Ergonomically Designed Workstations: Just a perk or a good business strategy

The decision to purchase an ergonomically designed workstation is usually precipitated by chronic pain. Many people do not consider a return on their investment, because when everything is weighed in the balance, they understand their health is what is most important. However, what if there is a need to balance multiple fiscal priorities with several critical budgetary needs. Well, there is good news. Investing in an ergonomically designed workstation can pay dividends in several ways if it is engineered specifically to address not only physical needs, but to increase productivity as well.

The transformative impact of an ergonomically designed workspace

The application of ergonomics is often seen as a required and trivial element of an organization’s loftier occupational health and safety program, rather than a worthwhile component of an effective business strategy. This is unfortunate. Along with the often-underestimated health benefits of an ergonomically designed workspace, there is the potential for a substantial and measurable ROI that merits serious consideration.

In any field, in an 8-hour workday, most workers may only be 85% productive under non-optimal conditions¹. In the radiology reading room, non-optimal conditions can include a traditional immobile desk, a standard sit-stand desk, standard office chair, and the lack of ambient light. Other non-optimal conditions include an unhealthful space between the user and computer screen, and the inability to raise and tilt the monitor to an appropriate height and angle to eliminate eye strain. Of course, there are many other contributing factors that inhibit optimal performance. Most often these are out of the users control due to a poorly designed workstation and its lack of sound ergonomic engineering. However, properly designed ergonomic solutions can help to regain some of the lost 15% productivity by improving work conditions and increasing efficiency¹. So the questions are, what ergonomic solutions can be applied to help increase productivity in the radiology reading room and is change truly necessary?

The need for change in the radiology reading room

“Sitting is the new smoking,” is a phrase that is now both popular and true. It was coined by Dr. James Levine, a professor of medicine at the Mayo Clinic². It is well documented that sitting for extended periods of time at a computer can be harmful. Sitting is associated with a higher risk of heart disease, cancer, diabetes, and obesity. It can even lead to death. In 2013, the World Health Organization estimated that 3.2 million people worldwide die prematurely each year due to a sedentary lifestyle³. Someone who sits for 6 hours per day or more is considered to have a sedentary lifestyle. This certainly includes Radiologists. More than half of them spend more than 8 hours at a workstation per day. In fact, a study was done by the Pennington Biomedical Research Center with the conclusion that people who sit for most of the day are 54% more likely to die from heart attacks⁴. One can argue that this is the extreme. Yet there are many other health consequences that impact productivity that are the direct result of sitting at a workstation all day, and they have been well researched. Some of the research includes the following:

A team led by Dr. Helena Bentley of the University of British Columbia in Vancouver conducted a questionnaire study that included 191 radiologists and radiology residents who were members of the Canadian Association of Radiologists; most (61%) worked in academic settings and 75.9% were staff radiologists. The survey assessed participants' experience of radiology workstation ergonomics and musculoskeletal discomfort. The researchers found that 78.5% of study participants experience musculoskeletal discomfort from use of radiology workstation, and 92.7% of these stated that this discomfort affected their productivity.
In 2017 ACR Human Resources Commission Workforce surveyed Radiologists and found that 16% had repetitive stress injuries, 25% had neck pain, and 32% had lower back pain.
The Journal of the American College of Radiology conducted a study in 2014 which concluded that more than 60% of radiologists currently suffer from repetitive strain injuries (71.2% experience neck pain, 57.7% experience shoulder pain, 46.8% experience back pain, 45.4% experience wrist and hand pain).
A 2014 study conducted by The MarkTech Group concluded that 87% of Radiologists reported experiencing physical discomfort and 66% of Radiologists reported significant eye fatigue.
More than 75% of radiologists report that they experience musculoskeletal discomfort from using workstations, according to a survey published December 29, 2022 in Academic Radiology⁵.

Anyone who experiences chronic pain understands how difficult accomplishing even the simplest of tasks can be; but let’s get down to brass tacks and discuss the financial impact chronic pain can make on an institution.

