Tyler's Personal Wiki - User contributions [en]

KP Rotations

2026-04-18T02:32:08Z

Tyler:

Radiology Rotations 2025

== Diagnostic Radiology ==

*Call
**CT Techs can sometimes bolus exams to the call list, so it's helpful to also filter for Stat CTs assigned to no one
**For other modalities, just wait for techs to push exams to the Reg Call lists
***On weekdays:
****US read by US1 until 1:30
****XR read by US1 until 4pm
*****But apparently ''except'' chest and abdominal inpatient XR after 2 PM (once Gen Rad 1 is done) per Mark Gotauco
****MRI read by MRI1 until 4pm
****CT perfusion read by MRI1
** Overnight coverage by call 1: on call for prelim service failure and DR procedures (primarily LPs if anesthesiology fails). There is support for deferring non-urgent procedures until the next day (e.g. enteric tubes).

*Regional Call 1 On Site on weekends and holidays
**Traditionally defaults to SMC but can be requested otherwise. The site a radiologist is technically responsible for is in the title of the assignment in the schedule.
**Covers ER/Inpatient exams
**Overreads CT, US and CR overnight StatRad exams (all modalities on Sat and Sun)
***Mon-Thurs 1030-1930
***Fri 1330-2230
***Sat-Sun 1300-2200

*Regional Call 2 On site on weekends and holidays
**Traditionally defaults to WMC but can be requested otherwise. The site a radiologist is technically responsible for is in the title of the assignment in the schedule.
**Covers ER/Inpatient exams
**Overreads CT, US and CR overnight StatRad exams (and all modalities on Sat and Sun)
***Mon-Thurs 1000-1900
***Fri 1100-2000
***Sat-Sun 1100-2100

*Swing
**As a reminder, starting on 12/1/25, we are trialing a Regional Call Swing Shift (REG CALL SWG). This person, who is also assigned to a stack rotation, is going to be helping with the incoming call studies from 3p-6p. They will have a proportional reduction in their stacks that are assigned that morning.
**For example:
***CT or MRI stacks: <s>25 studies, no CR</s>
***US stacks: <s>56 studies, no CR</s>
***GR stacks: <s>130 CR</s>
** The reduction of the routine work was initially 2/3 of a stack but was subsequently reduced to 1/2 of a stack

*CT 1 Filters
**Transcribed (in "Other Lists" dropdown), Filter: Assigned to NSR
**Unread, Filter: Stat/Performed Today (just to see what's being scanned)
**Unread, Filter: Reg Call 1/Reg Call 2/CT1
**Only reading CT. XR, US, and MR generally go to those modality shifts. Once day rotations start to finish, studies will start to go to Reg Call1 and Reg Call2 rotations.
**"Macro Stat Rad" for preliminary reports
**RTMC line (on SharePoint imaging) is for outpatients with urgent findings

*CT 1 Remote (Mon-Thurs)
**Covers ER/Inpatient exams from 0700-1030
**Overreads CT, US and CR overnight StatRad exams

*CT 1 Remote (Fri)
**Covers ER/Inpatient exams from 0700-1100
**Overreads CT, US and CR overnight StatRad exams

*CT 1 Remote (Sat-Sun)
**Covers ER/Inpatient exams from 0700-1200
**Overreads overnight StatRad exams (all modalities)

*SMC RDS LH WH “Weekend Reads”
**Sat-Sun and Holidays 0730-1330
**Reads inpatient CR and may cover SMC fluoro procedures
**Target: 180 CR (subtract 10 CR for each fluoro procedure)

*CT 2-9 “Stacked Rotations”
**Target: 32 CT/MRI and 30 CR

*MRI 1 Stat MRI Coverage
**Overreads MRI overnight StatRad exams
**Target: 20 MRI and 20 CR or 25 MRI

*MRI 2-9 “Stacked Rotations”
**Target: 32 CT/MRI and 30 CR

*US 1
**Covers STAT CR from 0730-1600 (excluding 1130-1230)
**Covers STAT US from 0730-1330 (excluding 1130-1230)
**Target: 30 US (Urgent), 30 CR, 4 CT

