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Radiology departments were forced to make significant changes in their routine during the coronavirus disease 2019 pandemic, to prevent further transmission of the coronavirus and optimize medical care as well. In this article, we describe our Radiology Department's policies in a private hospital for coronavirus disease 2019 preparedness focusing on quality and safety for the patient submitted to imaging tests, the healthcare team involved in the exams, the requesting physician, and for other patients and hospital environment.

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Diagnostic error and diagnostic delays in health care are widespread. This article outlines an improvement effort targeting weekday evening inpatient radiology delays through staffing changes replacing trainees with faculty-trainee team coverage, pushing faculty coverage from 4 pm to 8 pm. Order-report turnaround times (TATs), critical findings TATs for pneumothorax and intracranial hemorrhage (ICH), and percentage meeting target were compared pre and post implementation for the 4 to 8 pm time frame using the Mann-Whitney U and χ2 tests, respectively. Stakeholder surveys assessed patient safety, morale, education, and operational efficiency. Median TATs (minutes) improved: X-rays 906 to 112, computed tomography 994 to 84, magnetic resonance imaging 1172 to 233, and ultrasound 88 to 58. Median critical findings TATs (minutes) improved from 853 to 30 and 112 to 22 for pneumothorax and ICH, respectively, and the percentage meeting target improved from 45% to 65%. Survey results reported perceived improvement in patient safety, education, and operational efficiency and no impact on morale.

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ABSTRACT Radiology departments were forced to make significant changes in their routine during the coronavirus disease 2019 pandemic, to prevent further transmission of the coronavirus and optimize medical care as well. In this article, we describe our Radiology Department's policies in a private hospital for coronavirus disease 2019 preparedness focusing on quality and safety for the patient submitted to imaging tests, the healthcare team involved in the exams, the requesting physician, and for other patients and hospital environment.

RESUMO Os departamentos de radiologia precisaram adotar mudanças significativas em sua rotina durante a pandemia da doença causada pelo novo coronavírus, a fim de reduzir sua transmissibilidade e otimizar os cuidados médicos. Neste artigo, descrevemos as políticas adotadas pelo Departamento de Radiologia de um hospital privado durante a pandemia, com foco em qualidade e segurança de paciente submetido a exames de imagem, equipe de assistência do departamento de imagem, médico solicitante, demais pacientes e ambiente hospitalar.

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INTRODUCTION: The timely reporting of critical findings is considered by the Joint Commission as one of the main patient safety goals. Delays in critical radiological findings communication are directly related to delayed treatment initiation and death, constituting a major cause of medical malpractice suits. The aim of this study was to evaluate the impact of an educational initiative performed to reduce the notification times of critical radiological findings. MATERIALS AND METHODS: All records of critical findings reported in the Radiology Department were evaluated. The notification times before and after performing the educational intervention taking into account the patient type, study, and critical diagnosis were calculated, evaluated, and compared. T test and chi-square test were used for statistical analysis, considering a p value less than 0.05 to indicate statistically significant differences. RESULTS: We included 1949 reports, 805 before (41.3%) and 1144 (58.7%) after the intervention. Before the intervention, the mean time of critical finding report was 2.85 h for emergency patients and 3.07 h for hospitalized patients. After the intervention, a statistically significant decrease in the notification time was observed with a mean of 1.37 h for emergency patients and 2.43 h in the hospitalization patients. A statistically significant increase was observed in the proportion of reported findings in less than 15 min (7.08%, p < 0.01), 45 min (45.55%, p < 0.01), 60 min (55.86%, p < 0.01), and 120 min (80.68%, p < 0.01). CONCLUSION: The healthcare process in the Department of Radiology involves multiple actors who must be sensitized in the identification and reporting of critical radiological findings in order to reduce the notification times. Ensuring effective communication of critical findings is indispensable to ensure timely medical treatment.

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El principal problema del Servicio de Radiología del Hospital “EL RODEO” ha sido y ha fundamentado este trabajo, “la falta de información”, la cual nos impide conocer la cantidad necesaria de profesionales, insumos que necesita y tipos de prestaciones que brinda este Nosocomio, evidenciando las falencias en la gestión hospitalaria. Satisfacer esta necesidad nos va a permitir realizar una medición y posterior planificación para poder desarrollar un servicio continuo y eficaz a la población. Es por ello que el Objetivo principal es “Elaborar un análisis epidemiológico de la utilización de prestaciones radiológicas en el Hospital de El Rodeo”. En la gestión de los servicios de salud se recurre a las mediciones epidemiológicas para resolver el tipo y cantidad de servicios a ofrecer a la población a cargo y evaluar sus efectos e impacto. Para lograr el objetivo se ha recogido la totalidad de los datos que posee el servicio, y así conocer el nivel de utilización de la radiología del mencionado nosocomio. También a tener en cuenta que estos datos son tomados desde el año 2006 al año 2011, ya que no existe información previa

