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(A) The Eudaimonia Machine, as described by architect David Dewane, is a sequential progression through multiple spaces, each designed for different activities and levels of socialization and interaction. The intent is ultimately to prepare individuals to enter the "chamber" for deep work. (B) The Eudaimonia Machine adapted for the purposes of designing an activity-based reading room. The reading room assistants are positioned at the front of the space (gallery) to both welcome and triage visitors to the reading room; the staff lounge (salon) is for conversation and socialization; the consultation space (library) is for a body and neuroradiology attending radiologist and trainee team to consult with teams visiting the reading room in person; the collaboration space is where most of the day to day reading is performed and where attending radiologist-trainee interaction is facilitated; the deep reading space (chamber) is meant for highly complex studies that require sustained periods of uninterrupted focus.
Source publication
Physical and mental stressors on radiologists can result in burnout. Although current efforts seek to target the issues of burnout and stress for radiologists, the impact of their physical workspace is often overlooked. By combining evidence-based design, human factors, and the architectural concept of the Eudaimonia Machine, we have developed a re...
Contexts in source publication
Context 1
... to the work space, the Eudaimonia Machine is linear and purposeful, each of its five sequential rooms meeting the needs of specific work tasks. The gallery is meant for inspiration; the salon for socialization, inspiration, and fostering creativity; the library for research; the office for light work; and finally, the chamber for deep work (Fig. 1A). Each room follows the other in a sequential progression with one entrance and one ...
Context 2
... the redesign of our reading room, we adapted the Eudaimonia Machine concept for the specific activities and needs of those who work there (Fig. 1B). We envisioned a series of spaces within the reading room: The gallery, or front-facing room, serves as the space for reading room assistants, allowing them to welcome and direct consulting physicians to the correct workstation, and to perform other administrative tasks. The salon serves as a staff lounge for conversation and ...
Citations
... The full univariate data from the physician-specific OSI questionnaire for all the physicians included in the IPD analysis are given in Supplementary material 3. For those included in the IPD analysis, the total OSI scores were higher (x = 87.0 ± 7.8) among the 74 Table 2 for the total OSI scores in relation to CBI personal, work-related and patient-related burnout scores, with the three covariates: age, gender and whether or not assessment was when working during the COVID-19 pandemic. For personal burnout above the median integer cutpoint of 46, both working during the COVID-19 pandemic and unit change in OSI yielded significant ORs, with an order of magnitude greater p-value for unit change in total OSI scores. ...
... Thereby, she could also see her patients without having to search for another room, plus ensuring that she had the chance to take the above-described rest breaks (18,48). In Larsen et al. (74), focus groups of radiologists, referring clinicians and trainees gave their qualitative and quantitative feedback during the process of redesigning radiology reading rooms with "purposeful space" and separate areas for various work activities. Burnout was a noted consideration, but its explicit assessment was not reported. ...
... 270). Along these lines, as noted in Table 4, improved layout for radiology reading rooms appeared to help diminish interruptions, according to some of the physician statements as per (74). In particular, a deep reading space was designed for tasks that "require sustained periods of uninterrupted focus" (p. ...
Background
Physician burnout has become a public-health crisis. The need is dire for robust organizational solutions, focusing on reduction of specific stressors. The physician-specific Occupational Stressor Index (OSI) based on cognitive ergonomics can help. Individual-participant data (IPD) from different studies addressing physician burnout are lacking.
Aims
To perform IPD analysis regarding job stressors and their relation to physician burnout and to utilize the IPD results to inform a systematic review of the stressors that show an association with physician burnout, focusing on intervention studies.
Methods
PRISMA guidelines are followed for the IPD analysis and systematic review of intervention studies on the implicated stressors, taking the COVID-19 pandemic into consideration. The IPD analysis is performed on studies using the physician-specific OSI vis-à-vis burnout assessed by the Copenhagen Burnout Inventory (CBI). Odds ratios (OR) ± 95% confidence-intervals (CI) are reported, adjusting for age, gender and caring for patients with suspected COVID-19 infection.
Results
Three studies fulfilled the inclusion criteria, providing complete IPD data for 95 physicians. Thirty-two (33.7%) physicians had total OSI scores >88, for which intervention is urgently needed. Unit-change in the total stressor burden assessed via OSI yielded OR = 1.11 (95%CI: 1.03–1.18) (p = 0.003) for personal burnout, OR = 1.17 (95%CI: 1.08–1.26) (p = 0.0001) for work-related burnout and OR = 1.07 (95%CI: 1.01–1.15) (p = 0.03) for patient-related burnout. Caring for patients with suspected COVID-19 infection showed significant multivariable results (p = 0.04) only for personal burnout. Twenty distinct work stressors revealed multivariable associations with CBI. Systematic examination via PUBMED, CINAHL and OVID Medline yielded 33 publications mitigating those stressors among physicians. Adequate staffing was pivotal. Clerical staff off-loaded administrative burden. Information-technology staff helped diminish interruptions, enhancing workflow. Cross-coverage reduced time constraints, ensured separate periods for non-clinical tasks, and ≥1 work-free day/week. Several interventions impacted physician burnout, as did recognition of physicians' efforts/achievements. Other OSI-identified stressors were insufficiently examined in intervention studies: e.g. vacation; appropriately-timed, cross-covered restbreaks; and counter-measures for emotionally-disturbing aspects of MD's work, particularly during the pandemic.
