Case Study: Maintaining Productivity

Productivity is a primary concern in every radiology department. Yet, productivity is adversely affected when sonographers experience injury due to work-related musculoskeletal disorders (WRMSDs), the result of tissue trauma brought on by repetitive motions, forceful or awkward movements, duration of pressure, poor posture or improper positioning and excessive force or strain during ultrasound exams.

While many injuries are diagnosed and treated, almost a quarter of sonographers’ careers end as a result of their injuries, meaning hospitals and clinics are losing experienced sonographers.
Lexington Medical Center, located in one of South Carolina’s fastest growing communities, is a 346-bed metropolitan medical complex that anchors a comprehensive, countywide healthcare network.

Seeking to increase productivity and improve efficiencies in performing patient ultrasound exams, Lexington implemented Andover, Mass.-based Philips Medical Systems’ iU22 ultrasound system with protocols.

Protocols address ergonomic issues by providing sonographers with a tool that eliminates repetitive motion that can lead to WRMSDs, as well as a more ergonomically friendly design to help reduce sonographer stress during patient scans.

Scanning in Pain

In Beth Lindler’s 22 years working as a sonographer, she only began experiencing pain in the past year-and-a-half. Lindler’s symptoms included tenderness and pain at the medial epicondyle, which was made worse by flexing her wrist and applying pressure in order to acquire scans of larger or obese patients. She also experienced pain in the palm of her left hand from typing.

“As patient sizes have increased due to obesity, sonographers now need to press harder to get an optimal image, which causes stress on the wrist and elbow,” explains Lindler. “The constant need to press harder to compress the tissues has caused medial epicondylitis, or ‘golfer’s elbow.’ Then, I began experiencing pain in my left hand from the years of typing for annotation and constant squeezing of the gel bottle for exams.”

Her pain, which at first was limited to scanning of larger patients, eventually became so excruciating that it kept Lindler awake at night.

“When the pain became too severe, I had to file a worker’s comp claim, which kept me off the job for two months,” says Lindler. “When I did return, I was limited in scanning, which also affected our department’s productivity and efficiency, since we were down a sonographer. My injuries were so severe, that I had to consider a career change as a very real possibility.”

The Benefits of Protocols

As Lindler gradually increased her workload, she began utilizing the protocols feature, which is part of the Philips ultrasound system that Lexington had implemented. What Lindler realized was literally career-changing.

“As I used the system, I found that the transducer penetrates better so I don’t have to press as hard on the patient to obtain a quality image,” says Lindler. “With protocols’ automatic annotation, I don’t have to type anymore, which means a quicker exam time and allows me more time to rest my elbow, which is continuing to heal.”

After one month of using protocols, Lindler says her pain is almost completely gone.

“I still use the brace during scans since my right elbow is continuing to heal, but it does not hurt anymore during my normal life, and since the machine does most of the work in annotation, my left hand is totally healed,” she says.

In her department, Lindler says the radiologists also are pleased with the protocols feature, as they now have consistency in the images taken. They also like the report page that lists all the measurements.

“While we were all a bit skeptical at first, thinking protocols would be too rigid, we discovered the system is actually an ideal blueprint that you can add to or subtract from to provide a thorough exam,” Lindler says.

“If you decide to skip a view and come back to it later, this is done by the simple turn of a knob. After you freeze and store your image, the next annotation automatically is displayed. It provides consistency in measurements, exams and reports that are critical for radiologists and also saves each of us a tremendous amount of time. I’m now spoiled and don’t think I would like to go back to having to type.”


— Lisa Brandli is a syndicated journalist. Questions and comments can be directed to editorial@rt-image.com.