Care and feeding of a staff for filmless radiology

Texas Children's Hospital, a definitive care pediatric hospital located in the Texas Medical Center, has been constructing a large-scale picture archi val and communications system (PACS) including ultrasound (US), computed to mography (CT), magnetic resonance (MR), and computed radiography (CR). Deve loping staffing adequate to meet the demands of filmless radiology operatio ns has been a continuous challenge. Overall guidance for the PACS effort is provided by a hospital-level PACS Committee, a department-level PACS Steer ing Committee, and an Operations Committee. Operational Subcommittees have been formed to address service-specific implementations, such as the Emerge ncy Center Operations Subcommittee. These committees include membership by those affected by the change, as well as those effecting the change. Initia lly, personnel resources for PACS were provided through additional duties o f existing imaging service personnel. As the PACS effort became more comple x, full-time positions were created, including a PACS Coordinator, a PACS A nalyst, and a Digital Imaging Assistant. Each position requires a job descr iption, qualifications, and personnel development plans that are difficult to anticipate in an evolving PACS implementation. These positions have been augmented by temporary full-time assignments, position reclassifications, and cross-training of other imaging personnel. Imaging personnel are assist ed by other hospital personnel from Biomedical Engineering and Information Services. Ultimately, the PACS staff grows to include all those who must op erate the PACS equipment in the normal course of their duties. The effectiv eness of the PACS staff is limited by their level of their expertise. This report discusses our methods to obtain training from outside our institutio n and to develop, conduct, and document standardized in-house training. We describe some of the products of this work, including policies and procedur es, clinical competency criteria, PACS inservice topics, and an informal PA CS newsletter, As the PACS system software and hardware changes, and as our implementation grows, these products must to be revised and training must be repeated. Copyright (C) 1999 by W.B. Saunders Company.