Conclusions
Further participatory-action research is needed in well-controlled intervention trials to alleviate physician burnout.
... One field of study that can address these questions is human factors psychology-the study of interactions between humans and systems-here, AI [9]. A few studies have examined human factors in the context of radiology [10][11][12][13]. However, there are no published empirical studies examining human factors among radiologists in the context of AI implementation, although it has been broached in several theoretical papers [14][15][16][17]. ...
Objective:
To examine whether incorrect AI results impact radiologist performance, and if so, whether human factors can be optimized to reduce error.
Methods:
Multi-reader design, 6 radiologists interpreted 90 identical chest radiographs (follow-up CT needed: yes/no) on four occasions (09/20-01/22). No AI result was provided for session 1. Sham AI results were provided for sessions 2-4, and AI for 12 cases were manipulated to be incorrect (8 false positives (FP), 4 false negatives (FN)) (0.87 ROC-AUC). In the Delete AI (No Box) condition, radiologists were told AI results would not be saved for the evaluation. In Keep AI (No Box) and Keep AI (Box), radiologists were told results would be saved. In Keep AI (Box), the ostensible AI program visually outlined the region of suspicion. AI results were constant between conditions.
Results:
Relative to the No AI condition (FN = 2.7%, FP = 51.4%), FN and FPs were higher in the Keep AI (No Box) (FN = 33.0%, FP = 86.0%), Delete AI (No Box) (FN = 26.7%, FP = 80.5%), and Keep AI (Box) (FN = to 20.7%, FP = 80.5%) conditions (all ps < 0.05). FNs were higher in the Keep AI (No Box) condition (33.0%) than in the Keep AI (Box) condition (20.7%) (p = 0.04). FPs were higher in the Keep AI (No Box) (86.0%) condition than in the Delete AI (No Box) condition (80.5%) (p = 0.03).
Conclusion:
Incorrect AI causes radiologists to make incorrect follow-up decisions when they were correct without AI. This effect is mitigated when radiologists believe AI will be deleted from the patient's file or a box is provided around the region of interest.
Clinical relevance statement:
When AI is wrong, radiologists make more errors than they would have without AI. Based on human factors psychology, our manuscript provides evidence for two AI implementation strategies that reduce the deleterious effects of incorrect AI.
Key points:
• When AI provided incorrect results, false negative and false positive rates among the radiologists increased. • False positives decreased when AI results were deleted, versus kept, in the patient's record. • False negatives and false positives decreased when AI visually outlined the region of suspicion.
... In the interior planning of the radiology room, applying a modern minimalist concept, the colors used include green and white to psychologically treat the patient and make the room look more sterile. 9 Judging from the image of the application of materials and the application of color to the interior of this radiology room, the research on the study of the application of materials and colors in the radiology room of the Padang Panjang General Hospital with a modern minimalist concept is an interesting study to do. 4 ...
of radiology room at Padang Panjang hospital Resumen The Hospital is a health service infrastructure that provides complete health care. One of the facilities in the Hospital is the Radiology Room. What is meant by radiology is the part of medical science that studies imaging technology in the form of electromagnetic waves and mechanical waves that function to detect diseased internal organs of humans. The radiology room consists of the C.T. scan room, X-ray, MRI, etc. Radiologists play a very important role in the health sector because radiologists can provide assistance related to surgery, cancer, obstetrics, etc. In designing the radiology building, the architect has quite a role, one of which is applying materials that keep the radiology room sterile and applying safe materials for both staff and patients so that they are not exposed to radiation. The application of color is also very influential on the psychology of the patient and the user as a form of effort to make the user more comfortable while in the room and increase the hope of healing for the patient. The application of color can also reflect the image of the room. The material used in the radiology room is different from the room in general because radiation rays must be muffled and pay attention to the creation of sterility in the room. The methodology in this study uses the method of observation and data collection. Padang Panjang City Hospital is a class B hospital in which there are radiology facilities with a modern minimalist interior concept. The radiology room has 30 cm thick brick walls and is lined with 2mm-4mm thick lead. This is done so that radiation rays can be muffled and patients and users will not be exposed to radiation. This study was conducted to create the application of the right material as an effort to safety and comfort and to apply the role of color in the radiology room to increase the hope of healing for patients. This study applies the concept of a modern minimalist interior, prioritizing the function and effectiveness of the room and furniture. El Hospital es una infraestructura de servicios de salud que brinda una atención integral en salud. Una de las instalaciones del Hospital es la Sala de Radiología. Lo que se entiende por radiología es la parte de la ciencia médica que estudia la tecnología de imágenes en forma de ondas electromagnéticas y ondas mecánicas que funcionan para detectar órganos internos humanos enfermos. La sala de radiología consta del C.T. sala de exploración, rayos X, resonancia magnética, etc. Los radiólogos juegan un papel muy importante en el sector de la salud porque pueden brindar asistencia relacionada con cirugía, cáncer, obstetricia, etc. En el diseño del edificio de radiología, el arquitecto tiene un papel importante, uno de los cuales es aplicar materiales que mantengan estéril la sala de radiología