*US 2, 3 Stacked Rotations
**Target: 70 US and 30 CR

*Gen Rad 1
**On-Site @ WMC covering Fluoro procedures and sonohyst
**Target: 60 CR (STAT), 6 CT, 10 US (Mon and Fri)
**Covers STAT CR and US from 1130-1230

*Gen Rad 2
**On-Site @ SMC covering fluoro procedures
**Target: 30 CR (STAT), 4 CT, 20 US

*Gen Rad 3
**On-Site @ INT covering fluoro procedures and sonohyst
**CT Protocols
**Target: 40 CR (STAT), 40 US, 6 CT

*Gen Rad 4, 5 Stacked Rotations
**Target: 200 CR

*SKY 2 Stacked Rotation
**Target: 32 CT/MRI and 30 CR

*CEC
**On-Site @ CEC covering contrast injections

*NM 1 & 2
**On-Site if therapy needed
**Target: 12 PET-CT, 20 DEXA, 10 Gen Nucs (per Mirarchi, NM1 reads gen nucs from Sunnyside and NM2 reads gen nucs from Westside)
**From Mirarchi: If there are 2 of us on NM, we're supposed to read 12 PETs each. I think Maureen usually just reads the PETs assigned to her on NM 1 or 2. But, I often read studies not assigned to my list and then leave some that are. For example, there are currently 2 Urgent PETs on the list that aren't assigned so they won't be read until tomorrow. I'll probably preferentially pick those off then leave 2 of the "routine" studies currently assigned to NM 1. Or else sometimes a clinician will call asking for stat results because they're seeing the patient in clinic that day and want the results quickly, so I'll preferentially read that study. As long as you get 12 done no one cares which 12. If you prefer to just read the ones assigned to the rotation that's totally fine - however you want to handle the case load is fine.
** If there is only one rad assigned to NM for the day, read from both NM 1 and NM 2 lists. No DEXAs will be assigned.
** Once you're on the RAM license then Marcia will start scheduling you for therapies. She periodically e-mails a list of the scheduled therapies with the ones you're scheduled to consent in person at the top of the list. That will make more sense when you get the first e-mail. You'll have to pencil those into your personal schedule - they don't show up on the Lightning Bolt schedule.
** If you have a strong preference for which site you do therapies, you should make sure that's known. I've had them reschedule patients to travel to my site, and I haven't had problems or complaints about that so far.
** For NM post-processing, Philips Intellispace Portalnd and Terarecon (aka AquariusNET) are currently available (January 2026).

*Mammography Rotations:
**SKY 1
***On Site @ SKY covering Dx/Locs/Bx
***Target: 30 MG

**SMC Mamm 1Bx
***On Site @ SMC covering Dx/Bx
***Target: 40 MG -or- 35 MG + 1-2 MRI

**SMC Mamm 1
***On Site @ SMC covering Dx AM only
***Target: 20 MG -or- 15 MG + 1-2 MRI

**SMC Mamm 2
***On Site @ SMC covering Dx/Locs/OSF
***Target: 30 MG -or- 25 MG + 1-2 MRI

**INT Mamm 3Bx
***On Site @ INT covering Bx
***Target: 75 MG + 1-2 MRI

**INT Mamm 4
***On Site @ INT covering Dx
***Target: 40 MG -or- 35 MG + 1-2 MRI

**WMC Mamm 5Bx
***On Site @ WMC covering Dx/Locs/Bx
***Target: 40 MG -or- 35 MG + 1-2 MRI

**WMC Mamm 5
***On Site @ WMC covering Dx/Locs
***Target: 40 MG -or- 35 MG + 1-2 MRI

**Sal Mamm 6
***On Site @ Sal Cr covering Dx
***Target: 40 MG -or- 35 MG + 1-2 MRI

**LVK Clinic
***On Site @ LVK covering Dx/Bx
***Target: 25 tomo + 1-2 MRI

**ECG
***On Site @ Eugene covering Dx
***Target: 35 MG

Interventional Radiology
IR 1, 2
On Site @ SMC, CVL
IR 3
On Site @ SMC, US and CT guided procedures
IR 4
On Site @ WMC, US and CT guided procedures
IR 5
On Site @ WMC, CVL
IR 6
Clinic

