Making Adjustments
By Keith Loria
Radiology Today
Vol. 25 No. 7 P. 18

Tools for Addressing Ergonomic Needs

More than ever before, radiologists are aware of how ergonomics can not only improve their work performance but enhance their lives as well. However, there are challenges to creating the ideal environment. A significant challenge is home reading, which is becoming more prevalent and presents ergonomic issues.

“While it’s natural to think people are more comfortable at home, in actuality, it can be a much larger ergonomic challenge,” says Dave Minamoto, product and sales manager of ergonomic workstations for Double Black Imaging. “People tend to naturally assume they will be more comfortable and productive at home and, because of this, will tend to not pay attention to proper ergonomics. Almost everyone has a desk at home, but is it the correct environment for what they are actually going to be doing? Many times, it is not.”

Amar Shah, division chief for cardiac imaging of radiology at both North Shore University Hospital and Long Island Jewish Medical Center in New York, says striking the balance between maintaining productivity and a healthy lifestyle can be challenging at times. “The increased volume we face and the need to complete the work in a timely manner keeps many of us captive to our chairs and desks,” he says. “Reminding ourselves to stand, walk, and use the time to reflect is essential to mitigating burnout and promoting well-being.”

Over the years, Shah has seen four major changes in ergonomic design that have brought improvement— the use of advanced generation mice, including gaming mice, to improve hand and wrist positions and reduce inefficient/unnecessary clicking; the integration of headsets for radiologists who prefer voice commands for dictation, as an alternative to holding and clicking on microphones; the use of standing desks that allow radiologists to alternate positions; and a willingness to use different types of chairs to reduce back pain.

“New ergonomic tools have helped radiologists focus more on their well-being in the workplace,” he says. “By incorporating movement, self-reflection, and different ergonomic tools, radiologists have seen reduced back pain, wrist discomfort, and achiness that were often experienced from prolonged desk work.”

In Shah’s opinion, newer tools have been instrumental in addressing ergonomic needs. “Adjustability is very important,” he says. “When you are uncomfortable at your desk, you can spend extra time making various adjustments to get yourself in a position to work. That is time that is taken away from your ability to focus on the clinical conundrum or diagnosis in front of you. The better you feel when at your desk, the easier it is to focus on your work. And the better you feel, the more likely you are to be productive.”

Nisha Mani, MD, a diagnostic radiologist at HCA Florida Aventura Hospital, says more images are being produced today than ever before, which creates more eye strain, wrist issues, and back pain. “We use the sit/stand desk here, and that’s very helpful; I’ve noticed a big difference because we typically work eight to 10 hours, and you really need to change your positions, so it’s very important,” she says. “There’s also a mouse that allows you to program extra buttons to decrease the reliance on the keyboard.”

Evolving Ergonomics
For a long time, equipment that was designed for other uses was modified to fit radiology departments, but that meant compromises and forcing radiologists to adapt to the furniture, which runs contrary to best ergonomic practices.

That’s why Double Black Imaging’s desks are purposefully built for radiologists, by radiologists, Minamoto says. The company analyzes data and feedback from customers and collaborates with people in the medical imaging industry. For example, Double Black’s Phoenix II has several features that reduce strain for radiologists, including an electronic height-adjustable work surface that allows for sitting and standing options when working; independent preset heights for both the work surface and monitors; a quick transition time between positions, as well as between multiple users; and a waterfall front work surface edge that increases the contact area when resting arms on the work surface, which reduces arm/hand tingling caused by impingement of nerves and blood flow.

“Our products incorporate design elements specifically suited for radiology—especially our proprietary EZ-Track monitor mounting system,” Minamoto says.

Jeff Vanden Bosch, president of Ergo- Quest, Inc, which is known for its zerogravity workstations, says the company’s focus with radiology furniture is solving pain issues—especially back pain and circulation issues that often crop up. The goal is to create a balance between functionality and technology advancements.

“Our workstation offers options, particularly position options, including a zero-stress position, that allows for a different way of working, which most people have never tried,” Vanden Bosch says. ErgoQuest’s workstations not only recline to zero-gravity positions but also offer a motorized backrest, seat, and leg rest angles that are custom-sized to users’ body dimensions. In addition, they have an adjustable keyboard and mouse tray.

“Most of our clients aren’t especially interested in the design, so we focus on function,” Vanden Bosch says. “We want to be sure we can give them whatever body positions they need to access the technology without hurting themselves over the long hours they work.”

Steve Reinecke, senior director of business development for RedRick Technologies, which manufactures custom ergonomic workstations, says each piece of furniture and workstation is designed to ensure comfort and efficiency, no matter how challenging the setting may be. “We have options that work in whatever space is available,” he says.

