Since the development of Computerized Tomography (CT) in 1972, CT has always been a software-driven imaging modality.
Medical imaging equipment manufacturers such as GE, Siemens, Philips, Hitachi, and Toshiba/Canon have all developed vendor-specific software platforms along with manufacture specific terminology and technology which must be mastered in order to operate the systems effectively and safely for both the patient and operator.
The difference in the vendor-specific terminology is confusing to most newer CT Technologists, as well as the difference in software and hardware.
The issues arise with the way CT Imaging Technologists are trained to use the systems. Most technologists are trained by other technologists at the facility. Most were trained by someone else who had a varying degree of knowledge regarding proper system operation.
This “Shoulder to Shoulder” style of training leads to incomplete training and a technologist who knows barely enough to get by. Training of this style can be a liability to the patient and the facility.
Often times, the technologist doing the training will withhold information about a specific system operation so that they are perceived by management to be the “expert” and are of more value to a facility. This can hinder any exam from the basic to the more advanced procedures, frustrating many radiologists. This can lead to a catastrophe in an ‘on-call” situation when the ER has to wait for another technologist to come in because the one who is there is not well trained.
Some of the lucky few technologists are chosen by a facility to attend the manufactures training facility. This initial training is then followed by a week or two of onsite training.
Onsite training is meant to adapt the system to the customer’s facility and assure proper system function and acceptable image quality with the radiologist.
The same technologist who went to the training academy should also be attending the subsequent weeks of OEM training to further their knowledge of system operation.
Training which should include not only scan protocol building and basic patient scanning but the advanced procedures and software applications applicable to the system purchased by the facility.
This could include Cardiac Angiography and Function Analysis, Digital Subtraction Software, Brain Perfusion and Dual Energy imaging techniques and CT Fluoroscopy to mention a few.
Since some of the advanced applications require additional training, manufacturers sometimes provide a course at their training facility. However not all clinical applications can be taught effectively at a training facility without actual patients to scan, for example CT Flouro, CT Angiography, Cardiac, Brain Perfusion, and Dual Energy.
For onsite training, patients are required for the exams and may be in very limited supply. Often times, facility budget and time constraints leave the staff as a group of “Button Pushers”, and not well trained. Staff duties should be delegated so as to allow for the full training experience. If not, then the outcome is that not everyone is trained to the same level of expertise.
Staff will leave one facility for a better position, better pay, better hours, better training or a better location, taking the knowledge, and sometimes the training materials given to them for the site, with them. This can also leave a facility with a system that is not being utilized to its fullest potential.
Staff technologists who are well trained are happier on the job. They have the respect of their peers, administration, staff physicians, and patients.
By contrast, those with a lack of training are often classified as button pushers, doing nothing but the most routine scanning having to call in a more experienced technologist to complete the challenging studies, CTA, Cardiac CTA, Perfusion.
This leads to a delay in diagnosis and service to a patient. Technologists often get into the same rut at a facility because the equipment is used past its prime and often not replaced with state of the art systems that have more capability, lower patient exposure, and better image quality with advanced imaging protocols.
These are the staff who leave a facility, for better working conditions, training and pay. Proper applications training will lead to a happier and more productive staff with less turnover, especially with older systems and an untrained staff.
There are many pros to ongoing applications training, some of which are more notable than others. A well-educated staff leads to more complete exams for the reading radiologist and reduces the chance that a patient will be recalled to evaluate a hepatic filling defect or to obtain a proper early arterial phase in a tri-phasic study to evaluate for metastatic disease, or a delay image for contrast filling defect not seen by the Technologist who should review images prior to completing an exam.
This leads to an overall lower cost to the facility. Clinical Applications can review the staff’s operational workflow and offer recommendations for workflow enhancement so that the staff is working smarter and not harder.
Clinical Applications can assure your staff is operating with best clinical practices, assist your reading radiologist with issues regarding image quality, patient exposure, contrast timing, and the development of new imaging protocols and techniques which make diagnosis more accurate. An Applications Specialists can act as a lesion between the CT staff, management, and the Radiologist ensuring an effective educational experience for all your staff.
I recommend that an imaging department budget include clinical applications on-site support at a minimum of every two years. This continuing support is necessary, not only for the CT technologists, but for the physicians and patients as well.
This can be even more critical in a short term lease of imaging equipment, especially when the equipment is different from what the staff is currently using.
Clinical applications support can train your staff answering all their questions regarding system operation, assist with building scanning protocols, train them with the latest imaging software upgrades and suggest workflow modifications to enhance department productivity and patient experience.
Clinical applications support can handle issues with the radiologist regarding missed contrast timing, image quality, and system artifacts which affect their experience with the system.
This can improve transition time to a new system if the leased mobile is from the same OEM as a new system is installed, even though the software may be different or has more enhanced upgrades. At times you need a service engineer, at times your need applications support. They go hand in hand.
Here at Catalina Imaging, our goal is to create an experience that goes beyond your expectations, and applications support is just another way we can enhance that experience. Please feel free to contact us and see what we can do for you.