IR Film Targets:
IR 2, 3, 5
Target: 45 CR
IR 4
Target: 4 CT and 45 CR
IR 6
Target: 70 CR

Kaiser

2026-04-08T15:25:54Z

Tyler:

=== Internal Links ===
* [https://sp-cloud.kp.org/sites/NWPAccounting2 Reimbursement]
* [https://nwpkp.sumtotal.host/Broker/Account/Login.aspx? Training]
* [https://n23.ultipro.com/Login.aspx?ReturnUrl=%2fdefault.aspx HR]
* [https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices Imaging Sharepoint]
** [https://sp-cloud.kp.org/sites/KPNWImagingServices/Lists/Facility%20Phone%20List/By%20Facility.aspx?viewid=f8eabea2%2D4bd6%2D4eaf%2Dbe48%2Dfac642b1ada2 Imaging Phone List]
* [https://mykp.kp.org MyKP (Intranet)]
** Contains lots of tools, but have to navigate through a large list of tools that are sorted alphabetically. Two are pertinent to radiology and are good to add as favorites.
*** [https://cl.kp.org/nw/news/clinavail-new-home1.html Staff Availability NW] - good for contacting staff on call
*** [http://cl.kp.org/ Clinical Library] - contains practice guidelines for Kaiser

=== Rotations ===
* [[KP Rotations]]
* [[Weekend Reads Update 5/29/25]]

=== Institutional Guidelines ===
* [[Iliac Artery Aneurysms]]
* [[US Update 6/2025]]

=== PACS ===
* Command line application `swe` can completely kill the application if it freezes.

=== Up To Date ===
* Login via Epic to accrue CME

=== Kaiser Radiology ===
* [[KP Rotations]]
* [https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices Imaging Sharepoint]
* [https://sp-cloud.kp.org/sites/NWImaging/SitePages/Radiologist-QC-Entry-Form.aspx QC Form]

=== Track Recs ===
Some report templates contain specific codes embedded in fill-in fields that trigger entries in databases to ensure appropriate follow-up, but this is not apparent in the macro. The pertinent system macros are:
* "yellow dot" - triggers follow-up of an incidental finding that could be cancer. Encouraged to use the "FollowUp" icon at the top of powerscribe to input specific recs.
* "red dot" - same as "yellow dot" but in cases that are definitely cancer.
* "yellow dot not" - removes a yellow dot case from the track recs system.
* "red dot not" - removes a yellow dot case from the track recs system.
* "AAA" - just contains "AAA" at the very top of the report, which triggers follow-up. The macro also contains recommendations specific to Kaiser, but these are not necessary for the Track Recs system.
* "Lung Rads" - this macro is included at the end of the system LDCT Screening macro and contains necessary codes.

For reference, the embedded codes are put in fill-in fields like so:
[[File:Screenshot 2025-07-01 102848.png|none|thumb|Powerscribe Findings Codes]]

=== Picky System Templates and Reporting ===

Some providers have strong preferences about report format. Those reports include:
* DEXA
** The endocrinologists go by the National Osteoporosis Foundation
***[https://static1.squarespace.com/static/5d7aabc5368b54332c55df72/t/5dd2e2a92e1e1821e328308e/1574101724294/HCP+Toolkit-with+graphics.pdf Manual ]
*** [https://www.bonesource.org/healthcare-professionals-toolkit Toolkit]
*** Don't say osteopenia, say low bone mass
*** Men < 50 yo, children, and premenopausal women have an entirely separate diagnostic rubric (page 14 in manual)
*** Technical osteoporosis criteria aren't required for treatment recommendation (page 50 in manual). Anyone with T-score < -2.5 in spine or hip warrants treatment.
** Several fields (BMDs, trends, and FRAX results) are automatically imported into Epic, and this is dependent on the exact text preceding the values in the report. Be careful when adjusting your template!

Calling severe coronary arterial calcific atherosclerosis triggers cardiology consultation (according to Chip Robertson, cardiology lead)

=== Overnight Prelims ===
* All over-reads go to the RTMC in-basket. So, unless a discrepancy is extremely time-sensitive, you probably don't need to call them about it. It'll be reviewed.
* If there is a major discrepancy and the ordering provider is not available, the RTMC line is the appropriate resource.

