Tuesday, August 14, 2012

Tips from a road warrior (23): Document your parking spot.

DFW airport parking
can be challenging
I assume that I am not the only one who, coming back from a trip, has forgotten where I parked my car and found myself walking all the floors of a parking garage to spot it. I once actually had to hire a taxi to drive me around the different terminals at Dallas-Fort Worth (DFW), where there are 5 parking garages, to find it. I also have been known to forget my location in non-airport garages, especially when using a rental car, of which the brand and color I might have difficulty remembering.
To prevent it happening again, I currently use a well-proven system whereby I write down the parking spot on the envelope that contains all my travel information such as hotel confirmations, tickets, and contact information for the people I am supposed to meet. I stick with paper copy, unlike several of my colleagues who take a snapshot of the location indicator with their smart phone, which only works as long as your battery life holds out (as one of my colleagues found out).
The lesson learned from this experience is that documentation is a lifesaver, which applies not only to travels but also to the job of managing complex systems such as PACS systems. I have learned several examples where documentation has proven to be invaluable, especially in areas that you might not have thought of, some examples are listed below:
·         Calibration records: Most institutions calibrate their diagnostic monitors regularly, which should be the case for all of them. If not, then it is strongly recommended to keep track of the calibration information on a separate computer and make sure it is backed up. I know of at least one court case where a PACS administrator was required to pull records from a few years prior to show in court that the monitor a radiologist was using to perform a diagnosis was properly calibrated at the time of the diagnosis.
·         Hanging protocols and physician preferences: Imagine having to recreate all of these! Some of the software upgrades require them to be set up again. It is important to save and backup this information to avoid having to redo all of them again.
·         Addressing information: It may seem obvious, but I still meet PACS administrators occasionally who admit that they don’t manage AE titles properly. I have actually experienced port conflicts myself as I had several DICOM viewers installed, with some of them listening to port 104 as soon as the computer is started. Documentation is key. To change this at a modality is demonstrated here.
·         Locations of equipment and connectors, including type: People seem to move equipment to make space for another device and connect to another wall plug, which might or might not be live or may have a different setting. To find out if anything changes, it is important to document the current location and plug number.
·         Versions of modalities: Vendors like to upgrade their modality equipment, sometimes only notifying someone in biomed, and not the PACS team, which might impact the behavior and display of the images. It is important to document the software versions of all the modalities connected to the PACS to determine if anything has changed.
In conclusion, documentation is critical, especially for those areas you might not think of, to make sure you are not stuck or get lost as I used to when looking for my parking spot at the airport.