X-Ray Technician Workloads - Research Paper Example

X-Ray Workloads Running Head: X-RAY TECHNICIAN WORKLOADS AND PATIENT SATISFACTION X-ray technician Workloads and Patient Satisfaction: Extending Research Endeavors into X-Ray Workplace Conditions. [Your Name] [Your University] Abstract The working conditions of x-ray technicians are extremely important to ensure efficient and effective patient processing. To date there is little empirical research investigating workplace practices of x-ray technicians or regular monitoring of x-ray center procedures. This study aimed to identify a relationship between x-ray center workload across five days and patient satisfaction. Patients were approached when appearing for their appointment at reception and 30 completed a survey constructed for this study. The survey was made up of 12 items on 5-point Likert scales (1 = strongly disagree to 6 = strongly agree). It was found that there was a strong correlation between patient satisfaction and daily workload (r =.80). Hence, the hypotheses were partly supported. The relationship between x-ray technician specialty and patient satisfaction was insignificant. It is anticipated that this study will contribute to further understanding the workplace dynamics of x-ray centers. Introduction Definitions There is increasing realisation that for x-ray technicians to be capable of optimum performance that they need post-graduate training as a specialist. However, extended study at university is not always a feasible option for the x-ray operator, due to economic, personal or cultural factors. Also, it is important that the health care provided by practioners meet the needs of the community, and as such, most x-ray technicians find themselves needing to be multi-taskers as practioners (White & McKay, 2004). Further, recent studies indicate the sincere threat of a shortage of x-ray technicians in the immediate future (Patterson, Skillman, & Hart, 2004). Hence, it appears that the workplace conditions for x-ray staff are, at present, somewhat confusing. This workplace atmosphere may influence the quality of patient care, and it is anticipated that investigation of patient satisfaction and x-ray technician workload will shed light on the topic, at least within a hospital in the UK. This paper hopes to provide methodological insights in to analysis of the working conditions for x-ray staff. Ideally, this research will contribute to local, state and national standards regarding x-ray technician workloads and training. Also, this paper aims to contribute to the knowledge of the role of the x-ray technician and the workplace factors that impact on their performance. To date, there is a glaring neglect into the study of the x-ray technician workforce (Patterson et al., 2004). Further, reliable data is difficult to gather due to the different contexts of work environment, x-ray technician, and patient specific needs. A survey will measure patient satisfaction and x-ray technician workloads at a hospital in the UK. It is hypothesized that on the days of high workloads that the patients will report higher ratings of dissatisfaction. It is also expected that x-ray technicians that are specialists will receive higher ratings from patients with conditions which they specialize in, as compared to those not within their specialty training. A Review of the Literature To date, very little literature exists on the topic of x-ray technician working conditions. General information is readily available, such as the frequency of educational completions or numbers of licenses approved (Patterson et al., 2004). Research into this subject is critical, especially as x-ray technician services are unlikely to be distributed according to community needs. It is a limitation in the understanding of community health care needs when adequate data about the conditions of the workforce of x-ray technicians across time and location remains unknown. Further, issues of supply and demand of x-ray technicians for the future can be more adequately informed by way of empirical investigation into a subject such as x-ray technician workloads. Kumar, Moro & Narayan (2004) used a mixed method of survey and structured interview to analyse demographic, personal, occupation and workplace safety issues of x-ray technicians to determine the factors affects on x-ray staff physical well-being. A random sample of 20 x-ray technicians across two University hospitals (predominantly female [90%]) completed a survey. The magnitude, duration and frequency of the factors and any accompanying physical discomfort were analysed, based on severity, duration and recurrence. Although the technicians were relatively young (mean age of 35 years) they were found to have a range of significant musculoskeletal problems (83% reported backache, 39% neck pain, and 28% shoulder pain). Most of the technicians were found to have multiple experiences of pain. It was concluded that a lack of specailisation may have contributed to incorrect patient processing in the x-ray room (Kumar, Moro & Narayan, 2004). An alternative study by Nyak & Lindsay (2004) assessed an x-ray department's workload. Again a survey method was used. Two hundred and twenty-one surveys were completed by x-ray technicians. The median time to take an x-ray was 80 minutes, with a nine minute duration fro return to the hospital world. Requests were graded in the survey as "urgent", "soon" and non-urgent, however, there was minimal difference between the times taken to x-ray these categories (Nyak & Lindsay, 2004). Griffiths, Stanley, & Sids (2004) explored x-ray technician set-up methods and compared their accuracy of performance to within 3 mm. it was anticipated that this research would further inform best practices of x-ray technicians. It was found that set-up methods varied significantly (p = .001), and that accuracy was negatively related to the set-up method. Following this study all participating centers made practice changes to improve accuracy, such as with patient placement, iso-centre setting, imaging methods and bladder and rectal filling. The recommendations included; comfortable bladder; a standard firm head support rather than a pillow; the hands on the chest control for weight of the arms on the trunk; align lateral tattoos in longitudinal and vertical directions; and use of leg/ankle supports. It has been noted generally that traditional patient services are moving from secondary to primary settings. However, there is to date a lack of literature evaluating the effectiveness and efficiency of x-ray services in primary settings (Pallen & Linnane, 2005). For this reason alone it is critical that the benefits and disadvantages of present day x-ray working conditions be assessed, so as to maintain high standards of quality health care to the community. Method Participants Overall, there were 130 participants in this study. The sample was skewed in terms of gender, as there were 100 women and only 30 men. It was a convenience sample from the hospital/center in the UK, as patients were approached at admission and asked fro their participation following their x-ray session. The age of patients ranged from 18 to 45 years (as shown in Figure 1), with a mean age of 32 years (SD = 7.2). Figure 2. Bar graph of age distribution of x-ray patients. Informed consent needs to be seriously considered at the start of any research