Analysis of the X-ray Work Flow in Two Diagnostic Imaging Departments With and Without a RIS/PACS System

University of Camerino, Camerino, The Marches, Italy
Journal of Digital Imaging (Impact Factor: 1.19). 02/2006; 19 Suppl 1(S1):18-28. DOI: 10.1007/s10278-006-0858-3
Source: PubMed


A traditional radiological workflow is compared with one based on radiology information system/picture archiving and communication system (RIS/PACS). X-ray workflow process was considered in both radiology departments. First, the study identified the main phases of the research work as follows: Process Analysis, Data Collection and Elaboration, Interpretation. Afterwards, the main steps of the whole image acquisition process were defined, and each step was divided into a number of elementary operations. Then, the time required to complete each of these was measured. Data collected were elaborated and synthesized to obtain time frequency distributions for each step and evaluation of the total time for the whole working flow. Statistical elaboration of the collected data shows that x-ray working time decreases, between 35% and 57%, when RIS/PACS is used. Detailed analysis of the whole working process allows identification of possible critical points to improve the image acquisition process.

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    • "Data of this work were elaborated with similar statistical procedures of the quoted article. Unfortunately, we have to work with different time intervals, due to different measuring methods (manual, stopwatch [5] and electronic, extracted from RIS/PACS, this work). However, we can give a positive meaning to the time difference. "

    Intelligent Information Management 01/2010; 2:178-182.
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    • "Previous studies show wide divergence in research findings, e.g. workflow (Mariani 2006), PACS integration with other health systems (Kolovou 2005), hardware and infrastructure aspects (Brelstaff et al 2001), leadership and changes in the radiology department (Bedel 2004, Lawrence 2005), as well as effects of PACS on work practice (Yu 2005) . "
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    ABSTRACT: Radiological departments are changing rapidly due to the implementation of digital images and PACS (Picture Archiving and Communication Systems).The introduction of new technology seems to dissolve boundaries between the professions in the work environment where the technology is introduced. This process tends to change the organization and its routines.The aim of this qualitative study is to explore changes in radiographers' work with regard to skills, work practice and technology. The study used open-ended interviews to explore the radiographers' perceptions of such changes, and to identify problems and solutions pertaining to work practice. Inspiration is taken from grounded theory to explain the changes in work that were found. Respondents were selected from a total of 133 potential participants as a theoretical or purposive sample.The changing trends within the professional role indicated that radiographers, as image producers, shifted their focus from the ability to set the optimal exposure parameters in order to obtain the optimal image for diagnosis to become expert in exposure parameters, projection techniques and diagnostic practice, having multifaceted skills, as being the jack of all trades. When implementing PACS there was an obvious change in image production. At the start there were visions of new routines, and therefore the radiographers became early adopters to the new technology; in practice the organization was stacked in old routines, as the routines were inflexible and PACS work was pushed into old work routines. Although inflexible, this does not mean that they cannot change, and obviously in 2006 new routines had been implemented making it possible for the radiographers in finding new ways for collaborating with colleagues. The new technology immediately created a vision of improved service to the clinicians. In order to optimize the service the radiographers developed an insight into the need for a more comprehensive change in work using a new PACS technology and digital workflow. Using PACS technology, together with an adjustment to the new system workflow, the experience among radiographers was that the production of images increased and as a result the stress in work increased as well. Using PACS technology, medical staff had little control over the organization of image production and its workflow, so that radiographers experienced PACS as a more technical deterministic system allowing small human control in the organization of work.
    Radiography 05/2009; 15(2-15):121-133. DOI:10.1016/j.radi.2008.03.002
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