SUMMARY: The main problem Radiology Service " RODEO " Hospital has been and has informed this work , "lack of information " , which prevents us from knowing the number of professionals , supplies you need and types of services provided by this hospital , showing the flaws in hospital management . Meeting this need will allow us to take a measurement and further planning to develop a continuous and effective service to the population. That is why the main goal is to “Create an epidemiological analysis of the use of radiological services at the Hospital of The Rodeo”. In the management of health services epidemiological uses to solve the type and amount of services to offer to the people in charge and assess its effects and impact measurements. To achieve the objective has collected all of the data held by the service, and to know the level of use of radiology that hospital. Also note that these data are taken from 2006 to 2011, since there is no prior information

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The National Institute of Respiratory Diseases is a third level public hospital in Mexico City, which in 2007 acquired an RIS-PACS to be implemented at its Imaging Department (ID), with the objective to enhance its service. This department attends an average of 3,500 patients per month developing different image modalities. The objective of this work was to determine the overall sigma level performance of four processes of the ID: reception, X-ray, computed tomography, and radiologist diagnosis, considering process analysis and innovation through Six Sigma methodology, measuring the innovation effectiveness by means of indicators and learning curves. Initially, a first measurement (M 1) of the original processes was determined; once 13 innovations were implemented in a pilot program, two more measurements were done, 15 days after (M 2) and 30 days after (M 3), in order to know the impact of the innovations in the ID processes. The initial sigma level of the ID before innovations was σ 1 = 2.0, which means that there were 36 patients per day with a process defect during their stay at the ID. In the two following measurements, σ 2 = 2.2 which means that there were 28 patients per day with a process defect, and σ 3 = 2.3 with 24 patients per day with a process defect. These results demonstrate that the percentage of performance enhancement between the original process and 15 days later was 23 % and 30 days later an enhancement of 15 %. In total, an overall enhancement of 38 % was obtained at the ID of the institute.

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A adoção da cultura de proteção radiológica e de garantia de qualidade deve ser prioridade para a segurança dos exames radiológicos e do ambiente em que estão instalados os equipamentos de raios X. O artigo objetivou avaliar os procedimentos de biossegurança em três centros hospitalares de radiodiagnóstico. Realizou-se estudo prospectivo do tipo qualitativo observacional transversal, baseado no modelo de gestão organizacional desses centros, em Recife, de setembro/2008 a junho/2009, em cumprimento à Norma Regulamentadora 32 do Ministério do Trabalho. Observou-se que não conformidades técnicas ou operacionais ocorreram em função do desconhecimento da legislação; da ausência de programas de qualidade e segurança do paciente; da falta de sistematização de rotinas preventivas para manutenção dos equipamentos e falta de treinamento. Há necessidade da implantação de modelos de gestão focados no manuseio dos equipamentos segundo legislação e normas de biossegurança para prevenção de riscos à saúde ocupacional em centros de radiodiagnóstico.

Radiological protection and quality assurance should be a generalized priority integrating security standards of radiological tests and environmental protection where X-ray equipment is operational. This article aims at evaluating biosafety procedures. It includes a prospective study of qualitative cross-sectional observational approach, based on the organizational management model of three radio diagnostic centers in Recife, Pernambuco, Brazil. It ran from September 2008 to June 2009, and complied with the Regulatory Standard 32 of the Brazilian Labor Ministry. Technical and operational non-compliance was observed and found to result from the following factors: ignorance of legislation; lack of quality programs and of patient safety; lack of systematic preventive routines for the maintenance of equipment; and lack of training. There is need to implement business models focused on the handling of equipment in compliance with bio-security standards for the prevention of occupational hazards at diagnostic-radiology centers.

La adopción de la cultura de protección radiológica y de garantía de calidad debe ser prioridad para la seguridad de los exámenes radiológicos y del ambiente en que están instalados los equipos de rayos X. El artículo objetivó evaluar los procedimientos de bioseguridad en tres centros hospitalarios de radiodiagnóstico. Se realizó estudio prospectivo del tipo cualitativo observacional transversal, basado en el modelo de gestión organizacional de eses centros en Recife-PE-Brasil, de septiembre/2008 a junio/2009, en cumplimiento a la Norma Regulamentadora 32 del Ministerio del Trabajo. Se observó que no conformidades técnicas u operacionales acaecieron en función del desconocimiento de la legislación; de la ausencia de programas de calidad y seguridad del paciente; de la falta de sistematización de rutinas preventivas para manutención de los equipamientos y falta de entrenamiento. Hay necesidad de la implantación de modelos de gestión focados en el manoseo de los equipamientos según legislación y normas de bioseguridad para prevención de riesgos a ala salud laboral en centros de radiodiagnóstico.

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This paper presents a radiological collaborative tool capable of direct manipulation of Digital Imaging and Communications in Medicine (DICOM) images on both sides, and also recording and reenacting of a recorded session. A special collaborative application protocol formerly developed was extended and used as basis for the development of collaborative session recording and playback processes. The protocol is used today for real-time radiological meetings through the Internet. This new standard for collaborative sessions makes possible other uses for the protocol, such as asynchronous collaborative sessions, decision regulation, auditing, and educational applications. Experimental results are given which compare this protocol with other popular collaborative approaches. Comparison of these results shows that the proposed protocol performs much better than other approaches when run under controlled conditions.

