Truncated careers in nuclear medicine technology: increased job control may improve retention.

OBJECTIVES: The aim of the study was to gain understanding of why nuclear medicine technologists (NMTs) leave and to compare workforce and service provision trends with diagnostic imaging professionals. DESIGN AND SETTING: A survey of all NMT professional body members in New South Wales, the Australian Capital Territory and Queensland was conducted. This paper reports on survey findings of those no longer working as a NMT. Analysis of 1996, 2001 and 2006 Australian Census data and Medicare statistics was made for NMTs, sonographers and radiographers. MAIN OUTCOME MEASURES: The five most influential reasons for leaving nuclear medicine were measured by survey. Census data measured workforce characteristics; size, sex, age. Medicare statistics measured national service provision. RESULTS: Primarily, limited career pathways and professional plateau influence retention of NMTs, with sonography a common career move. Nuclear medicine technologists are young (44.3% <30 years) compared with radiography (52.3% <40 years) or sonography (52.8% <40 years). From 2001 to 2006, service provision in nuclear medicine grew by 11.8% compared with 36% in ultrasound but the workforce size decreased by 4.9% whereas sonographers increased by 51.1%. CONCLUSIONS: Increasing the level of job control is the most likely factor in creating a positive change to the NMT job characteristics and improving retention.

The impact of computerized provider order entry systems on medical-imaging services: a systematic review.

BACKGROUND: Computerized provider order entry (CPOE) systems have been strongly promoted as a means to improve the quality and efficiency of healthcare. METHODS: This systematic review aimed to assess the evidence of the impact of CPOE on medical-imaging services and patient outcomes. RESULTS: Fourteen studies met the inclusion criteria, most of which (10/14) used a pre-/postintervention comparison design. Eight studies demonstrated benefits, such as decreased test utilization, associated with decision-support systems promoting adherence to test ordering guidelines. Three studies evaluating medical-imaging ordering and reporting times showed statistically significant decreases in turnaround times. CONCLUSIONS: The findings reveal the potential for CPOE to contribute to significant efficiency and effectiveness gains in imaging services. The diversity and scope of the research evidence can be strengthened through increased attention to the circumstances and mechanisms that contribute to the success (or otherwise) of CPOE and its contribution to the enhancement of patient care delivery.

The work environment and its effect on engagement and retention of nuclear medicine technologists: differences between public and private sector workers.

OBJECTIVE: The retention of Australian nuclear medicine technologists (NMTs) is poor with the future workforce size in question. As a consequence, the primary aim of this study was to determine Australian NMTs' level of work engagement and the factors influencing this to identify the issues surrounding retention. METHODS: The job demands resource model assumes that each job has its own demands and resources and the balance between these can influence the level of work engagement. Lower levels of work engagement are predictive of an intention to leave. Work engagement levels can be measured using the Utrecht work engagement scale. This study used the Utrecht Work Engagement Scale in a self-report questionnaire with additional open-ended and closed-ended items designed to evaluate satisfying job characteristics. Members of the professional body in specific geographical locations of Australia were invited to participate. RESULTS: A 49.6% response rate was achieved (n=201); of these, 164 were practicing NMTs. Public sector workers had significantly lower total mean scores (P=0.05) on the Utrecht Work Engagement Scale and the subscale of dedication (P=0.005) compared with private NMTs. Seven of the 14 job satisfaction closed-ended items were statistically significantly lower for public NMTs: the level of decision making; feelings of importance with the tasks performed; feedback on tasks and roles; and relationships with physicians, staff and the organization. CONCLUSION: To improve the retention of NMTs, changes in the job resources and demands are needed. Advanced practice roles may improve retention by enhancing the job resources.

The effects of technological developments on nuclear medicine technologist productivity: a systematic review.

OBJECTIVES: Nuclear medicine has changed rapidly as a result of technological developments. Very little is reported on the effects these developments may have on technologist productivity. This study aims to determine whether advances have created a workplace where more patient studies can be performed with fewer technologists. The level of change in automation or time taken to perform a routine task by the nuclear medicine technologist as a result of technological development over the past decade is reported. METHODS: A systematic review was conducted using Embase.com, Medline, INSPEC, and Cinahl. Two authors reviewed each article for eligibility. Technological developments in routine areas over the past decade were reviewed. The resultant automation or time effects on data acquisition, data processing, and image processing were summarized. RESULTS: Sixteen articles were included in the areas of myocardial perfusion, information technology, and positron emission tomography (PET). Gamma camera design has halved the acquisition time for myocardial perfusion studies, automated analysis requires little manual intervention and information technologies and filmless departments are more efficient. Developments in PET have reduced acquisition to almost one-fifth of the time. CONCLUSIONS: Substantial efficiencies have occurred over the decade thereby increasing productivity, but whether staffing levels are appropriate for safe, high quality practice is unclear. Future staffing adequacy is of concern given the anticipated increasing service needs.

Will the Australian nuclear medicine technologist workforce meet anticipated health care demands?

Determination of national nuclear medicine technologist workforce size was made from census data in 2001 and 1996 and from the professional body in 2004. A survey conducted by the authors in 2005 provided retention patterns in north-eastern Australia and suggested causes. Utilisation of nuclear medicine diagnostic services was established through the Medicare Benefits Schedule group statistics. More than half the nuclear medicine technologist workforce is under 35 years of age. Attrition commences from age 30, with very few workers over 55 years. In 2005 there was a 12% attrition of the survey workforce. In the past decade, service provision increased while workforce size decreased and the nuclear medicine technologist workforce is at risk of failing to meet the anticipated rise in health service needs.

A profile of Australian nuclear medicine technologist practice.

BACKGROUND: Nuclear medicine in Australia has encountered significant change over the past 30 years, with a move to privately owned practices, technological advances and the transfer of education of the nuclear medicine technologist (NMT) from technical college apprenticeships to university degrees. Currently, shortages of nuclear medicine technologists are reported in some states of Australia. It is not known whether changes in NMT practice or the type of centre in which an NMT works have an influence on retention of staff. AIM: The primary objective of this survey was to establish a profile of NMT practice in Australia, with the aim of producing baseline data that could be used in further research to establish levels of retention and job satisfaction. METHODS: Chief technologists in three states of Australia were invited to respond to a written questionnaire. The questionnaire included data about staffing levels, imaging modalities, procedures performed, and movement of staff. Findings presented will relate to the profile of practice data only. RESULTS: Forty-eight (54%) chief technologists responded to the questionnaire with 73% working in privately owned practices. The majority of centres employ up to two full-time equivalent nuclear medicine technologists and have two gamma cameras and one full-time equivalent nuclear medicine physician. Most centres perform a limited range of studies with bone scans predominating. More than half the centres make some use of a centralized radiopharmacy service. CONCLUSION: Further research is required to determine how these changes may impact on workplace satisfaction and in turn, on retention.

Continuing education and professional development

The success of a profession will be determined upon its education and training. A profession is required to encompass: a core body of knowledge; a set of ethical codes of practice; and have practitioners with humanistic qualities. In order to maintain the success of a profession it is necessary to have continuing education, which enhances professional development. Continuing professional education includes a form of self-regulation, which ensures the maintenance of a minimum standard of practice in this ever-changing workplace, and by regulating this standard, the discipline becomes more accountable to the client and the profession as a whole. In Australia, the Nuclear Medicine society's continuing education programs and Universities offering postgraduate programs promote continuing education. If technologists are to successfully keep up with developments in instrumentation, protocols and changing health care requirements, we must ensure that the education of practitioners does not cease at certification of entry to the workplace