Reicher John, Currie Stuart, Birchall Daniel
1 Department of Neuroradiology, Newcastle Upon Tyne Hospitals NHS Foundation Trust , Newcastle upon Tyne , UK.
2 Department of Radiology, Leeds General Infirmary , Leeds , UK.
Br J Radiol. 2018 Apr;91(1084):20170284. doi: 10.1259/bjr.20170284. Epub 2018 Feb 1.
As the volume and complexity of imaging in the UK continues to rise, there is pressure on radiologists to spend increasing lengths of time reporting to cope with the growing workload. However, there is limited guidance for radiologists about structuring the working day to strike the necessary balance between achieving satisfactory reporting volume and maintaining quality and safety. We surveyed 86 neuroradiologists (receiving 59 responses), regarding time spent reporting, frequency and duration of work breaks, and break activities. Our results demonstrate that some neuroradiologists report for up to 12 h a day and for 4 h before taking a break. Mean duration of breaks is less than 15 min and these often consist of computer screen-based or cognitively demanding tasks. Many areas of medicine have looked to the aviation industry to develop improvements in safety through regulated, standardised practices. There are parallels between the work of air traffic controllers (ATCs) and radiologists. We review the legislation that controls the working hours of UK ATCs to minimise fatigue-related errors, and its scientific basis. We also consider the vigilance decrement, a concept in cognitive science which describes the reduction in performance with increasing time-on-task. We conclude that, in comparison with ATCs, work patterns among radiologists are poorly standardised and potentially dangerous. Evidence suggests that placing limits on reporting time and minimum break duration, as well as ensuring appropriate break activities, can benefit reporting quality. It is imperative that radiologists and managers heed these lessons, to improve standards and protect patients from error.
随着英国影像检查的数量和复杂性持续增加，放射科医生面临着越来越大的压力，需要花费更长时间进行报告以应对不断增长的工作量。然而，关于如何安排工作日程，以便在完成令人满意的报告数量与保持质量和安全之间取得必要平衡，针对放射科医生的指导却很有限。我们对86名神经放射科医生进行了调查（收到59份回复），内容涉及报告所花费的时间、工作休息的频率和时长以及休息期间的活动。我们的结果表明，一些神经放射科医生每天报告长达12小时，且连续报告4小时才休息。休息的平均时长不到15分钟，而且这些休息通常包括基于电脑屏幕的任务或需要认知能力的任务。医学的许多领域都期望借鉴航空业的经验，通过规范、标准化的做法来提高安全性。空中交通管制员（ATC）的工作与放射科医生的工作存在相似之处。我们回顾了控制英国空中交通管制员工作时间以尽量减少与疲劳相关错误的立法及其科学依据。我们还考虑了警觉性下降这一认知科学概念，它描述了随着任务执行时间增加，表现会下降。我们得出结论，与空中交通管制员相比，放射科医生的工作模式标准化程度低且可能存在危险。有证据表明，限制报告时间和设定最短休息时长，以及确保适当的休息活动，有助于提高报告质量。放射科医生和管理人员必须吸取这些教训，以提高标准并保护患者免受错误影响。