=== Incidental Follow-up ===
* See the Track Recs section above
* Incidental findings require follow-up are handled with "yellow dot" (possible cancer) and "red dot" (definite cancer).
* The yellow dot case autotext will flag the study so that administrators ensure the patient gets follow-up.
* The yellow dot can be removed on a subsequent exam with a different autotext.
* The red dot autotext will flag the finding as definitely cancer and (presumbably) trigger referrals.
* There is also a "blue flag" in Powerscribe that helps "yellow dot" cases.

=== Nuclear Medicine ===

* [https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices/SitePages/NM%20-%20Procedure%20Manual.aspx Procedure Manual]

=== Workflows ===
[[Coronary CTA]]

=== Logistics ===
* TIE Lines
** Sunnyside: 31-XXXX in house, 503-571-XXXX from outside
** Westside: 24-XXXX in house, 971-310-XXXX from outside
** Interstate: 16-XXXX in house, 503-331-XXXX from outside
** Salmon Creek: 69-XXXX in house, 360-571-XXXX from outside
** Longview-Kelso: 23-XXXX in house, 360-575-XXXX from outside

[https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices Imaging Services]

[https://sp-cloud.kp.org/sites/KPNWImagingServices/Lists/Facility%20Phone%20List/By%20Facility.aspx?viewid=f8eabea2%2D4bd6%2D4eaf%2Dbe48%2Dfac642b1ada2 Imaging Phone Directory]

[https://cl.kp.org/nw/news/clinavail-new-home1.html Staff Availability NW] - tool for finding on call providers. This is also at [https://mykp.kp.org MyKP] (see above).

See Outlook or Teams for additional contact information.
* PACS Support Line - For workstation, PACS software, or desk help
* File room - For questions about studies and worklists
* IT Tie Line - Overall KP IT

=== Policies and Practices ===
[[FAQ on FTE and Leave]]
* Tumor Boards
** Worklists are in the "Workqueue List" in Epic. There are many, and you'll have to search for them. Here are two examples:
*** Chest Conference: ID 71818, Name ONC CASE CONF CHEST/THORACIC
*** GI Tumor Board: ID 71810, Name ONC CASE CONF GI
** Compensated by removing studies from your worklist for the day. There's a precedent for 10 CTs for a tumor board. I asked for 6 PETs for a tumor board on my NM days.
*** Helwig clarified that the precedent/agreement is that hours of work should translate to Ws. So, if prep+conference takes 4 hours, that'd be 0.5 W worth of work off the list.
* Call Bonus
** After 52 CT+MRI studies on Reg Call shifts, additional studies can be claimed for SRs (change announced 2/4/26 by Teran's email)

=== Supplemental Reads ===
Supplemental Reads (SRs) are a means of reimbursement for additional work at the following rates (using W as a unit of work). These rates are also useful for converting between types of work and adjusting worklists at rates that are generally acceptable to administration and the file room.
* Time: 4 hours = 1 W
* CT/MR/CT Chest/MR Body: 16 studies = 1 W
* US/US Thyroid: 40 studies = 1 W
* CR/DXA: 90 studies = 1 W
* PET: 8 studies = 1 W

=== Scheduling ===
[https://lblite.lightning-bolt.com/viewer/ Lightning Bolt]

Requests are closed for the next unassigned month as it is being built.
Radiologists should be available for 2 Fridays, 2 Saturdays, and 2 Sundays per month to facilitate scheduling.

Extra compensation:
* Log shift in Lightning Bolt with "Create Fill"
* Assignment: EXTRA COMP
* Custom Time: 4 hours for every W (make sure it doesn't overlap with a shift worked that day)
* Reason: 2 EXTRA CLINIC
* Location: Wherever it was worked (usually home)
* Notes
** If consulted regarding a specific patient, put MRN in
** If just an extra stack, put in "1W - SR READS"

Requests predominantly first come first serve except time around major holidays (Spring Break, Thanksgiving, Christmas)

Request Codes
* EDU ALL DAY - Educational Leave (2 weeks/year for 0.9 FTE)
* OUT OF OFFICE - Self Care
** Must include "Reason" field as 0 SELF CARE
* VAC PTO ALL DAY - PTO

Determining remaining PTO, EDU leave, and Self-Care days
* Workdays are 9 hours, so figuring the number of self-care days and educational leave remaining based on what's in the pay statement requires that conversion.
* Don't forget to look ahead in the schedule to determine how many have been requested but not accounted for on payroll.