The financial impact of chronic pain

In August of 1997, the General Accounting Office (GAO) released a 141-page report titled ‘Worker Protection: Private Sector Ergonomics Programs Yield Positive Results.’⁶ The study was to determine what interventions can be made to reduce worker’s compensation costs. The final case study included companies who employed office workers and other workers in the financial planning, electronics assembly, medium and heavy truck assembly, healthcare, and defense systems industries. A few years before the study began, each company implemented a full ergonomic program with solutions that directly addressed the main risk factors of musculoskeletal injuries. Some change implementations included providing employees with ergonomic tools in office environments such as chairs, keyboard trays, and glare filters, as well as implementing physical design, workflow and system changes to reduce MSD risk factors in workers. Organizations demonstrated significant reductions in workers’ compensation claims, ranging from 35% to 91%. The average cost per injury claim was also reduced by up to $16,500.

A reduction in the cost of claims is good, but avoiding claims all together is even better. The study, mentioned previously that was led by Dr. Helena Bentley of the University of British Columbia in Vancouver that revealed that 78.5% of the radiologists experienced musculoskeletal discomfort/pain, and over 90% reported that their discomfort adversely impacted their productivity, cited (2) two common reasons for discomfort. They were:

The top of the monitor was not at eye level
Wrists were not flat and straight when using their mouse

The study concluded with the sound idea that paying attention to radiology workstation ergonomics increases efficiency and productivity while decreasing musculoskeletal pain. Practically speaking, John Hopkins Hospital certainly found that to be true. They reduced the occurrence of Musculoskeletal Disorders (MSDS) by 80% over a 6-year period by deploying an ergonomic program. It is unknown how many work hours, and dollars, might have been lost if John Hopkins did not address these occurrences with their ergonomic program.

However, it is known that ergonomic intervention has a return on investment (ROI) of 17 to 1 ⁷. Dr. Alan Hedge is a Professor Emeritus in Human Centered Design at Cornell University. He is a thought leader in design and ergonomics. In a Podcast on April 26, 2023 he reiterated that typically, there is an $18 return for every dollar invested in ergonomics. The ROI is 17:1. One (1) dollar returns 18 dollars (17+1). Based on analysis of 2,547 compensable Work-Related Musculoskeletal Disorders (WRMSD). WRMSD’s cost $1 of every $3 spent on workers’ compensation.⁸

Ergonomically designed workstation: More than just a perk

Research suggests that ergonomically designed workstations and spaces are more than just a perk. The investment in them is a wise business strategy. A reduction in computer related injuries and an increase in productivity adds up to more money gained; but how much? How can the ROI be calculated? One of the more obvious and straightforward ways includes knowing a few data points to measure the impact of an ergonomic solution and quantify cost savings.

Understandably, there are flaws with such simple calculations, such as: computer related injuries can be exacerbated outside of the work environment, some people are more prone to such injuries, and WRMSD are complex and sometimes the reasons are not fully understood. But there is one thing that is certain. There is a very real and negative impact when WRMSD are ignored, affecting the health and well-being of the worker as well as the bottom-line of an organization. Naturally therefore, there is willingness to accept ROI calculations that are known to be a little flawed.

Still, some Ergonomists attempted to develop algorithms and methods for quantifying the ROI of an ergonomic program. Supriya Lahri, Judith Gold, and Charles Levenstein published an Economics Evaluation Proceeding Paper titled, 'Net-cost Model for Workplace Intervention'. The study provides a simple transparent framework to estimate the net economic costs of investments in ergonomic interventions applied to reduce lower back pain⁹. An overview of the model looks like this:

S. Lahiri et al. / Journal of Safety Research - ECON proceedings 36 (2005) 241 - 255

In 2008, Alan Hedge at Cornell University published a simple online ergonomics ROI estimator¹⁰. It is uncertain what the algorithm behind this calculator is, but it is quite interesting, nonetheless.

There are many models on the internet today that help administrators decide the value and ROI of an ergonomic program. However, perhaps none of them are more convincing than the very real-world illustration below.

If a Radiologist earning $300,000 per year loses 30 minutes a day of lost productivity due to discomfort and/or pain that equals $72 lost. Over a full year that would amount to $18,720 per year lost. Multiply that by 7, since most institutions have at least 7 Radiologists on staff, and you get $131,040 lost per year. Imagine what the dollar figure would be if more than 30 minutes per day were lost. Imagine if reducing discomfort could not only regain the $131,040 lost, but also increase productivity, and just one more scan was read by each Radiologist a day.

