Are You Reading the Yellows, or Am I?
By Phillips CD
When did that word become a derogatory term? That is, for sure, a recent construct. I read from a worklist and I’ll bet you do, too. Stat exams get a special feature of some form on the worklist I view. For me, fortunately, it is just colored red. Look here, radiologist. Read me. Again, my age gives me away, but I remember when stat exams got hung on a viewbox immediately by the film room staff. In front of me. While I watched. And they handed me the request and a tape to dictate it so they could immediately get it to the transcriptionist, who immediately transcribed it and returned it to me to sign. And, they stood patiently and watched me until I did it.
Today, we read from worklists. I guess, somehow, it was thought too easy to tell people to read from the top down (or maybe we all have that rebel in our soul, and everyone dives randomly for some exam in the mid-point) so the “stat” exams could just be placed at the top of the list. So, we exploit the color monitor, and the important studies came up in red. Very conspicuous.
The peacock of exams, calling attention to itself by its brilliant plumage.
But, what about the “super-stat” exam? Or the “urgent” exam? Or the “patient waiting in the clinic” exam? Or the “I’ve got a flight to catch, so you need to get me this report” exam? Oh, don’t worry. I’ve got hundreds. What color do they get? Do they need another color? You know the answer to that one: damned straight they do, how else will you recalcitrant radiologists know the difference? So, the worklist got a few more colors. Red, yellow, purple, gold, green, etc, etc.
Clearly, this led to a moment of Zen for the radiologists, who then immediately understood the complexities not only of the exams but of the worklist and were able to quickly and efficiently move throughout, plucking the most important of studies first, and then moving down the queue to end their shift on time, having been super-efficient and getting the opportunity to break for lunch while not missing a beat. Do you believe that? Nope? You’ve been reading this column for too long.
I’ve seen colleagues with over six color-coded exam priorities. Let me tell you something, that’s at least five too many. I’ve heard from one that has a FLASHING priority tag. Whoa. Put that thing back in the holster. Please, IT person, disable that function and step back. Too much information. Would a flashing yellow have priority over a solid red? Does the flash occur as Morse code? A green that is flashing S.O.S in Morse code. would be the penultimate. The top priority might be a Pac-Man-yellow priority tag that, just like Pac-Man, eats the other items on the worklist. It stands alone at the end, and you MUST read it.
Our lives have gotten so complicated. A worklist that requires a college education and an ergonomics professor to explain seems a bit much. Ooooh. What if you’re color blind?
Come on, attend to that flashing yellow chest film on the worklist. Get that thing out of here. Keep doing that good work. Mahalo.
Dr. Phillips is a Professor of Radiology, Director of Head and Neck Imaging, at Weill Cornell Medical College, NewYork-Presbyterian Hospital, New York, NY. He is a member of the Applied Radiology Editorial Advisory Board.