== Facilities ==

=== Sunnyside (SMC) ===
* Physician parking is on the roof of the parking garage
* There are other physician parking areas (see the facility map)
* The physician lounge is near 3 South. Go up the F elevator or stairs and the door is nearby.

=== Westside (WMC) ===
* Physician parking is on the top floors of the garage (4 and up).

=== Interstate ===
* Physician parking is on the bottom floor of the garage.

Kaiser

2026-04-08T15:24:45Z

Tyler:

=== Internal Links ===
* [https://sp-cloud.kp.org/sites/NWPAccounting2 Reimbursement]
* [https://nwpkp.sumtotal.host/Broker/Account/Login.aspx? Training]
* [https://n23.ultipro.com/Login.aspx?ReturnUrl=%2fdefault.aspx HR]
* [https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices Imaging Sharepoint]
** [https://sp-cloud.kp.org/sites/KPNWImagingServices/Lists/Facility%20Phone%20List/By%20Facility.aspx?viewid=f8eabea2%2D4bd6%2D4eaf%2Dbe48%2Dfac642b1ada2 Imaging Phone List]
* [https://mykp.kp.org MyKP (Intranet)]
** Contains lots of tools, but have to navigate through a large list of tools that are sorted alphabetically. Two are pertinent to radiology.
*** [https://cl.kp.org/nw/news/clinavail-new-home1.html (Staff Availability NW)] - good for contacting staff on call
*** [http://cl.kp.org/ (Clinical Library)] - contains practice guidelines for Kaiser

=== Rotations ===
* [[KP Rotations]]
* [[Weekend Reads Update 5/29/25]]

=== Institutional Guidelines ===
* [[Iliac Artery Aneurysms]]
* [[US Update 6/2025]]

=== PACS ===
* Command line application `swe` can completely kill the application if it freezes.

=== Up To Date ===
* Login via Epic to accrue CME

=== Kaiser Radiology ===
* [[KP Rotations]]
* [https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices Imaging Sharepoint]
* [https://sp-cloud.kp.org/sites/NWImaging/SitePages/Radiologist-QC-Entry-Form.aspx QC Form]

=== Track Recs ===
Some report templates contain specific codes embedded in fill-in fields that trigger entries in databases to ensure appropriate follow-up, but this is not apparent in the macro. The pertinent system macros are:
* "yellow dot" - triggers follow-up of an incidental finding that could be cancer. Encouraged to use the "FollowUp" icon at the top of powerscribe to input specific recs.
* "red dot" - same as "yellow dot" but in cases that are definitely cancer.
* "yellow dot not" - removes a yellow dot case from the track recs system.
* "red dot not" - removes a yellow dot case from the track recs system.
* "AAA" - just contains "AAA" at the very top of the report, which triggers follow-up. The macro also contains recommendations specific to Kaiser, but these are not necessary for the Track Recs system.
* "Lung Rads" - this macro is included at the end of the system LDCT Screening macro and contains necessary codes.

For reference, the embedded codes are put in fill-in fields like so:
[[File:Screenshot 2025-07-01 102848.png|none|thumb|Powerscribe Findings Codes]]

=== Picky System Templates and Reporting ===

Some providers have strong preferences about report format. Those reports include:
* DEXA
** The endocrinologists go by the National Osteoporosis Foundation
***[https://static1.squarespace.com/static/5d7aabc5368b54332c55df72/t/5dd2e2a92e1e1821e328308e/1574101724294/HCP+Toolkit-with+graphics.pdf Manual ]
*** [https://www.bonesource.org/healthcare-professionals-toolkit Toolkit]
*** Don't say osteopenia, say low bone mass
*** Men < 50 yo, children, and premenopausal women have an entirely separate diagnostic rubric (page 14 in manual)
*** Technical osteoporosis criteria aren't required for treatment recommendation (page 50 in manual). Anyone with T-score < -2.5 in spine or hip warrants treatment.
** Several fields (BMDs, trends, and FRAX results) are automatically imported into Epic, and this is dependent on the exact text preceding the values in the report. Be careful when adjusting your template!