When thinking of the effects of an ergonomic program, in the real world with tangible results, it begins to make even more sense that acquiring an ergonomically designed workstation is not just a perk but a smart business strategy. At the very least, it is a business consideration that warrants further exploration.

What kind of an ergonomic workstation can increase productivity?

If the expectation is increased productivity, then there is no short answer to this question. Investing in an ergonomic workstation demands examination because not all “ergonomic” workstations on the market today are designed with sound ergonomic engineering that stands the test of time. However, below are a few features to look for in a workstation if optimizing productivity is the goal.

The monitor array should be able to move all around the desktop, not just front to back and side to side. This enables the user to intuitively bring the image as close as needed, instead of adjusting body position to accommodate the eyes. If this is not a feature in a workstation, it defeats the purpose of having a workstation that is ergonomically designed.
The monitor array should be engineered to support multiple heavy displays. Each display should be fully and independently adjustable to tilt up and down and left and right. And each can also be independently turned from a portrait to a landscape position. Displays are a big investment for any institution. If the monitor mount is not engineered correctly, mechanisms can wear overtime. This leads to unstable positioning that leaves the monitors vulnerable to sagging and falling forward overtime which equates in down time and loss of productivity.
Each display should be easily and independently adjustable to meet the needs of each user. Complete flexibility is paramount for precise viewing and to achieve greater visual acuity. This is critical for all industries but especially when accurate diagnostics are critical.
The monitor array should be engineered to move easily and smoothly anywhere over the surface of the desktop. Hands adjustments should always be fluid and intuitive. If not properly engineered, incremental movements studder and will discourage users from moving the array to accommodate their eyes. Instead, the tendency will be to adjust body posture out of alignment, which in turn defeats the purpose of having a workstation that is ergonomically designed.

The bottom-line

The medical field today is a competitive business environment and retaining radiologists and attaining patients is certainly a challenge. Controlling expenses while optimizing the allocation of resources is expected, reasonable, and leads to a healthy bottom-line. However, institutions that focus chiefly on expenditure and choose not to invest in contemporary strategies, may flourish in the short-term, but often struggle in the long-term. This is exceedingly evident in the radiology reading room, where keeping up with the latest technology is paramount to achieve optimal productivity.

Effective allocation of investment dollars in support of highly valued assets, such as Radiologists, is an important factor of the growing profitability of an institution. Neglecting to do so can have obvious adverse consequences. It is why many have taken the lead to act on behalf of their organization and purchase ergonomically designed workstations for not only their reading rooms but also in places where computer workers sit for long hours. Those who have done so, realized increased productivity resulting in a positive effect on one number most often cited as a barometer of successful business strategies…the bottom-line.

Work Cited:

¹Oxenburgh, M. (1991). Increasing productivity and profit through health and safety. Australia: CCH International.

²connect.mayoclinic.org/blog/living-with-mild-cognitive-impairment-mci/newsfeed-post/repost-sitting-is-the-new-smoking/

³World Health Organization. Physical inactivity: a global public health problem. Geneva: World Health Organization; 2008. ncbi.nlm.nih.gov/pmc/articles/PMC5618737/

⁴Pennington Biomedical Research Center

⁵academicradiology.org/article/S1076-6332(22)00646-8/fulltext

⁶gao.gov/assets/hehs-97-163.pdf

⁷Applied Occupational and Environmental Hygiene, 13(4), pp. 212–213. tandfonline.com/doi/abs/10.1080/1047322X.1998.10390067. Hendrick, H.W. (2003). Determining the cost-benefits of ergonomics projects and factors that lead to their success. Applied Ergonomics. 34(5): 419-427.

⁸Ergonomics ROI with Dr. Hedge | E2. tumeke.io/updates/ergonomics-roi-with-dr-alan-hedge-e2]

⁹premus2004.ethz.ch/downloads/Vorl_Beweg/gute%20Artikel/02_Lahiri2005_CostModelForWorkplaceInterventions.pdf

¹⁰ergo.human.cornell.edu/CUROIEstimator.htm