AIUM: Ultrasound ergonomics key to quality care

ORLANDO, FL - Ultrasound ergonomics is key to quality patient care because if sonographers aren't healthy, the quality of their service suffers, according to a presentation Monday at the American Institute of Ultrasound in Medicine (AIUM) meeting.

What's needed is a framework for improving not only the big ergonomics problems often found in the ultrasound suite, but also the small ones, presenter Kevin Evans, PhD, of Ohio State University in Columbus told session attendees.

"The goal is to promote the importance of total worker health across the health system," he said.

Ergonomics can be defined as the interaction between humans and other elements of a system that hopefully improves human well-being as well as the overall system performance, Evans said.

The way things often work now, patients are at the center of the healthcare enterprise -- which is appropriate -- but providers are often lumped in with equipment and tools. Instead, healthcare providers need to share that center spot to make the work system safer and more effective.

"The current hospital work framework puts the patient in the center, with other factors such as methods, tools, tasks, and care environment in service of patient health and satisfaction outcomes," he said. "I'd suggest an improved framework for a hospital work system would put patients and staff in the middle, adding staff health, comfort, and functional capacity to the list of desired outcomes."

It can be relatively easy to fix some of the "macro" ergonomics problems, such as adding an adjustable chair and exam couch to the imaging area. But smaller problems, such as nonadjustable ultrasound equipment, need to be addressed.

"Microergonomic interfaces have to facilitate the staff to complete their method of imaging without undue stress and strain," Evans said.

And it can be difficult to communicate to hospital administrators the need for ergonomic ultrasound imaging, according to Evans.

"The hospital administrator is cued in to tracking injuries in nurses, but they may not have a clue what sonographers are doing," he said. "So we've got a lot of educating to do with higher hospital administrators. And even if department chairs are aware of the issue, they're in a quandary because their financial resources are dwindling."

The issue of ergonomics must be addressed across a range of hospital departments, Evans said.

"Radiology has historically provided bedside diagnostic examinations for chronically ill patients, but there's often not enough room," Evans said. "How can this scenario be reimagined? As well, emergency medicine has historically had critically ill patients in bays or pods to provide trauma care. How can ultrasound be provided so that both patient and provider are safe? And for ob/gyn, how can the traditional private exam room be made more flexible to accommodate safe and reliable ultrasound imaging?"

Ongoing conversations are needed to determine ways to implement ergonomic tools and protocols, Evans concluded. The goal would be total worker health -- a U.S. Centers for Disease Control (CDC) approach that seeks to improve well-being in the workforce for the benefit of not only the workers but also those they serve.

"As methods for providing care to patients change and grow, sonologists and sonographers have to continue learning and adapting the examination schedule, length of time, and quality oversight," he concluded. "We cannot do things the way we've always done them. We need to adapt and rethink how we image."