Calling severe coronary arterial calcific atherosclerosis triggers cardiology consultation (according to Chip Robertson, cardiology lead)

=== Overnight Prelims ===
* All over-reads go to the RTMC in-basket. So, unless a discrepancy is extremely time-sensitive, you probably don't need to call them about it. It'll be reviewed.
* If there is a major discrepancy and the ordering provider is not available, the RTMC line is the appropriate resource.

=== Incidental Follow-up ===
* See the Track Recs section above
* Incidental findings require follow-up are handled with "yellow dot" (possible cancer) and "red dot" (definite cancer).
* The yellow dot case autotext will flag the study so that administrators ensure the patient gets follow-up.
* The yellow dot can be removed on a subsequent exam with a different autotext.
* The red dot autotext will flag the finding as definitely cancer and (presumbably) trigger referrals.
* There is also a "blue flag" in Powerscribe that helps "yellow dot" cases.

=== Nuclear Medicine ===

* [https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices/SitePages/NM%20-%20Procedure%20Manual.aspx Procedure Manual]

=== Workflows ===
[[Coronary CTA]]

=== Logistics ===
* TIE Lines
** Sunnyside: 31-XXXX in house, 503-571-XXXX from outside
** Westside: 24-XXXX in house, 971-310-XXXX from outside
** Interstate: 16-XXXX in house, 503-331-XXXX from outside
** Salmon Creek: 69-XXXX in house, 360-571-XXXX from outside
** Longview-Kelso: 23-XXXX in house, 360-575-XXXX from outside

[https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices Imaging Services]

[https://sp-cloud.kp.org/sites/KPNWImagingServices/Lists/Facility%20Phone%20List/By%20Facility.aspx?viewid=f8eabea2%2D4bd6%2D4eaf%2Dbe48%2Dfac642b1ada2 Imaging Phone Directory]

[https://cl.kp.org/nw/news/clinavail-new-home1.html Staff Availability NW] - tool for finding on call providers. This is also at [https://mykp.kp.org MyKP] and should be added as a favorite tool. Navigate to ''All Tools'' to find it. The tool is named ''Staff Availability NW'' but the list is alphabetized and only shown partially, so select the range containing ''S'' to find it.

See Outlook or Teams for additional contact information.
* PACS Support Line - For workstation, PACS software, or desk help
* File room - For questions about studies and worklists
* IT Tie Line - Overall KP IT

=== Policies and Practices ===
[[FAQ on FTE and Leave]]
* Tumor Boards
** Worklists are in the "Workqueue List" in Epic. There are many, and you'll have to search for them. Here are two examples:
*** Chest Conference: ID 71818, Name ONC CASE CONF CHEST/THORACIC
*** GI Tumor Board: ID 71810, Name ONC CASE CONF GI
** Compensated by removing studies from your worklist for the day. There's a precedent for 10 CTs for a tumor board. I asked for 6 PETs for a tumor board on my NM days.
*** Helwig clarified that the precedent/agreement is that hours of work should translate to Ws. So, if prep+conference takes 4 hours, that'd be 0.5 W worth of work off the list.
* Call Bonus
** After 52 CT+MRI studies on Reg Call shifts, additional studies can be claimed for SRs (change announced 2/4/26 by Teran's email)

=== Supplemental Reads ===
Supplemental Reads (SRs) are a means of reimbursement for additional work at the following rates (using W as a unit of work). These rates are also useful for converting between types of work and adjusting worklists at rates that are generally acceptable to administration and the file room.
* Time: 4 hours = 1 W
* CT/MR/CT Chest/MR Body: 16 studies = 1 W
* US/US Thyroid: 40 studies = 1 W
* CR/DXA: 90 studies = 1 W
* PET: 8 studies = 1 W

=== Scheduling ===
[https://lblite.lightning-bolt.com/viewer/ Lightning Bolt]

Requests are closed for the next unassigned month as it is being built.
Radiologists should be available for 2 Fridays, 2 Saturdays, and 2 Sundays per month to facilitate scheduling.

