Simple changes can lead to comfort on a shoestring

Few sites have the resources to redesign from scratch when making the shift to soft-copy reading. But even departments that are taking a step-wise approach to digital integration can incorporate simple ergonomic principles without making an enormous investment.

One solution involves self-contained workstation units that incorporate furniture, ventilation, heating, and lighting. Originally designed for the nonmedical market, they have been adapted for radiology workstation applications. One such all-in-one unit by Poetic Technologies was displayed at the 2003 RSNA meeting.

"We've seen some nonmedical solutions in the range of $2000 to $5000 or so," said Dr. Eliot Siegel, chief of radiology and nuclear medicine at the VA Medical Center in Baltimore. "These are units that can be dropped into an existing area without extensive architectural changes."

Units equipped for radiologists' use are likely to range a bit higher, however. Siegel estimates these would cost between $5000 and $10,000.

Other ad hoc tips for soft-copy ergonomics can help a practice avoid breaking the bank:

Determine what is more important: collegiality or acoustic privacy. Finding out what suits the environment best in terms of noise can help identify solutions, said Bill Rostenberg, vice president of Smith Group Architects and Planners of San Francisco.

"It's relatively easy to change materials and finishes to provide wall, floor, and ceiling surfaces that dampen sound," he said.

Swap out fluorescent lighting with indirect, adjustable room lighting that provides an even level of illumination, Rostenberg said.

Supplement room lighting with adjustable task lighting at workstations. Install variable-height worktables for monitors and keyboards. Simply switching from fixed-height data tables to adjustable ones can make a huge difference in reading comfort.

Keep alternators and workstations separate, as alternators create nightmarish glare for monitors. If possible, eliminate use of alternators entirely, said Tom Hanson, an applications specialist at Froedert Hospital in Milwaukee.

"We didn't want the glare or the noise," he said. "We got everyone to agree to bite the bullet and get rid of the alternators. They're not missed."

Make adjustments as needed to "the three points of contact." Rostenberg notes that ergonomics are based on these three points: where eyes interact with computer monitor, where fingers contact keyboards, and where the user's body rests in a chair. Adjustments to any or all of the above will go far toward achieving an ergonomic environment.

If the budget can afford only one reading room luxury, make it a Herman Miller Aeron chair for each radiologist, said Paul Nagy, director of the radiology informatics laboratory at the Medical College of Wisconsin. At well under $1000, the chairs cost little compared to monitors. And if the chair lasts four years and is used for eight hours a day, the cost breaks down to about 9¢ an hour.

"It's like a Porsche," he said. "Your radiologist will love you for it. How much is that worth?"