Perceptions and use of computed tomography in a Hospital Emergency Department: technicians’ perspectives

Objective: This study traces the evolution of perceptions and use of Computed Tomography (CT) by radiology technicians in the emergency department (ED) of a hospital in Italy across a 7-year period. Background: The sociotechnical context of the CT room of an ED has been neglected by scientific research— potentially impacting safety. Method: Two studies were performed, one in 2011 and one in 2018. Six CT technicians were involved in each. Structured interviews were performed to gather information on perceptions related to the evolution of the use of CT according to nine different factors—e.g. the level of complexity, and mental workload. Observations were performed on duration of exams, the flow of people, conversations, and any critical issues. Results: The CT technology is appreciated, used effectively and with confidence by CT technicians. From 2011-2018, the execution times of the exams have decreased but not the proportion of time dedicated to the patient. Expectations for future improvements are limited by issues concerning the design of both the user interface and the social context of the ED workplace. Conclusions: The safety and efficiency of the system as a whole are greatly dependent on the competence of the CT technicians. CT manufacturers rely on this competence to help compensate for the deficiencies created by suboptimal user interfaces and the lack of fit of the technology with the social context of the workplace. Application: Training programs aimed at improving the management of relationships and communications between staff could improve performance and efficiency. CT manufacturers should try to better understand the cognitive and operational context of the workplaces where CT technicians work—and to design better diagnostic technology which accounts for these operational realities.