project (Shank, 2002). Consent is about participants making a reasonable choice to take part in the study, as such; their aspirations need to "fit" with the goals of the research (Mason, 1997). To assure that the participants for the present study was fully informed; the primary investigator discussed the proposed consent form with work colleagues. This assured the investigator that possible ambiguities in meaning, confusing sentence structures and missing information are less likely to exist within the form (Patton, 2000). All participants were assured of their rights to confidentiality, anonymity, and voluntary withdrawal without penalty. It was made very clear to the patients that their answers to the interview questions and to the surveys and within the focus group would in no way affect their future treatment. Signing of the consent form provided permission to have their interviews audio-visually recorded. The participants were asked if they understand what is involved in the project, and unfamiliar terms were explained. The name and contact details of the researcher were also made known. Materials The survey was developed for this study specifically. The questionnaire consisted of twelve 5-point Likert scale items to measure the perceptions of satisfaction of patients (1 = strongly disagree to 5 = strongly agree). Four demographic items were also included to aid in grouping, and to provide control variables. The scales were added across to give a minimum score of 12, and a maximum score of 60. This questionnaire was piloted for clarity and validity on patients at another x-ray center. Design This study is a survey design quasi-experiment. It is a quasi-experiment because the sample was neither randomly selected, nor randomly allocated to groups. Further, the independent variable (the x-ray procedure) was not directly manipulated by the primary investigator. The dependent variables were the total score on the survey and x-ray workloads for each day over a 5-day period. Using SPSS v. 13, the raw data was analysed using descriptive tests for frequencies and percentages for categorical data (i.e. demographic items, individual responses to each scale item, workload numbers for each day and the week's total). Chi square tests were used to cross-tabulate demographics and patient responses to individual items (Bailey & Burch, 2002; Bernard, 2000). Also, Pearson's r correlations were used to explore the potential relationship between perceptions and x-ray workloads, as both of these variables provide continuous data suitable for this test Gliner & Morgan, 2000; Maxim, 1999). A one-way ANOVA was run to determine if the variance across the data sets of the workload across the five days is significant. This helped to narrow the search for clues as to workplace conditions that may impact on patient satisfaction. However, this test was only used because a preliminary Levene's test was insignificant, indicating homogeneity of variance across the data sets and meeting the assumption for a group comparison. Procedure Permission was sought by letter from the director of the .. x-ray center/hospital to ask their patients to take part in the study. A week before the surveys were distributed flyers was placed on billboards in the waiting room to alert patients of the invitation to participate. On the day of the study, the primary investigator approached patients following their admission by reception and asked the patient for 10 minutes of their time after their x-ray session. The patient at that time was informed of the requirements of the study, provided with an informed consent form to sign, as well as information sheet with information about the study and the contact details of the primary investigator and their supervisor. On completion of the survey the patient was debriefed, told the true hypothesis of the study, and sincerely thanked for their contribution. Results The total number of patients to the . center from '06 to .. '06, was 405. Table 1 highlights the different means and standard errors across the five days. The mean number of patients peaked on the Wednesday. Table 1 Comparison of Daily Means of Patient Numbers for the Study Period Day Mean Patient Numbers Standard Error of Mean Monday 32 8.27 Tuesday 37 9.57 Wednesday 45 8.22 Thursday 29 7.64 Friday 33 8.55 The one-way ANOVA found that the workloads across the days were significantly different, F (4, 28) = 7.3, p < .05. The survey responses had a mean score of 53.25 (SD = 3.76), indicating that patient perceptions of satisfaction with the x-ray center was acceptable (scores below 45 representing more negative perceptions of service). A Pearson's correlation between the workload means and the mean patient satisfaction score revealed that a significant positive relationship exists (r = .83). There were no significant results from the Chi square tests. Several of the demographical (categorical) responses appear to be skewed, and this may explain the lack of relationship between specific patient characteristics, daily workload or level of satisfaction. It may be that the infrastructure of the x-ray center need for modification may cross all demographic boundaries; the issue is pertinent. The descriptive summaries also provide insight into areas in which the workload of the x-ray center may be heaviest, and so technicians may need to tailor their approach during these peak times, as shown in Figures 1- . Figure 1. Gender distribution of the sample. It appears that two thirds of the patients were female. It is evident that the sample was not normally distributed in regards to age either, as shown in the bar graph in Figure 2. The ages of the respondents ranged from 18 to 45 years. Almost half of the respondents were under the age of 30 years. The mean age was 43 years with a standard deviation of 13. Additionally the modal age was 21 years, having a frequency of 4. As such, there was great variability within the sample that may have confounded the more specific results, such as determining if there is an association between workday workload and gender or age. However, the timing of the study may have had an influence, as the surveys were conducted during the working hours of Monday to Friday. Figure 2. Age distribution of the sample of patients. Over one-third of the sample was aged between 26-35 years. And almost two-thirds of the sample was under the age of 35 years. Type of x-ray for the patient showed that almost half of the sample had their chest and arms x-rayed (46.7%). A large proportion of the sample answered that they were there because of their lower back (0.27). Over one tenth of the participants indicated that they needed a chest and arm x-ray (16.7%). A small percentage indicated that they were there for their legs (6.7%), and only a handful responded that the appointment was for a head x-ray (3.3%). Figure 3. Pie chart of the distribution of the body parts that were x-rayed for the patients. Of the sample, almost one third spent 82 minutes within the x-ray center, as shown in Figure 4. Appointment and x-ray session times ranged from 57 minutes to 1 hour and forty-minutes across the 5 days of the study. There were three modes within the data set, with 86 participants for each of the categories between 61 minutes - 90 minutes. The average patient processing time was 75 minutes. Time Taken (minutes) Frequency Cumulative Frequency Read More