Written by Channing Pressler, Briana Rogers, Jo Ann Montemayor, Kate Bouressa
Yesterday, when I logged on at 3:30 PM, I launched all the resources needed for my shift. There are many (Tonight’s Huddle Grid, Cisco Finesse, Jabber, email, ActiveFax, BoxER, ServiceNow, Primordial, Synapse, PACS Exam Finder, BoxWorkflow, SR, RadPoint, BoxPoint, Portal Page, Compass, Centricity, MI, Meditech, Procedure Cards, Specials On-Call Contact Sheet, Nuance PS360, UDS, and AcuReports)! I joined our department group chat – my coworkers and I are always in communication.
We had a pre-shift meeting, called a Huddle, with our manager, Jo Ann. Huddles are fun. We chatted about how we were doing and what was going on with us. We went over anything new that has come up, reminders, and how things went yesterday. We shared our feedback and asked questions.
For the first hour, the radiologists transitioned from day to evening. I received many radiologists’ instant messages and a mix of daytime and evening phone calls. I had exams interpreted from the daytime shift by the day radiologists, checked email, and reviewed Huddle Grid for tonight’s responsibilities. I prepared for the evening radiologists by checking ServiceNow and the BWF Assistant Queue for pending items I need to bring to their attention.
The evening radiologist shift started at 4:30 PM. Every unread STAT exam populated BoxWorkflow at 4:30 PM. If an exam is STAT, that means it needs to be read as soon as possible. I checked to see if they were already being interpreted by a daytime radiologist by looking in Synapse and Powerscribe. I made sure I didn’t give it to an evening radiologist if a daytime radiologist was interpreting it.
At night, we’re paired up with radiologist “buddies.” I sent an instant message to my buddies to let them know we were paired up, and we exchanged extensions with each other. My buddies IM’d me or called me if they needed assistance with anything through the shift.
I was responsible for assigning Seton exams to the radiologists. While I assigned exams, I answered and made phone calls, responded to instant messages, and performed shared duties with my team. I monitored four folders in Synapse and the BoxWorkflow unassigned queue. Before I assigned the exam, I confirmed ordering provider information and provided their name and direct number in the notes before giving the exam to a radiologist. Sometimes we don’t have that number, and I must figure it out quickly before I assign the exam. We assign exams evenly to all the radiologists.
There are many considerations to make while I assign exams.
Some patients have multiple exams, like trauma patients, and they must be split up in very specific ways among the radiologists. We match the specialty of the exam to the radiologist in the right slot. Sometimes a radiologist is in a slot that has responsibilities that aren’t the same as their usual specialty. For example, last night, there was an MRI of the brain that needed to be interpreted. Dr. Patel and Dr. Richards were working. I assigned it to Dr. Richards because he was in a neuro slot, but I couldn’t assign it to Dr. Patel because he wasn’t. Tomorrow Dr. Patel and Dr. Putnam are both working in neuro rotations, and if I receive a pediatric neuro exam, I will assign it to Dr. Patel because that is his specialty. I am responsible for knowing a lot, so I can be accurate and efficient when assigning exams. I’m proud of how much I know about radiologists and their responsibilities.
Sometimes a patient will have one study at the beginning of my shift and a follow-up study later in my shift. I make sure to assign it to the same radiologist.
All the exams the radiologists interpret at night are STAT. By the way, I do all of this, for every exam, in less than 2.5 minutes! Phew!
The phone calls I answered were from hospital and ARA technologists, referring doctors we’ve paged, patients, ER doctors, and nurses. I made calls to hospital technologists about requests from the radiologists, paging services, emergency departments, hospital operators, and nurses. One of my responsibilities was to relay results to ordering providers when the radiologist asked me to.
Then I received a call about an emergency interventional procedure. The trauma surgeon had a patient that needed an urgent pelvic embolization due to trauma. I stayed calm and asked questions about the patient. I connected the trauma surgeon with the on-call interventional radiologist. The interventional radiologist told me to activate the hospital on-call specials team right away. I used my specials contact sheet to call the on-call specials department for the hospital and told them about the patient. I updated the radiologist, who was leaving to go to the hospital. I had to move all the radiologist’s unread exams from their BoxWorkflow queue and update my coworkers. Then the hospital on-call team called me back—they had a question about the patient. I called the radiologist on their cell phone to get the answer and relayed the answer right away. When this kind of emergency comes up, it is the number one priority. The radiologist must go right away, and the on-call hospital team has to deploy to the hospital right away too. I’m glad I was able to help. The radiologist told me I did a great job.
While I was on dinner break, my coworker covered their duties and my duties. When I come back, I’ll do the same for them. During my break, I like to eat, watch Netflix, and get away from my computer!
At 10:45 PM, I double-checked all lists to see what could be redistributed before the next radiologist shift transition. We touched base with our radiologist buddies before the shift transition to confirm which exams they’re going to interpret before they leave for the evening.
At 11:00 PM, the second shift radiologists leave, the overnight radiologists arrive, and we redistribute the exams between the second and third shift radiologists. I also log into SR to assign pediatric exams. It’s a very busy time of the night. There are a lot of moving parts during the radiologist shift transitions.
At 2:30 AM, it got so busy that the radiologist captain told me to call back-up. I checked RadPoint for the on-call radiologist’s name and their contact preference. I woke them up, and they logged on within a few minutes. We redistributed exams between the overnight radiologists and the back-up radiologist. They were able to help, luckily, and we didn’t have to call a second back-up!
What a night! 4:00 AM was the end of my shift. I woke up around 11:00 AM. I ate breakfast, worked out, and had fun summer activity time with my kids before I returned to work at 3:30 PM. I hope I don’t get called in tomorrow!