Optimizing Radiology Reading Room Design: The Eudaimonia Radiology Machine

Abstract

Physical and mental stressors on radiologists can result in burnout. Although current efforts seek to target the issues of burnout and stress for radiologists, the impact of their physical workspace is often overlooked. By combining evidence-based design, human factors, and the architectural concept of the Eudaimonia Machine, we have developed a redesign of the radiology reading room that aims to create an optimal workspace for the radiologist. Informed by classical principles of well-being and contemporary work theory, Eudaimonia integrates concerns for individual wellness and efficiency to create an environment that fosters productivity. This layout arranges a work environment into purposeful spaces, each hosting tasks of varying degrees of intensity. The improved design addresses the radiologist's work requirements while also alleviating cognitive and physical stress, fatigue, and burnout. This new layout organizes the reading room into separate areas, each with a distinct purpose intended to support the range of radiologists' work, from consultation with other health care providers to reading images without interruption. The scientific principles that undergird evidence-based design and human factors considerations ensure that the Eudaimonia Radiology Machine is best suited to support the work of the radiologists and the entire radiology department.

Keywords: Burnout; evidence-based design; human factors; reading room.

Fig 1

(A) The Eudaimonia Machine, as described by architect David Dewane, is a sequential progression through multiple spaces, each designed for different activities and levels of socialization and interaction. The intent is ultimately to prepare individuals to enter the “chamber” for deep work. (B) The Eudaimonia Machine adapted for the purposes of designing an activity-based reading room. The reading room assistants are positioned at the front of the space (gallery) to both welcome and triage visitors to the reading room; the staff lounge (salon) is for conversation and socialization; the consultation space (library) is for a body and neuroradiology attending radiologist and trainee team to consult with teams visiting the reading room in person; the collaboration space is where most of the day to day reading is performed and where attending radiologist-trainee interaction is facilitated; the deep reading space (chamber) is meant for highly complex studies that require sustained periods of uninterrupted focus.

Fig 2

(A) Iterative floor plan. The first version of the reading room was critiqued for not having enough space in the consult area to accommodate body and neuroradiology attending radiologist and trainee pairs. The space did not require both a staff lounge and a conference room; removing the conference room provided more space for an expanded consult and reading room assistant space. The placement of walls and position of workstations within the collaboration space impeded line of sight and situational awareness, both of which were deemed necessary to encourage attending radiologist and trainee interaction and awareness of impromptu discussions with other radiologists about interesting patients and imaging findings. (B) Revised floor plan featured increased space for two reading room assistants upon entry to the reading room, expanded consult space to accommodate four radiologists (body and neuroradiology attending radiologist and trainee pairs), and a staff lounge with sink and casual seating. Deep reading room was expanded to enable seating for nine radiologists.

Fig 3

Mock-up tours. A full-scale mock-up was built out of a steel framework and foam core panels. Visits were facilitated by project architects and designers. A total of eight visits including 51 multidisciplinary stakeholders (attending radiologists and trainee radiologists, reading room assistants, technologists, administrative staff, and research staff) were organized to enable staff to experience the spaces and ask questions of the architects and each other. Light furniture served as stand-ins for workstations and ancillary furniture and could be easily shifted to test usability of the spaces.

Fig 4

Final floor plan. Two major changes were made for the final design. First, the reading room assistant space was expanded to include space for processing CD requests for patients; a greeting desk was positioned as the first thing visitors would see upon entering the reading room. Second, the deep reading space was reduced from nine to five workstations; in both full-scale mock-up tours and during focus group conversations, trainees expressed concerns that attending radiologists could be tempted to spend inordinate amounts of time in this space (“hiding”). Limited seating (and signage describing a deep reading protocol) is meant to encourage attending radiologists to use the space for the intended purpose of deep reading of complex cases and to return to the teaching and collaboration space when finished.

Fig 5

National Institute for Occupational Safety and Health Hierarchy of Controls (from National Institute for Occupational Safety and Health Workplace Safety and Health, 2015 [25]).