alter a space within the confines of an existing physical structure, says according to William N. Bernstein, AIA, principal of Architecture for Radiology, in New York City. Radiology practices often need to make alterations when they outgrow their current space, add more staff or especially when they add PACS.
Whether the project is in a new or renovated space, Bernstein suggests that the reading room considerations are the same, including: understanding the workflow within the reading environment, such as the desire for privacy versus collaboration; lighting; acoustics; HVAC; along with materials and colors. Comparing a private to a collaborative image reading environment becomes particularly relevant in an academic teaching hospital, where the reading of images often takes place in a group setting with residents.
Bill Rostenberg, AIA, director of research at Anshen + Allen in San Francisco, offers a similar methodology for reading room project planning, adding on the priorities of structural space, ergonomics and connectivity.
Let there be light
Lighting is key because of the effect it can have on the occupants of the reading room. Rostenberg sees lighting as the most important consideration in the design because of the evolution to reading soft-copy images; however, he notes that with flat-panel monitors, some of the reflection complications have become easier to solve. The misconception of a completely dark room also has been disproven.
“There is much more pressure to read more and more images, more quickly and more accurately in today’s reading [environment] due to the emergence of volume and dynamic quality certain modalities, like CT and MRI, which produce both 2D and 3D, anatomic and physiological data,” Rostenberg says. “As a result, the interaction between the radiologist and the image is much more intense and active, resulting in frequent repetitive work injuries and eye fatigue. In general, it becomes a lot more important to have the proper type of lighting.” Indirect lighting is superior, whether it is reflected off the ceiling or the walls.
Bernstein says that there are three current foci for lighting: what is the ideal lighting for working on a computer screen; how is the lighting controlled; and energy conservation. Aesthetics and the target of illumination also are important aspects of consideration.
The most common request with lighting is controllability, Bernstein says. “People who work at individual workstations want to control the lighting in their individual area,” he says.
“The basic goal is to have general room illumination that does not cause any interference with the monitors, which can be achieved with ambient lighting,” Rostenberg says. “It should be generally equal to the amount of light coming from the monitors. The reader should not have any contrast or distraction from the lighting in their peripheral view.” Task lighting is needed to assist with note-taking at the workstation.
From the ground up
New construction was the route Memorial Hermann Katy Hospital in Texas took in 2006 when it built new reading areas as part of a new building, says Steve Dinwiddie, director of imaging services. The hospital is one of 11 hospitals in the Memorial Hermann Healthcare System in Houston that each year completes 80,000 imaging exams.
At the facility, radiologists have their own individual reading room with no windows, equipped with an Anthro Carl’s Table workstation, four monitors, phone, fax machine and temperature control. Within the rooms are fluorescent lighting with two switches for control, Dinwiddie says.
Despite lighting controls, most of the radiologists prefer to shut the room lights off and use the back lighting on the workstation to create indirect light. To take notes and make phone calls, the radiologists often use their task lamp, too, which is