As radiology braces for a surge in imaging procedures in the aftermath of the COVID-19 pandemic, facilities must take action to regain the public’s trust that they can undergo imaging exams safely without being at risk for infection. Implementing a number of steps, including universal masking and spacing out imaging exam times to permit adequate time to sterilize imaging suites.
Sanitizing protocols deployed during COVID-19 need to be assessed to determine realistic times between scheduled exams for each type imaging suite, as well as the need for additional staff to perform this enhanced sanitizing efficiently. Logistics for sanitizing waiting rooms, staff rooms, and computer monitors, keyboards, mice/controls, and workstations also need to be determined.
Radiology departments may wish to extend their hours to achieve imaging volume goals. Radiologists may wish to reassess standard exam protocols to determine if and how they could be streamlined. It may be appropriate to determine if implementing clinically proven abbreviated or accelerated protocols, such as those for magnetic resonance imaging (MRI), would be clinically appropriate and beneficial.
For hospital radiology departments, plans to continue to provide essential imaging services for patients with known or suspected COVID-19 need to be made, and logistics assessed with respect to plans for imaging virus-free patients. The challenges associated with this are so individualized to a radiology department that they are not within the scope of this article, and are best made by a dedicated task force of administrative staff, technologists, and radiologists.
Once logistics are determined, the daily volume of emergency exams need to be estimated. From these statistics, tiered plans of attainable estimated volumes should be developed. The research companies in the segment of teleradiology recommend developing tiers that include non-urgent time-sensitive exams, elective care, and screening. From this, the scheduling of daily exam workloads for each modality and imaging suite can be developed, as it is highly unlikely that radiology departments will be able to initially achieve their pre-COVID-19 workflows while maintaining strict safety procedures for both patients and department staff. The RSNA COVID-19 Task Force advises that two vital factors that support a slow, gradual ramp-up of imaging volumes are the prevention of increased staff and patient exposures to COVID-19 and the regaining of patient confidence with respect to being safe inside a radiology department.
Staff needs to realistically assess the physical layout and size of their imaging facility. This includes the number of patients who can be accommodated while maintaining safe social distancing in both check-in and patient-only waiting rooms (such as those for diagnostic mammography patients), the ability to initiate one-way traffic flows in hallways, and the size and layout of radiology reading rooms, scanner console areas, and staff work and lounge areas to accommodate safe social distancing. Radiologists whose presence is not required onsite are encouraged to do remote exam interpretation via teleradiology. Advanced Telemed Services has gone a long way in regaining public trust for Teleradiology in these trying times of covid-19.
Telephone and email communication with patients relating to scheduled exams should be initiated so that patients have completed all paperwork prior to arrival. The radiology department staff need to be proactive with patients in advising that COVID-19 risk is low and in explaining the safeguards being taken within the radiology department. It is important to provide calming, fact-based information to patients — and for that matter, radiology staff — to alleviate fears. Any history of COVID-19 exposure by a patient should be obtained and assessed in conjunction with scheduled appointment reminders.
Prior to entry into a radiology department, all patients, staff, and accompanying visitors (if allowed) should be screened for symptoms of COVID-19. A plan is needed for the management of individuals who screen positive or suspicious.
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