Reinecke cites three major factors that require adjustability to provide an effective ergonomic solution. They are: “sit to stand,” the height of the monitor relative to the mouse and keyboard so a user’s neck is in an optimal position, and a monitor mount that can adjust the entire monitor array to allow a radiologist to work with a single, unbroken surface. “Those three functions need to be quick and easy,” he says.

Gathering Feedback
As a result of manufacturers working with radiologists and collecting feedback to improve equipment ergonomics, improvements have been made throughout the industry.

“In collaborating with radiologists, I analyze and ask questions to get them thinking outside of what their normal setup has typically been,” Minamoto says. “Such questions help us determine what can make radiologists more comfortable and productive in the reading room. Why should they have to conform to their workspace? I want to show our radiologists that just because something is the way it is right now, that doesn’t mean it must be that way. We don’t want them making compromises when it comes to their health and well-being.”

Mani feels that talking with manufacturers about ergonomic challenges is a significant opportunity because radiologists best understand what is working and what is not. Some changes she would like to see in future design include more desk options that are individualized for a radiologist’s body type and solutions that reduce the need for a keyboard and mouse, “maybe done virtually somehow,” she says.

“Ergonomics is very important because it helps with mental activity and allows you to focus more on what you’re doing and provide the best job,” Mani says.

As with radiologists, radiologic technologists often provide feedback about how to improve software tools they engage with, for example, reducing the number of “clicks” needed to use a tool or advocating for automation when possible. “Radiology technologists often focus on how our technology needs to reduce the number of steps and clicks for our technologists using equipment such as CT and MR and, in ultrasound, to make things such as probes and screen design more optimal for our team,” Shah says. “We recognize that technologists need ergonomic enhancements, too.”

Double Black takes a four-tiered approach to research and development. This consists of analysis, assessment, design, and prototyping.

“We analyze their needs and observe radiologists as they work so we can determine pain points through observation and discussions,” Minamoto says. “We complete onsite assessments to look at current environments, equipment, and workflows, then we identify strengths and weaknesses and look at ways we can improve their physical performance while ensuring a productive workflow. We then integrate application-specific findings, using tools such as Rapid Upper Limb Assessment, to develop product designs and see it through the prototyping and testing process.”

The bulk of the information on the utility of the company’s products is based on partners’ feedback through postdeployment follow up. “We have a [return on investment] calculator that we share with our partners during this process so they understand how impactful these ergonomic changes are,” Minamoto says. “Given the importance of diagnostic imaging in health care, it’s easy to see how much of an impact ergonomic improvements can have on patient care and the radiologist’s health.”

Moving Forward
It’s not enough to have the right furniture and equipment; radiologists must be properly trained and educated on how to use everything correctly. “While some of the education process is directing/instructing radiologists on how our products improve ergonomics, the bulk of what we do tends to be asking questions and having our customers self-discover,” Minamoto says. For example, Double Black asks questions such as, “Do you ever look at images up close?” or “Does this cause any discomfort/ pain in your neck/shoulders?”

“We tell them, instead of leaning forward, try moving the monitors closer or farther away using the EZ-Track and see if that helps,” Minamoto says. “Without knowing other, more ergonomic ways exist, we fall into the trap of conforming to our environment. Improving ergonomics is a way to get our environment to conform to us, not the other way around.”

Reinecke says it’s important to work with the radiology team and make sure they understand how to get the most from their workstation. It’s a conversation that helps both sides. “We put a lot of effort into being face-to-face with clients in their reading rooms to collaborate and hear from them what their struggles are,” he says. “That has helped to develop future products as well.”

The reading room of the future, Shah posits, will adapt to the needs of younger people in the industry. “One area to consider is how to build a collaborative in-person or virtual reading room that integrates physician and emotional wellness tools into our immediate environment and day-to-day practice,” he says. “Integrating chairs and desks that can rotate, recline, and allow the reader to be in more than just a sitting or standing position may allow team members to work in a more comfortable position and integrate virtual technology for viewing images.”

An additional change to consider is the increased ability to use Bluetooth technology for dictation from a singular device, he says. Removing the need to be tethered to microphones has the potential to reduce the incidence of repetitive wrist injury.

Creating an environment where radiologists have tools to reduce workplace-related injuries is incredibly important in not only reducing repetitive injuries but also keeping the entire team satisfied. “By introducing these types of tools for our team, we signal that we take their well-being seriously and want them to be healthy and focused while doing their work,” Shah says. “This gesture, while seemingly small, can go a long way to promoting a culture of wellness and reducing burnout.”

— Keith Loria is a freelance writer based in Oakton, Virginia. He is a frequent contributor to Radiology Today.