1. Faster and more flexible
Working more efficiently through wireless digital radiography
Who/Where
Particularly for routine examinations such patients, as the Hamburg Federal Armed
X-ray department, Hamburg Federal as radiography, digital devices with wireless Forces Hospital forms part of the civilian
Armed Forces Hospital, Germany
portable detectors offer a lower X-ray dose healthcare system of Hamburg as well.
of radiation and improved image quality
while making the work significantly easier. "This technical innovation
"It is quicker, it is easier to operate and, is not only an advantage
most importantly, the image quality is an for military personnel, but
improvement over the imaging plate systems
also for civilian patients."
that we have been using until now," summarizes
radiographer Slawomir Skrzypczak. He works For example, let us consider a bed-ridden
closely with the DigitalDiagnost system in elderly lady who has recently had an operation
The Challenge
the radiology department of the Hamburg on her knee and needs to be X-rayed — a
To create an X-ray room in which
patients can be examined quickly, Federal Armed Forces Hospital, and he is routine examination. The head radiographer,
effortlessly and without any major
thoroughly impressed. Elisabeth Wolking, already possesses all of
transfers taking place
the relevant patient data — the radiology
What's more, he is not alone: Since the information system has sent it to the
radiology department of the Hamburg Federal DigitalDiagnost system. All Ms. Wolking needs
Armed Forces Hospital set up its new X-ray to do is to select the examination protocol
room with DigitalDiagnost technology at the system's intuitive and easy-to-use Eleva
including a wireless portable detector, all of user interface which already contains all
the department's radiographers prefer to use exposure settings as pre-sets, leaving her with
this device. It features three detectors: an more time to look after the patient. There is
The Solution in-table detector, a wall-mounted detector no need for her to expend time and energy
DigitalDiagnost digital X-ray system and a wireless portable detector. transferring the patient on to the examination
with additional portable, wireless
portable detector table and causing her unnecessary pain. Instead,
"This gives us the widest range of options," the radiographer completes the examination
says Slawomir Skrzypczak. According to using the wireless portable detector by placing
Slawomir Skrzypczak, it also allows them it in the bed under the patient's knee. The
to examine patients in the most precise way joint is painful and must be moved as little as
possible, while ensuring the procedure is possible. Elisabeth Wolking puts the X-ray tube
fast and comfortable for the patient. This in position; with the lowest possible X-ray dose
technical innovation is not only an advantage of radiation automatically pre-set, she can now
for military personnel, but also for civilian easily take the exposure.
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2. She has to wait just five seconds before This is especially useful for X-rays of the radiography of large objects, for example
the image she has taken appears on the extremity and thorax. "Of course, we could pelvis X-rays. "We used to find X-rays like
application workstation monitor in front of take X-rays like these using a cassette-based these rather difficult," confirms Slawomir
her. After ensuring the quality of the image X-ray system, but it would be nowhere Skrzypczak. Digital processing using the
is sufficient, she can now conclude this part near as easy and, above all, would not offer image processing software UNIQUE
of the examination. The image data is sent this level of quality and speed," affirms (UNified Image QUality Enhancement) has
directly to the internal PACS image archiving Slawomir Skrzypczak. made the system less sensitive to exposure
system and both Dr. Hans-Michael Schlegel problems. This is an important factor for
COL MC. and the surgeon operating on the In this regard, the wireless portable radiographers to consider. "After all, we
knee can access the X-rays immediately. detector not only offers the greatest degree want to take X-rays at the lowest possible
of flexibility — the combination of wall- X-ray dose of radiation so that the patient
"Working wirelessly improves mounted and in-table detectors allows is protected, but we also want to get the
superior X-rays to be taken, e.g. X-rays of best possible images."
hygiene around the the pelvis in the event of a neck of femur
hospital bed." fracture. "On one level, we can take X-rays
using the in-table detector as before, but on "We do not cause the patient
"I am grateful we have the wireless portable a second level, we can also take axial images unnecessary pain."
detector, particularly when examining without any trouble," explains Skrzypczak.
patients who must be monitored," explains The vertical stand is so flexible that it can Slawomir Skrzypczak can now scarcely
Slawomir Skrzypczak. "They are already be moved closer to the patient along with imagine working without the digital, wireless
connected to so many cables and tubes, so the mobile examination table, so that images system — and he is not the only one. In
it's good that I don't have to keep my eye on can be taken at a 90-degree angle. "During fact, if the radiographers had their way, all
a bulky device cable." It's also inevitable that this time, the patient lies on the examination of the X-ray systems workstations would
cables come into contact with the ground, table and must not be moved. This means we be equipped with a wireless portable
which may bring pathogens into the patient's do not cause the patient unnecessary pain." detector, as Dr. Hans-Michael Schlegel
bed. Working wirelessly therefore improves COL MC. confirms: "I have never seen my
hygiene around the hospital bed. The image quality of devices that were radiographers be so enthusiastic about
previously used in the department was a device after such a short time."
The wireless portable detector also comes not so good, particularly when it involved
into its own when examining the increasing
numbers of heavily overweight patients.
If they are so severely injured that they
cannot lie or sit on the examination table
under their own power, they must be lifted
onto it by the radiographers. If the X-ray is
taken using the wireless portable detector,
the patients can remain in their wheelchair
or on their stretcher and the radiographers
do not need to do any heavy lifting.
Overtable X-ray of
the lower extremity
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3. Dr. Hans-Michael Schlegel COL MC.
with the wireless portable detector
What makes you stand out from other
hospitals or specialist clinics?