y aplicar materiales seguros tanto para el personal como para los pacientes para que no se expongan a la radiación. La aplicación de color también influye mucho en la psicología del paciente y del usuario como una forma de esfuerzo para que el usuario se sienta más cómodo mientras está en la habitación y aumentar la esperanza de curación del paciente. La aplicación de color también puede reflejar la imagen de la habitación. El material utilizado en la sala de radiología es diferente al de la sala en general porque los rayos de radiación deben amortiguarse y prestar atención a la creación de esterilidad en la sala. La metodología en este estudio utiliza el método de observación y recolección de datos. El hospital de la ciudad de Padang Panjang es un hospital de clase B en el que hay instalaciones de radiología con un concepto interior moderno y minimalista. La sala de radiología tiene paredes de ladrillo de 30 cm de espesor y está revestida con plomo de 2 mm a 4 mm de espesor. Esto se hace para que los rayos de radiación puedan amortiguarse y los pacientes y usuarios no estén expuestos a la radiación. Este estudio se realizó para crear la aplicación del material correcto como un esfuerzo por la seguridad y la comodidad y para aplicar el papel del color en la sala de radiología para aumentar la esperanza de curación de los pacientes.
... Extracting from the Eudaimonia architectural concepts tested at The Children's Hospital of Philadelphia, different sections within the department may be created where the level of distraction aligns with the task being performed. A less accessible section can be turned into a "distraction-free" area to allow deep focussed work, while the on-call service can occur in an area allowing for moderate to considerable distraction [6]. ...
... In their ethnographic study of reading room interruptions, Smith and colleagues [4] reduced the time between interruptions by more than 80% through strategies that included a resource radiologist who handled non-interpretive tasks, a restructured phone tree to route calls through a team of reading room assistants, transferring authority over image questions and answers to technologists, and clear signage to direct visitors to the appropriate radiologist. A more elaborate idea would be to change the layout of the reading room to include conferencing/social space (for tasks where there are expected interruptions but there is no obligation to produce reports during that rotation) alongside deep-thinking space that is insulated from all interruption [12]. To support such a change, a department would need to revamp workflow and embrace an interdependent team approach. ...
The field of radiology has benefited greatly from the technological boom that has brought greater precision, efficiency and utilization amid an exponential growth in medical science. The downside is that the same technology that has allowed the field to grow is contributing to an erosion of interpersonal communication and connection with patients and referring physicians. Remote reading has displaced us from the communal reading room, where much interaction and teaching used to take place. The “invisible” radiologist must transcend these barriers in order to preserve and strengthen the role of radiology in medical care. With modest adaptation, radiologists can regain their identity as consultants, where they have the greatest chance to show their value and thwart the drive toward commoditization.
Breast radiologists have high rates of burnout. Some contributing factors include the sedentary nature of the occupation, reading room design and isolation associated with higher volumes, and increased remote interpretation. Reading rooms can also be filled with numerous distractions and produce conditions that do not support optimal workflow. Identifying and addressing these issues may help prolong physician careers and increase overall productivity. This article presents approaches to improve wellness for breast imaging radiologists and reduce the overall rate of burnout.
Misdiagnosis in breast imaging can have significant implications for patients, healthcare providers, and the healthcare system as a whole.
Some of the potential implications of misdiagnosis in breast imaging include delayed diagnosis or false reassurance, which can result in a delay in treatment and potentially a worse prognosis. Misdiagnosis can also lead to unnecessary procedures, which can cause physical discomfort, anxiety, and emotional distress for patients, as well as increased healthcare costs. All these events can erode patient trust in the healthcare system and in individual healthcare providers. This can have negative implications for patient compliance with screening and treatment recommendations, as well as overall health outcomes. Moreover, misdiagnosis can also result in legal consequences for healthcare providers, including medical malpractice lawsuits and disciplinary action by licensing boards.
To minimize the risk of misdiagnosis in breast imaging, it is important for healthcare providers to use appropriate imaging techniques and interpret images accurately and consistently. This requires ongoing training and education for radiologists and other healthcare providers, as well as collaboration and communication among healthcare providers to ensure that patients receive appropriate and timely care. If a misdiagnosis does occur, it is important for healthcare providers to communicate with patients and provide appropriate follow-up care to minimize the potential implications of the misdiagnosis. This may include repeat imaging, additional biopsies or other procedures, and referral to specialists for further evaluation and management.
Question What factors most contribute to and what implications stem from misdiagnosis in breast imaging?
Findings Ongoing training and education for radiologists and other healthcare providers, as well as interdisciplinary collaboration and communication, is paramount.
Clinical relevance Misdiagnosis in breast imaging can have significant implications for patients, healthcare providers, and the entire healthcare system.
