Author:

Keywords:

Case studies, patient safety, performance, qualtity improvement, radiography

Abstract:

Purpose: In this study we focus on the use of Fluoroscopy-Guided Positioning (FGP) techniques in radiography. In Belgium, and some other European countries, FGP is common practice. We investigate the importance of knowledge, skills and attitudes of imaging staff and organizational factors with respect to applying non-FGP. Methods and Material: Four case studies were performed in Belgian hospitals. To develop an in-depth understanding of imaging practices, technologists and radiologists were interviewed (n=40), complemented with non-participative observations (200 hours) and image and document analyses. Knowledge and attitudes of staff and organizational factors are considered. Results: Organizational factors are of major importance for adequate positioning. Clinical leadership of radiologist and chief technologists as well as suitable X-ray devices and positioning aids were identified as important determinants. Furthermore a lack of skills and knowledge of (advanced) positioning techniques and negative attitudes towards non-FGP were present. More precisely, staff expressed concerns with respect to the impact on the workload and workflow. Finally, adequate supervision, regularly feedback and coaching (by radiologists, chief technologists and peers) were identified as important enabling factors for increasing the quality of the applied imaging techniques. Conclusion: A holistic approach considering knowledge, attitudes and contextual-organizational factors is needed to improve imaging practices. Clinical leadership of physicians, supervisor and peers are important enablers.