Presentation
The Sonography Grand Challenge Longitudinal Research Study: A National Effort to Improve Healthcare Workforce Health and Well-Being
DescriptionThis session will describe the creation and implementation of a national effort to identify and address worker health and well-being at a broad profession-based level, including the organization of a profession-wide alliance, the development of a profession-specific sociotechnical framework, and the launch of a national longitudinal research registry.
The pervasive issue of work-related musculoskeletal disorders (WRMSD) among sonographers was first reported in a professional editorial more than 30 years ago. Since then, a plethora of case reports and survey studies have documented a persistent prevalence of injuries in up to 90% of sonographers. A limited number of observational and small-sample intervention studies have analyzed postures, kinematics, and muscle activation to explore risks related to ultrasound equipment design and sonographer ergonomics. As a result of these reports, awareness has increased across the sonographer workforce, and recommendations have been released that call for improvement in equipment design and the implementation of ergonomic practices to improve the health and well-being of sonographers. Of note, multiple documents with guidelines and practice principles for the prevention of WRMSD in sonographers have been published by the Society for Diagnostic Medical Sonography (SDMS), the American Institute of Ultrasound in Medicine (AIUM), and the National Institute for Occupational Safety and Health (NIOSH).
These efforts have resulted in improvements to equipment design and adjustability and have spurred the widespread availability of ergonomic training opportunities for sonographers; however, there has been no measurable decline in the prevalence of WRMSD among the sonographer workforce. Current evidence is limited to reporting prevalence among small samples that only estimate loose associations between risk factors and WRMSD. These studies have primarily focused on injury risk related to the interface of an individual worker, ultrasound equipment, and imaging task, and there is limited understanding of the administrative and organizational contexts. Moreover, due to their cross-sectional nature, previous studies have not identified the incidence of new-onset injuries nor adequately qualified WRMSD within ultrasound users as acute or chronic conditions. Longitudinal data that examine the onset and progression of WRMSD across time and more fully evaluate the intricate complexities across all worker, work, and workplace contributors to improvement or decline in sonographer health and well-being were needed to advance worker health efforts.
The Grand Challenge Alliance (hereafter referred to as the Alliance) was developed to stop, or at least reduce, WRMSD resulting from the performance of diagnostic medical ultrasound. This Alliance is formed by eight national professional societies, certification providers, and accreditation organizations representing various sonographer workforces. At the outset, a metrics workgroup was established to develop measures and examine outcomes of Alliance efforts (e.g., design summit, hackathons). Upon review of existing evidence and identification of the issues noted above, the group quickly identified a need to provide a mechanism for monitoring the progress of WRMSD across time and examine potential unexplored contributors requiring action. It was the intent that this effort would (1) leverage repeated measures across time to identify key risk factors related to the onset or exacerbation of WRMSD that can be targeted through other Alliance efforts and (2) provide a means for examining the remediation of WRMSD among workers based on the adoption of such efforts.
As a result, our research team developed and launched an ongoing longitudinal research effort. Our core interdisciplinary research team includes a sonographer, an industrial and systems engineer, and an occupational therapist. We have integrated our complementary expertise in sonography practice, human factors, ergonomics, and injury prevention, and holistic perspectives on total worker health and well-being. At the project's outset, our team developed a sociotechnical systems framework to ensure that the work considered a broad range of work systems and process factors associated with worker health and well-being outcomes. Specifically, we adapted the Systems Engineering Initiative for Patient Safety (SEIPS) to create the Sonography Work Systems model as a foundation for our efforts. With support from the Alliance, an initial questionnaire was launched to gather baseline data across various factors (i.e., worker, tasks, tools, organization, environment, and processes) and worker health outcomes (i.e., musculoskeletal injury, physical discomfort, headaches, and visual strain). To measure changes over time, understand other worker outcomes (e.g., burnout), and more deeply examine specific system and process factors, three follow-up questionnaires have been sent at six-month, one-year, and two-year intervals to the 3659 ultrasound users who joined the research registry.
Paramount among our findings are previously unreported associations among organizational and environmental factors within the healthcare setting. Interruptions to workflow timing and pacing due to administrative issues, patient characteristics, and other scheduling challenges is one factor associated with most poor worker health outcomes across all types of sonographers. Similarly, the number of organizational policies and procedures relating to ergonomics and injury prevention is highly predictive of worker experiences of work-related discomfort – the more policies the less likely a sonographer is to report discomfort. In addition to robust quantitative modeling, our work employs qualitative, first-hand experiences to uncover critical barriers to sonographer health. For example, sonographers’ successful use of adaptable equipment and implementation of ergonomic training, which is challenged by a lack of representation across levels of influence within and across organizations.
This effort, now in its third year, has provided invaluable insights and created a foundation for the Alliance to shift and extend conversations related to interventions for addressing WRMSD to factors that extend beyond equipment design and individual worker ergonomics. Specifically, our efforts create opportunities for system-wide communication strategies and the development of organizational policies to address the pervasive worker health issue. Such policies and other procedures employed at the organizational level are likely to have a broader impact on improving the health and well-being of workers across the overall hospital environment.
