| "The Perfect Reading Room:
Doing It Your Way", (c) Amy Buttell Crane, Health Imaging & IT, April
1, 2008
When it comes to reading rooms, perfection exists in the
convergence of science and personal preference. Many factors, such as
the distance from your eye to the monitors, aren’t in dispute; for
others, such as the type of chair, ideal room temperature and reading
position are personal to individual radiologists. An environment that
merges essential ergonomics with individual needs creates the perfect
reading room with more comfortable, less stressed, more productive
radiologists.
The convergence of science and personal preference creates a dilemma,
especially for large radiology groups that want to capitalize on
cutting-edge research that establishes a connection between improved
reading room design and higher productivity when designing a reading
room, but who also don’t want to get caught up signing blank checks to
personalize every aspect of the reading room for physicians with
widely differing preferences.
The answer? A carefully crafted mixture of scientifically tested
qualities designed to appeal to the broadest range of radiologists
possible, coupled with a mixture of features that allow each
radiologist to customize his or her environment to his or her
individual needs. “Many factors combined make for an optimal reading
room where radiologists are less stressed and happier at work, leading
to improved productivity for a relatively tiny investment,” says Eliot
Siegel, professor and vice chairman of the Diagnostic Radiology
Department at the University of Maryland School of Medicine and chief
of imaging for the VA Medical Healthcare System in Baltimore, Md., and
well-known reading room researcher.
“The typical view of radiologists at hospitals is that they are
already pampered, so they see the addition of better ventilation and
lighting controls as well as high-tech chairs and adjustable desks as
frills,” Siegel continues. “But when the stoicism typical of many in
medicine interferes with making these adjustments, it is to the
detriment of the patients and the health of the radiologists.”
Radiologists who work in poor environments tend to have more eye
strain, a higher level of repetitive stress injuries, poor job
satisfaction and lower productivity than radiologists who work in
optimal reading room environments.
Mark Herbst, MD, PhD, president of St. Petersburg Independent
Diagnostic Radiology in Clearwater, Fla., couldn’t agree more. After
revitalizing his reading room with a new Anthro Carl’s Table and Verte
Chair, he says, “my productivity has increased by 50 percent. I do all
the work that I have to do in a day and do it faster and am more
comfortable. I am much happier at work, and that’s something you can’t
put a price on.”
Characteristics of the Perfect Reading Room
Experts cite a number of factors that are present in a perfect reading
room, including:
 | Lighting. “Lighting is a major issue in reading
rooms,” says David Hirshorn, MD, of Massachusetts General Hospital
and Staten Island University Hospital, in New York, who specializes
in radiology informatics. “The biggest mistake people make is to use
direct overhead lighting, which causes glare and can lead to eye
strain as can working in a dark room. I’ve found that indirect light
that is dimmable and where the light bounces off the wall is best.”
Eliot Siegel, professor and vice chairman of the Diagnostic
Radiology Department at the University of Maryland School of
Medicine and chief of imaging for the VA Medical Healthcare System
in Baltimore, Md., notes that when a number of radiologists work
together in the same room, installing individual adjustable lighting
in each work area allows each doctor to adjust the light to his or
her own preferences.
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| Monitors. Flat-panel monitors are best because
they tend not to generate much heat, unlike older CRT monitors.
Studies reveal that the optimal number of monitors for interpreting
radiology studies is two; installing three or four shows no
discernable increase in productivity or accuracy, and is generally
much more expensive. Ideally, the monitors should be placed 40
centimeters from the eye. Also, the monitor should be no taller or
not much taller than eye level; otherwise you have to look too far
up or down, which can cause eye, neck and shoulder strain.
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| Computer mice. Traditional computer mice can
cause fatigue and even repetitive stress injuries to a radiologists’
wrists, so many experiment with varying designs. Hirshorn uses a
RollerMouse Pro, which allows him to quickly move through CT scans
and other studies that have hundreds or thousands of slices, while
slowing down for studies that require more time to interpret. Mark
Herbst, MD, PhD, president of St. Petersburg Independent Diagnostic
Radiology in Clearwater, Fla., uses a KVM Video mouse that allows
him to control multiple computers from a single device so he can
move images from one computer to another with a flick of the mouse.
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| Chair Height. Chair height and armrests should
be adjustable. “Your forearms should be parallel to the ground and
your wrists should be straight,” says Hirshorn. “The armrests should
be at the same level as the desk.”
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| Desk Adjustments. Herbst’s adjustable
workstation allows him to work sitting down during the day and then
to work standing up later in the day, when he needs a change from
sitting down. A desk, table or workstation that permits adjustment
of its overall height as well as adjusting the height at which the
keyboard and mouse sit is vital, says Hirshorn. Siegel notes that
his laboratory is testing a new system designed to model a
treadmill, where a radiologist could stand, walk slowly or walk more
quickly while reading images.
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| Temperature Control. Because temperature and
ventilation are so personal to each radiologist, Siegel recommends
that each reading area have individual controls that can be adjusted
for both temperature and the level of ventilation. “Some people
really like air blowing on them; others hate it,” says Siegel. “So
it’s important to allow each radiologist some control over
ventilation and temperature when they are interpreting scans.”
Herbst has an entirely separate part of his office building for him
and another part for his assistant where each can independently
adjust both the temperature and ventilation controls. “She likes it
much warmer than I do, so this way we each can set the temperature
for exactly how we want it,” he says.
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| Noise. The widespread adoption of PACS has in
most cases allowed hospitals and imaging centers to decouple reading
rooms from their former proximity to scanning medium. That has
eliminated the noise that formerly distracted radiologists from
concentrating on interpreting images. However, noise is still an
important factor to consider, especially when radiologists work
together in a larger room or are in a hospital or multi-specialty
group. A solo practitioner, Herbst has installed high-quality
speakers in his office to listen to podcasts and music while he
interprets studies. Hirshorn also listens to music, but if he is in
a room with others, he does so using headphones. Noise canceling
partitions and barriers in walls can help insulate radiologists from
outside noise, minimizing distractions. |
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