Whistle while you work

2015 04 20 11 53 22 952 Gnomes Snow White Dwarves 200

It isn't often that I have something to be cheery about at work. Conditions in England's National Health Service (NHS) aren't generally conducive to smiling, spontaneous laughter or outbursts of song. U.K. radiology is in a particularly dark place at the moment. But the last 12 months have seen this radiologist quite bright-eyed and positively bushy-tailed at times. I have been known to whistle the odd merry tune apropos of nothing.

The reason for this uncharacteristic jauntiness is fairly simple. It wasn't that we were lucky enough to recently fund five new posts for experienced radiologists or consultants. It wasn't the pleasant surprise at getting five applicants. It wasn't the frank astonishment at appointing five highly promising individuals. It wasn't the bewildering fact that they've all turned out to be absolutely cracking new colleagues. Admittedly, this has helped, but it isn't the real reason.

Dr. Paul McCoubrie is a consultant radiologist at Southmead Hospital in Bristol, U.K.Dr. Paul McCoubrie is a consultant radiologist at Southmead Hospital in Bristol, U.K.
Dr. Paul McCoubrie is a consultant radiologist at Southmead Hospital in Bristol, U.K.

The truth behind my buoyant spirits is moving into our new hospital building. It opened in May 2014 after nine years of planning and building. Two distinctly down-at-the-heel old hospitals were merged into a single, brand new, huge building. It took 46,000 m3 of concrete and 7,000 tons of structural steel to construct one of the largest buildings in Bristol, at a cost of 430 million pounds (598 million euros).

Part of the joy is the physical beauty of the building. The main atrium is six stories of multicolored glass. Natural light abounds. Simply strolling through it puts a spring in your step. Installation art and courtyard gardens are around each corner.

Part of the joy is finally seeing what we planned so meticulously finally come to fruition. Our radiology department was highly engaged, unlike others. We spent countless hours with the architects and planners. There was table thumping at times. We moved doorways by 5 cm and light switches by less. It was worth it; we got the department that we needed. Moreover, all the design features that we insisted upon are now working like a dream. One of the planning team is fond of quoting, "People got the department that they deserved," to which I smiled knowingly.

The impressive atrium of the Brunel Building at Southmead Hospital Bristol.The impressive atrium of the Brunel Building at Southmead Hospital Bristol.

Part of the joy is a profusion of new scanners. The lengthy planning had blighted scanner replacement. We, therefore, limped along on some ancient machines. One famous 14-year-old four-slice CT had literally no original parts apart from the outer casing; everything had been replaced at least once. A 17-year-old MRI system broke irreparably; it literally went "bang" and that was that. The new hospital, however, is crammed with gleaming new machines. We stared, slack-jawed and drooling.

Part of the joy is ergonomic PACS stations. We designed a suite of identical reporting rooms with highly adjustable chairs and tables. They are immensely comfortable -- a prolonged reporting session no longer feels like a physical chore.

Part of the joy is the direct adjacencies. The main radiology department is literally in the middle of the hospital. Nothing is far away. Our admin office is next to the reporting suite and opposite the secretaries' office and the coffee room. These four points form a holy quadrilateral, especially the latter.

Part of the joy is a hot/cold split. All clinical enquiries, trauma calls, and urgent cases go to our separate emergency radiology subdepartment. This is nested within the emergency department and is staffed 24/7 by more junior colleagues, or registrars, and 8 a.m. to 8 p.m. by consultants. We all work in shifts to make the intensity of the work bearable. The main department is, therefore, deliberately interruption-free by design.

Part of the joy is new facilities that we never had before. We built a huge interventional radiology (IR) unit. Specifically designed with six fluoroscopy rooms (including one hybrid suite) and a 16-bed day-case unit, patient throughput is slick, and IR is now assuming its rightful prominence. Then there is the self-contained one-stop breast unit. And not forgetting the brand new PET/CT suite too.

Part of the joy is, bizarrely, an open-plan office. Much feared but, in fact, a very sociable admin space. All 35 consultants share a big office with large south-facing windows. Quiet enough to get your head down, but a colleague is always on tap for a second opinion. It has also brought us together as a group in a way that we didn't foresee.

A single quote encapsulated all this the other day. One of my new colleagues said unprompted, "This must be the best radiology department in the U.K." I agreed, grinning. But then again he was one of our old registrars, so he would say that.

Dr. Paul McCoubrie is a consultant radiologist at Southmead Hospital in Bristol, U.K.

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