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OBJETIVO: O objetivo principal deste trabalho foi avaliar os serviços de radiodiagnóstico médico de dois hospitais públicos que fazem uso de equipamentos de raios X na cidade de Rio Branco, Acre. MATERIAIS E MÉTODOS: Foram realizadas entrevistas, medições e observações diretas, usando como referência a legislação brasileira em vigor, com especial ênfase à Portaria SVS/MS n° 453 de 1998, que estabelece as diretrizes básicas de proteção radiológica em radiodiagnóstico médico e odontológico. RESULTADOS: Os dados obtidos indicaram a ocorrência de elevado número de itens em desacordo com a legislação consultada em ambos os serviços radiológicos dos hospitais pesquisados, especialmente equipamentos funcionando de forma parcial e o descumprimento de alguns protocolos de segurança. CONCLUSÃO: As infrações técnicas ou operacionais foram, basicamente, em decorrência do desconhecimento sobre a legislação, a ausência de programa de manutenção preventiva dos equipamentos e da falta de investimentos em treinamentos e/ou cursos de atualização profissional. A melhoria dos serviços de radiodiagnóstico médico das instituições investigadas requer, portanto, uma série de modificações, que vão de simples às mais complexas.

OBJECTIVE: The main objective of the present study was to evaluate radiodiagnosis services in two public hospitals with x-ray equipment in the city of Rio Branco, Acre, Brazil. MATERIALS AND METHODS: Interviews, measurements and direct observation were performed, following the Brazilian legislation in force, especially the Order (Portaria) SVS/MS 453 of 1998 of the Ministry of Health establishing the basic guidelines for radiation exposure protection in medical and odontological x-ray facilities. RESULTS: The data indicated a high rate of non-compliance with the legislation in both radiological services, especially concerning poor equipment operation, and non-compliance with some safety protocols. CONCLUSION: Basically, technical and operational infractions have occurred as a result of a broad unfamiliarity with the legislation, the absence of a preventive equipment maintenance program, besides low investment in training and/or courses for professional updating. Therefore, a considerable number of simple and complex changes are demanded to improve the quality of the investigated radiodiagnosis services.

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El desarrollo de sistemas de evaluación que midan el desempeño y motiven al cumplimiento de las metas institucionales es fundamental en la gestión del personal. Nuestro centro ha desarrollado indicadores de calidad y productividad que pueden ser utilizados con este fin. La reducción de la capacidad instalada, de dos a un tomógrafo computado y de cinco a cuatro salas de radiología convencional, además de los distintos cambios en los procesos, hicieron imprescindible un aumento en las competencias del personal de las unidades involucradas.

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Este trabalho tem como objetivo analisar os custos para a implantação de um serviço de mamografia de pequeno porte. Para realizá-lo, além da pesquisa bibliográfica, foi efetuada uma pesquisa, por meio de questionário, junto a diversas empresas, em vários estados do Brasil, que atuam na área da radiologia médica. O questionário utilizado visava levantar o custo de aquisição de bens e serviços - equipamentos, móveis e utensílios, diversos materiais e produtos utilizados, serviços, mão-de-obra, encargos, contribuições sociais e outros - pertinentes a um serviço de mamografia. Visava, também - na medida em que este serviço, além de seu papel social, pode ser caracterizado como sendo uma atividade econômica -, analisar sua viabilização, do ponto de vista econômico-financeiro. Como conseqüência das análises realizadas, foi formulada uma relação entre as variáveis receita, custo e retorno que permitisse aos serviços de mamografia de pequeno porte o equilíbrio das contas, a remuneração dos recursos investidos e o lucro.

The authors examine the financial costs for implementation of a small mammography service. The literature was reviewed and a survey based on questionnaires applied to various companies specialized in medical radiology in different States of Brazil was carried out. Questionnaires were used to collect data on the costs of goods and services of mammography services such as equipment, furniture and fixtures, consumable products and materials, personnel, social contracts, and income taxes. Considering the social role of these companies but also their enterprise activity, the questionnaires were also employed for the analysis of economic and financial viability. The analysis of the data allowed us to establish a relationship between the variables — income, cost and return — that could ensure financial viability and profit in the implementation of a mammography service

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Este trabalho apresenta a implementação de um mini-PACS (sistema de arquivamento e comunicação de imagens) que está sendo estruturado junto ao Serviço de Radiodiagnóstico do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, como parte do projeto de um serviço de radiologia digital ("filmless")

This paper describes the implementation of a mini-PACS (picture archiving and communication system) at a university hospital ("Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo"), as a component of a project for a filmless radiology facility.

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The authors' radiology department recently found that assorted problems had accumulated over time into a long to-do list. Mr. Keen and Ms. Fegley describe the process they followed to implement continuous quality improvement and develop task force teams to address particular problems.

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