Case examples of resilience in nuclear medicine
| Description | Location | Individual choice or formal policy | Resilience characteristic(s) |
|---|---|---|---|
| Staff arrive at work ∼10–15 min earlier than officially scheduled to commence radiopharmaceutical preparation and avoid interruptions | Hot-lab | Individual choice, but consistently observed in all individuals rostered to this role | Anticipatory |
| At key times, technologists preparing or administering radiopharmaceuticals would not respond to telephone calls, overhead pages or attempts by other staff to initiate communication | Hot-lab, scan room, injection room | Individual choice, observed on some occasions | Responsive, past experience |
| During radiopharmaceutical preparation, staff keep their eyes on the material being prepared and sometimes elect not to respond to professional or social communication or choose to ‘multitask’ by keeping their focus on the material being prepared while responding to others | Hot-lab | Individual choice, observed on some occasions | Responsive, past experience |
| Use of bar-coding technology for individual radiopharmaceuticals | Hot-lab | Formal departmental policy, used consistently by all technologists rostered to this role | Attentive, past experience |
| Use of sticky notes on patient request forms or phials to convey key information, especially if a technologist is expecting to be absent for a while | Hot-lab, scan room, clerical area | Individual choice, but consistently observed in all individuals rostered to this role | Anticipatory |
| Printout of requested procedures for the day are colour-coded for tests requiring different radiopharmaceuticals | Hot-lab | Individual choice, but consistently observed in all individuals rostered to this role | Attentive, anticipatory |
| Printouts conveying important elements of quality assurance procedures are displayed at eye level in the hot-lab radiopharmaceutical work area | Hot-lab | Formal departmental policy, used consistently by all technologists rostered to this role | Attentive, past experience |
| Technologists defer initiating conversation with a colleague if he/she appears busy | All work areas | Individual choice, observed on some occasions | Anticipatory, past experience |
| The use of whiteboard to convey weekly information about the delivery of external supplies | Hot-lab | Formal departmental policy, implemented by senior technologists | Attentive, anticipatory |
| Some interruptions, usually in the form of professional communication between technologists, are used to alert one another to potential pitfalls about procedures or patients; for example, a request for a thyroid scan may be converted to a parathyroid scan after medical review, thus necessitating the preparation of a different radiopharmaceutical | Patient waiting room, scan room, hot-lab, in transit | Individual choice, but consistently observed in all individuals in the direct care of a patient | Attentive, responsive, anticipatory |
| Multitasking is frequently employed by all technologists, sometimes to avoid external stimuli from interrupting the primary task | All work areas | Individual choice, but consistently observed in all individuals | Responsive |
| Certain high-risk procedures, particularly therapeutic nuclear medicine, are rostered to an individual technologist who becomes responsible for all aspects of its conduct | Hot-lab, scan room, patient waiting room | Formal departmental policy adopted by all technologists rostered to this role | Anticipatory, past experience |
| Some technologists defer their lunch or break in order to stay in the control room (adjacent to scanners) so as to troubleshoot any potential complications during a procedure | Scan rooms | Individual choice, observed in a few technologists | Responsive, anticipatory |
| Some interrupted tasks may be resumed by a second technologist to help continue a procedure and/or ensure quality is maintained | Scan rooms, hot-lab | Individual choice, observed on some occasions | Responsive |
| Although most staff carry mobile telephones, these are switched to vibrate and are not looked at, except during personal time | All work areas | Directive from the chief technologist | Past experience |
| If a senior technologist does not respond to an overhead page or telephone call, the clerical staff redirect the call to another senior technologist | Clerical work area | Individual choice, observed on some occasions | Responsive |
| Scan protocols and patient information sheets are stored on all computers for easy access | Scan rooms, clerical areas | Departmental policy used by all nuclear medicine technologists | Attentive, anticipatory |
| Technologists proactively contact patients and external health professionals before the procedure is scheduled to facilitate smooth conduct of procedures | Clerical areas, scan rooms | Individual choice, but observed in all individuals rostered to this role | Anticipatory |