Ergonomic Radiology Reading Rooms

As ergonomics and the sit/stand desk movement become more mainstream, many radiologists are making tweaks or complete overhauls to their reading rooms.

This allows radiologists to customize their work space while allowing better flow and collaboration among other radiologists and also with referring physicians.

As a certified ergonomist, Dawn Harman, encourages radiologists to use a sit/stand desk, and to stand for at least 20 minutes an hour. “So many times when I go in, they’re doing “turtleneck,” with their face close to the screen and their shoulders hunched over. “It’s not proper positioning,” she said. That leads to neck, back, and shoulder issues. Moving around is important for a person’s health.

Harman is also a sales manager with Evolve Ergo Workplace in New Hampshire, providing reading room design consultation. After the company installs the products, she returns to make sure the radiologists are using the equipment properly and getting the ergonomic benefits from their new equipment and design.

Here are ergonomic reading rooms that have affected work flow and comfort for the radiologists working there.

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This reading room at the University of Pennsylvania, was designed by RedRick Technologies to be an open and collaborative environment.

“Often you’ll find that radiologists don’t like their backs to people coming up behind them. In an academic setting this works well,” said Greg Patrick, RedRick’s President. That’s because there’s more collaboration in this environment, and it’s easier for physicians to gather around a station or move between stations this way. “When something interesting is being reviewed at a particular work station, they’ll push back and roll over (in their chairs), to gather around that work station.” The sit/stand desks quickly adjust to the reader’s preference.

While not sound-proof, this room has sound-absorbing panels on the walls to reduce echo and reverberation in the room. The ceiling tiles have a high noise absorption rating, higher than normal acoustic tiles, Patrick said. The panels between the work stations also absorb sound. The floor is made from recycled rubber. Not only is it environmentally friendly, it’s more comfortable to stand on and also absorbs sound. “It’s not much better than carpet (for absorbing sound), but carpet can become a house keeping nightmare.”

The ambient light source is behind the monitors, creating a soft glow along the walls and reflecting from the ceiling. The main fluorescent ceiling lights are turned off, and there’s no light source from the top coming down. “You want to balance the illumination between the monitors and the visual field surrounding the monitors. This is proven to help reduce eye fatigue,” said Patrick. “You don’t want a dark room or an overly bright room.”

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When George Bisset, MD, chief of pediatric radiology at Texas Children’s Hospital interviewed there more than seven years ago, he found that the reading rooms were fragmented, scattered around the hospital. Previously, referring physicians might have to seek out subspecialty readings from several reading rooms around the hospital for information on a single patient. For a cancer patient, for example, that physician might go to one station for a chest CT searching for lung metastasis, a reading room elsewhere for primary tumor activity in PET scans, and a third office for an MRI of the lower extremity.

“One thing I had experienced at other institutions before was that if you’re trying to get collaboration from a research and teaching perspective, and even clinically consulting with your colleagues, you’d like to be able to take advantage of that expertise in the same room,” Bisset said. He told the Texas Children’s Hospital CEO that he wanted to create a large reading room where radiologists could work individually, but have group workstations for larger discussions.

They created a reception or concierge station at the entrance, with two facilitators stationed there. They answer incoming phone calls and direct referring clinicians to the right workstation.

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Bisset describes their reading room as large, with about 20 workstations. The room has some artificial divisions, with the body imagers on one side, nuclear medicine along one wall, and neuroradiology along another wall. The workstations in the middle are “flex stations,” which can be used by any subspecialist.

The room uses back-lit lighting from behind the workstation, which makes it a calming environment and promotes a quiet atmosphere. Previously the lighting in each separate reading room at Texas Children’s Hospital was different, as was the ergonomics of the workstations. Each time a radiologist switched to a different room, that physician needed to adjust to the phone location, log-in area, microphone location, desk type, soundproofing, etc. Now it’s standardized.

Each station has a small gooseneck light coming from the left side of the work space, which is good for consulting a book, like if a radiologist needs to look up bone age calculations. The light positioning does not disturb other radiologists.