One of our definite plus points is that we
use state-of-the-art equipment. This puts
patients at an advantage as they are subjected
to a lower X-ray dose of radiation during
examinations. As a Federal Armed Forces
Hospital, we operate certified quality
management procedures. I am convinced that
we give more of our time to patients and can
use the full range of medical diagnostic and
treatment options available. This hospital
brings together a host of different disciplines.
There is a flat hierarchy and the level of
interdisciplinary cooperation is good. The
result is that our patients are satisfied. We
often get the feedback that we are friendlier
towards them than other hospitals.
Unfortunately, there is some bad news for
patients covered by public health insurance:
We can only diagnose them as an emergency
case or if they are in-patients. Out-patients
must be covered by private health insurance.
However, this does not make us any different
Interview emergencies determine the day-to-day from other radiological departments that do
operation of our radiology department. not have an X-ray clinic, as statutory health
Dr. Hans-Michael Schlegel COL MC., Chief They make up around 80% of the cases we insurance patients are the exception here.
Physician of the radiology department at the deal with. They are primarily older people
Hamburg Federal Armed Forces Hospital who have fallen. We then provide further Are there any particularly tricky cases
treatment for 90% of these emergencies. that are difficult to examine with
Dr. Schlegel, Hamburg Federal Armed conventional X-ray equipment?
Forces Hospital has been treating How important is treatment of civilian Definitely traumas with older people.
civilian patients since 1969. Since patients in your department? Very often, they are not overly mobile
2006, it has been part of Hamburg's Up to now, the majority of our patients and sometimes not as mentally alert
emergency service network. To what are military personnel, as patients are as they once were. This used to make
extent do emergencies determine transferred to us from all military clinics in examinations quite difficult.
the course of your working day? the region. This will probably change when But now that we have the wireless digital
127 of our 307 beds are currently available the military is restructured and the relative detector, it has become much easier:
for civilian patients. Particularly at night, proportion of civilian patients increases. The patients can simply sit or lie down,
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4. Bed X-ray of the lower leg using the wireless portable detector
and the examinations are much quicker, cassette-based X-ray system in the intensive What features would you like a future
which reduces patient waiting times. There is care unit, but only because the wireless wireless portable detector to have?
no read-out required as with cassette-based connection for the digital device did not The detector could be flatter. But above all,
systems, meaning we save two to three reach that far. it would be nice if it were suitable for use in
minutes per X-ray. As the data is transferred extreme environments such as Afghanistan.
digitally, I can see straight away whether an How have organizational processes To do this, it would need to be lighter and
image has been successful. This saves a lot of been changed by the X-ray system? smaller, and the entire X-ray system would
time, particularly during routine X-rays. We streamlined the radiology department have to be waterproof, dust-proof and
some time ago. Now things are more likely able to withstand temperatures of –20 to
What advantages do the new digital to run to schedule, as procedures such +50 degrees Celsius. Then there would be
X-ray system and the wireless portable as the read-out process of cassettes are no need for us to read out the cassettes,
detector offer you from a diagnostic omitted. The time we save can be spent as we have been doing until now.
point of view? on patients.
The exposure is simply better, meaning the In addition, the data could then be
image quality is better too. X-rays that used Do you save on costs compared with transferred quickly to a larger medical
to be complicated or virtually impossible, the old system? facility. In difficult cases, for example,
such as axial neck of femur X-rays, are now If we can replace the imaging plate system specialists can then be consulted
no trouble at all. This means we can give completely, then yes. However, we need to at this facility.
a much clearer diagnosis. safeguard against failure. But our first task is
to check whether we can get rid of imaging
In what circumstances do you still use plate technology completely from our day-
the cassette-based X-ray device? to-day working processes. We hope this will
When the digital detector is unavailable. happen in the not-too-distant future.
Until recently, we were still using the
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5. Clinic Profile image data is created, distributed and saved
digitally. The report that corresponds to
Radiology Department, Hamburg
each image can also be loaded quickly and
Federal Armed Forces Hospital
easily and saved on CD-ROM if necessary.
Offering 307 beds, Hamburg Federal
Armed Forces Hospital is one of the five The range of services offered by
DigitalDiagnost TH/VM in the
largest military hospitals in Germany and Department VIII — Radiology includes all
Federal Armed Forces Hospital
is located in Hamburg's Wandsbek district. conventional X-ray procedures (excluding
It is the largest military treatment facility mammography and angiography):
in northern Germany and is a key part of • Computed tomography (MS spiral
Hamburg's civilian healthcare network. CT scan)
Since January 2007, it has been an academic • Digital radiography and digital archiving
teaching hospital affiliated with the University and distribution system (PACS)
Medical Centre Hamburg-Eppendorf (UKE). • Magnetic resonance tomography (MRT)
including the possibility of examining
Department VIII — Radiology sees itself patients on mechanical ventilation
as a service provider for all other in-house • Sonography
departments as well as for patients who • Needle aspiration biopsies and punch
require immediate out-patient treatment. biopsies
As well as patient safety and accurate • Facet joint infiltrations
diagnoses, the department aims to provide • Periradicular therapy
patient comfort and rapid availability
of diagnostic findings. Naturally, the Its diagnostic focus is on:
department offers an on-call radiology • Stage diagnosis of germ cell tumors
service for urgent examinations. It also of the testicles and of tumors in the
carries out X-ray rounds that not only head and throat
strengthen support for other departments, • Medical imaging of diseases of the
but are also used to provide training. What's temporomandibular joint
more, it organizes lectures that are certified • Imaging of injuries to the
by the German Medical Association. The musculoskeletal system
hospital is entirely "film-less," meaning
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4522 962 71281 * MAR 2011
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