Table 3.

Case examples of resilience in nuclear medicine

Description	Location	Individual choice or formal policy	Resilience characteristic(s)
Staff arrive at work ∼10–15 min earlier than officially scheduled to commence radiopharmaceutical preparation and avoid interruptions	Hot-lab	Individual choice, but consistently observed in all individuals rostered to this role	Anticipatory
At key times, technologists preparing or administering radiopharmaceuticals would not respond to telephone calls, overhead pages or attempts by other staff to initiate communication	Hot-lab, scan room, injection room	Individual choice, observed on some occasions	Responsive, past experience
During radiopharmaceutical preparation, staff keep their eyes on the material being prepared and sometimes elect not to respond to professional or social communication or choose to ‘multitask’ by keeping their focus on the material being prepared while responding to others	Hot-lab	Individual choice, observed on some occasions	Responsive, past experience
Use of bar-coding technology for individual radiopharmaceuticals	Hot-lab	Formal departmental policy, used consistently by all technologists rostered to this role	Attentive, past experience
Use of sticky notes on patient request forms or phials to convey key information, especially if a technologist is expecting to be absent for a while	Hot-lab, scan room, clerical area	Individual choice, but consistently observed in all individuals rostered to this role	Anticipatory
Printout of requested procedures for the day are colour-coded for tests requiring different radiopharmaceuticals	Hot-lab	Individual choice, but consistently observed in all individuals rostered to this role	Attentive, anticipatory
Printouts conveying important elements of quality assurance procedures are displayed at eye level in the hot-lab radiopharmaceutical work area	Hot-lab	Formal departmental policy, used consistently by all technologists rostered to this role	Attentive, past experience
Technologists defer initiating conversation with a colleague if he/she appears busy	All work areas	Individual choice, observed on some occasions	Anticipatory, past experience
The use of whiteboard to convey weekly information about the delivery of external supplies	Hot-lab	Formal departmental policy, implemented by senior technologists	Attentive, anticipatory
Some interruptions, usually in the form of professional communication between technologists, are used to alert one another to potential pitfalls about procedures or patients; for example, a request for a thyroid scan may be converted to a parathyroid scan after medical review, thus necessitating the preparation of a different radiopharmaceutical	Patient waiting room, scan room, hot-lab, in transit	Individual choice, but consistently observed in all individuals in the direct care of a patient	Attentive, responsive, anticipatory
Multitasking is frequently employed by all technologists, sometimes to avoid external stimuli from interrupting the primary task	All work areas	Individual choice, but consistently observed in all individuals	Responsive
Certain high-risk procedures, particularly therapeutic nuclear medicine, are rostered to an individual technologist who becomes responsible for all aspects of its conduct	Hot-lab, scan room, patient waiting room	Formal departmental policy adopted by all technologists rostered to this role	Anticipatory, past experience
Some technologists defer their lunch or break in order to stay in the control room (adjacent to scanners) so as to troubleshoot any potential complications during a procedure	Scan rooms	Individual choice, observed in a few technologists	Responsive, anticipatory
Some interrupted tasks may be resumed by a second technologist to help continue a procedure and/or ensure quality is maintained	Scan rooms, hot-lab	Individual choice, observed on some occasions	Responsive
Although most staff carry mobile telephones, these are switched to vibrate and are not looked at, except during personal time	All work areas	Directive from the chief technologist	Past experience
If a senior technologist does not respond to an overhead page or telephone call, the clerical staff redirect the call to another senior technologist	Clerical work area	Individual choice, observed on some occasions	Responsive
Scan protocols and patient information sheets are stored on all computers for easy access	Scan rooms, clerical areas	Departmental policy used by all nuclear medicine technologists	Attentive, anticipatory
Technologists proactively contact patients and external health professionals before the procedure is scheduled to facilitate smooth conduct of procedures	Clerical areas, scan rooms	Individual choice, but observed in all individuals rostered to this role	Anticipatory