The pervasive issue of work-related musculoskeletal disorders (WRMSD) among sonographers was first reported in a professional editorial more than 30 years ago. Since then, a plethora of case reports and survey studies have documented a persistent prevalence of injuries in up to 90% of sonographers. A limited number of observational and small-sample intervention studies have analyzed postures, kinematics, and muscle activation to explore risks related to ultrasound equipment design and sonographer ergonomics. As a result of these reports, awareness has increased across the sonographer workforce, and recommendations have been released that call for improvement in equipment design and the implementation of ergonomic practices to improve the health and well-being of sonographers. Of note, multiple documents with guidelines and practice principles for the prevention of WRMSD in sonographers have been published by the Society for Diagnostic Medical Sonography (SDMS), the American Institute of Ultrasound in Medicine (AIUM), and the National Institute for Occupational Safety and Health (NIOSH).
These efforts have resulted in improvements to equipment design and adjustability and have spurred the widespread availability of ergonomic training opportunities for sonographers; however, there has been no measurable decline in the prevalence of WRMSD among the sonographer workforce. Current evidence is limited to reporting prevalence among small samples that only estimate loose associations between risk factors and WRMSD. These studies have primarily focused on injury risk related to the interface of an individual worker, ultrasound equipment, and imaging task, and there is limited understanding of the administrative and organizational contexts. Moreover, due to their cross-sectional nature, previous studies have not identified the incidence of new-onset injuries nor adequately qualified WRMSD within ultrasound users as acute or chronic conditions. Longitudinal data that examine the onset and progression of WRMSD across time and more fully evaluate the intricate complexities across all worker, work, and workplace contributors to improvement or decline in sonographer health and well-being were needed to advance worker health efforts.
The Grand Challenge Alliance (hereafter referred to as the Alliance) was developed to stop, or at least reduce, WRMSD resulting from the performance of diagnostic medical ultrasound. This Alliance is formed by eight national professional societies, certification providers, and accreditation organizations representing various sonographer workforces. At the outset, a metrics workgroup was established to develop measures and examine outcomes of Alliance efforts (e.g., design summit, hackathons). Upon review of existing evidence and identification of the issues noted above, the group quickly identified a need to provide a mechanism for monitoring the progress of WRMSD across time and examine potential unexplored contributors requiring action. It was the intent that this effort would (1) leverage repeated measures across time to identify key risk factors related to the onset or exacerbation of WRMSD that can be targeted through other Alliance efforts and (2) provide a means for examining the remediation of WRMSD among workers based on the adoption of such efforts.
As a result, our research team developed and launched an ongoing longitudinal research effort. Our core interdisciplinary research team includes a sonographer, an industrial and systems engineer, and an occupational therapist. We have integrated our complementary expertise in sonography practice, human factors, ergonomics, and injury prevention, and holistic perspectives on total worker health and well-being. At the project's outset, our team developed a sociotechnical systems framework to ensure that the work considered a broad range of work systems and process factors associated with worker health and well-being outcomes. Specifically, we adapted the Systems Engineering Initiative for Patient Safety (SEIPS) to create the Sonography Work Systems model as a foundation for our efforts. With support from the Alliance, an initial questionnaire was launched to gather baseline data across various factors (i.e., worker, tasks, tools, organization, environment, and processes) and worker health outcomes (i.e., musculoskeletal injury, physical discomfort, headaches, and visual strain). To measure changes over time, understand other worker outcomes (e.g., burnout), and more deeply examine specific system and process factors, three follow-up questionnaires have been sent at six-month, one-year, and two-year intervals to the 3659 ultrasound users who joined the research registry.
Paramount among our findings are previously unreported associations among organizational and environmental factors within the healthcare setting. Interruptions to workflow timing and pacing due to administrative issues, patient characteristics, and other scheduling challenges is one factor associated with most poor worker health outcomes across all types of sonographers. Similarly, the number of organizational policies and procedures relating to ergonomics and injury prevention is highly predictive of worker experiences of work-related discomfort – the more policies the less likely a sonographer is to report discomfort. In addition to robust quantitative modeling, our work employs qualitative, first-hand experiences to uncover critical barriers to sonographer health. For example, sonographers’ successful use of adaptable equipment and implementation of ergonomic training, which is challenged by a lack of representation across levels of influence within and across organizations.
This effort, now in its third year, has provided invaluable insights and created a foundation for the Alliance to shift and extend conversations related to interventions for addressing WRMSD to factors that extend beyond equipment design and individual worker ergonomics. Specifically, our efforts create opportunities for system-wide communication strategies and the development of organizational policies to address the pervasive worker health issue. Such policies and other procedures employed at the organizational level are likely to have a broader impact on improving the health and well-being of workers across the overall hospital environment.
Event Type
Oral Presentations
TimeTuesday, March 262:10pm - 2:30pm CDT
LocationSalon A-1
Hospital Environments