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At the Texas Children’s Hospital reading room, people approach the radiologists’ reading area from the periphery, not the back. “It still serves a collaborative environment, but gives the radiologist a little more seclusion for getting the work done,” Patrick said of the RedRick-designed room.

Each station adjusts for desk height (standing or sitting), which takes 10 seconds – it’s electronically controlled. The monitors are adjustable, as are the chairs. “They are more comfortable and now I don’t hear anyone complaining about their backs. I haven’t heard a single complaint about ergonomics in this environment,” Bisset said.

The feedback about the room has been outstanding. “When people come from other institutions to visit us, they’re wowed by the appearance.” If Bisset were to tell the hospital’s radiologists that they were going back to the old system, he said there would be a revolt.

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This Breast Imaging Center at Juravinski Hospital in Hamilton, Ontario, is similar in layout to University of Pennsylvania’s reading room. This one has three stations and is a collaborative environment as well. “A lot of surgeons come in the morning. They entertain a lot of visitors in this room,” said Patrick. “This has been quite a success for them, to enhance their relationships.”

Juravinski’s room uses acoustical partitions, blue lighting, and sit/stand work stations, Both the desktop and monitor sets are independently height adjustable. There’s no cable clutter on the floor. While not a specific ergonomic issue, cables can trap dust as well as create tripping hazards. The cables are incorporated into the desk, and the computer CPU doesn’t sit on the floor.

“With ergonomics, you think of the chair being adjustable or the desk going up and down,” said Patrick. “Ergonomics is the relation of the human in the work place. Everything in the zone that affects the human being is part of the discussion, including clutter in the workspace. It’s important to have all the things you need in the workplace positioned appropriately without your feet getting caught up. That may not be a physical stress, but a mental one.”

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This reading room at Elliot Hospital in New Hampshire contains three work spaces, with two seen in the photo, and the third behind the bookcase. Elliot is a smaller community hospital, not an academic environment. “It’s a place for radiologists to be sequestered and get the work done,” Patrick said. RedRick used lines and curves to create a customized environment to give the radiologists privacy to focus, along with a collaborative place in the middle for colleagues to gather.

In addition to the adjustable desks, monitors and chairs, the phone is on an articulated arm. That keeps the phone in reach, but off the desk.

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RedRick created a collaborative reading room for a research hospital in Tennessee. They designed it with two zones, one for neuroradiologists and one for body imagers. The groups are separated by glass panels so they could still have a good visual connection with colleagues through the glass, but maintain some acoustic control. “One group could be more vocal, but each group has different styles of working,” Patrick said. The workstations face inward for increased collaboration and conversation.

As with other ergonomic work stations, they incorporated acoustic panels on the wall, blue ambient lighting, and sit/stand desks with adjustable monitor stands.

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With goals of saving radiologists’ time, increasing the flow, and decreasing radiologists’ physical stress, John Mukai, MD, and David Bader, MD, of St. Vincent Hospital’s Department of Radiology in Worcester, MA, and Eliot Siegel, MD, from University of Maryland School of Medicine, are developing work stations that include six to eight monitors, and wireless headsets that allow radiologists to talk on the phone and dictate, while not physically connected to the computer.

Mukai said that previously he used two work stations, one with four monitors and the other as a two monitor specialty station, like for PET imaging or cardiac CT. Their innovation was to use the same six monitors, but attach them to one computer and run both applications on that computer, with one keyboard and one mouse. Their specialty monitors were, portrait (tall) ones, giving better visualization. 

Mukai estimates that a four-monitor workstation already costs about $20,000, and modifying it to be a six monitor station only cost another $1,000 for the additional monitors and video card, or $2,000 for four monitors. Their system uses a sit/stand table from RedRick. In this photo, the station uses six30-inch monitors in portrait style. These are 4MP fusion monitors reengineered by Barco. Working as RadFlowSpace, Mukai, Bader, and Siegel have a workstation design laboratory in Worcester where they test out their designs.