Rapid growth of the MREH clinical imaging department services (>122,000 procedures, 2019) over the past five years had created a fast-paced environment, demanding high-quality work. Pre-COVID 19, the department was experiencing poor outcomes in staff stress risk assessment; long wait times for patients, and an overcrowded waiting room. Although appointment levels temporarily decreased during the pandemic, it was soon apparent that outpatient and virtual clinics (VCs) required enhanced support, due to increases in waiting lists. However, new social distancing requirements dictated fewer patients in waiting rooms, and some patients were reluctant to attend appointments, not knowing what to expect. Rapid changes were necessary, with little time for a full assessment of their impact.

The department expanded its service, with new VCs, and protocols. The VCs now primarily operate in evenings and Saturdays during outpatient clinic downtime. Staff work 12 hour days, with two teams, separate managers and alternating rotas. With increased responsibility and training, imaging staff lead VCs. They also call patients before their appointment to ask and answer questions and explain requirements.

Staff survey results now show significant improvement in all stress categories. Patient responses (n=255), also show significantly favourable results with patients indicating an overall good or excellent experience with the service (96%).

The switch to a 12-hour day and compressed workweek can be a risk. Fortunately, in our department, it has been beneficial. This improvement is likely due to certain factors, such as task diversification, the autonomy that staff experience in leading VCs, and extended roles. Smaller work teams provide quick and better contact with managers, improvement in teamwork and opportunity for better relationships. Finally, patient phone calls reduce patient anxiety and improve communication, and reduced staff stress undoubtedly impacts quality of patient care.