Extra compensation:
* Log shift in Lightning Bolt with "Create Fill"
* Assignment: EXTRA COMP
* Custom Time: 4 hours for every W (make sure it doesn't overlap with a shift worked that day)
* Reason: 2 EXTRA CLINIC
* Location: Wherever it was worked (usually home)
* Notes
** If consulted regarding a specific patient, put MRN in
** If just an extra stack, put in "1W - SR READS"

Requests predominantly first come first serve except time around major holidays (Spring Break, Thanksgiving, Christmas)

Request Codes
* EDU ALL DAY - Educational Leave (2 weeks/year for 0.9 FTE)
* OUT OF OFFICE - Self Care
** Must include "Reason" field as 0 SELF CARE
* VAC PTO ALL DAY - PTO

Determining remaining PTO, EDU leave, and Self-Care days
* Workdays are 9 hours, so figuring the number of self-care days and educational leave remaining based on what's in the pay statement requires that conversion.
* Don't forget to look ahead in the schedule to determine how many have been requested but not accounted for on payroll.

== Facilities ==

=== Sunnyside (SMC) ===
* Physician parking is on the roof of the parking garage
* There are other physician parking areas (see the facility map)
* The physician lounge is near 3 South. Go up the F elevator or stairs and the door is nearby.

=== Westside (WMC) ===
* Physician parking is on the top floors of the garage (4 and up).

=== Interstate ===
* Physician parking is on the bottom floor of the garage.

Kaiser

2026-04-08T15:23:44Z

Tyler:

=== Internal Links ===
* [https://sp-cloud.kp.org/sites/NWPAccounting2 Reimbursement]
* [https://nwpkp.sumtotal.host/Broker/Account/Login.aspx? Training]
* [https://n23.ultipro.com/Login.aspx?ReturnUrl=%2fdefault.aspx HR]
* [https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices Imaging Sharepoint]
** [https://sp-cloud.kp.org/sites/KPNWImagingServices/Lists/Facility%20Phone%20List/By%20Facility.aspx?viewid=f8eabea2%2D4bd6%2D4eaf%2Dbe48%2Dfac642b1ada2 Imaging Phone List]
* [https://mykp.kp.org MyKP (Intranet)]
** Contains lots of tools, but have to navigate through a large list of tools that are sorted alphabetically. Two are pertinent to radiology.
*** Staff Availability NW - good for contacting staff on call
*** Clinical Library - contains practice guidelines for Kaiser

=== Rotations ===
* [[KP Rotations]]
* [[Weekend Reads Update 5/29/25]]

=== Institutional Guidelines ===
* [[Iliac Artery Aneurysms]]
* [[US Update 6/2025]]

=== PACS ===
* Command line application `swe` can completely kill the application if it freezes.

=== Up To Date ===
* Login via Epic to accrue CME

=== Kaiser Radiology ===
* [[KP Rotations]]
* [https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices Imaging Sharepoint]
* [https://sp-cloud.kp.org/sites/NWImaging/SitePages/Radiologist-QC-Entry-Form.aspx QC Form]

=== Track Recs ===
Some report templates contain specific codes embedded in fill-in fields that trigger entries in databases to ensure appropriate follow-up, but this is not apparent in the macro. The pertinent system macros are:
* "yellow dot" - triggers follow-up of an incidental finding that could be cancer. Encouraged to use the "FollowUp" icon at the top of powerscribe to input specific recs.
* "red dot" - same as "yellow dot" but in cases that are definitely cancer.
* "yellow dot not" - removes a yellow dot case from the track recs system.
* "red dot not" - removes a yellow dot case from the track recs system.
* "AAA" - just contains "AAA" at the very top of the report, which triggers follow-up. The macro also contains recommendations specific to Kaiser, but these are not necessary for the Track Recs system.
* "Lung Rads" - this macro is included at the end of the system LDCT Screening macro and contains necessary codes.

For reference, the embedded codes are put in fill-in fields like so:
[[File:Screenshot 2025-07-01 102848.png|none|thumb|Powerscribe Findings Codes]]

=== Picky System Templates and Reporting ===

Some providers have strong preferences about report format. Those reports include:
* DEXA
** The endocrinologists go by the National Osteoporosis Foundation
***[https://static1.squarespace.com/static/5d7aabc5368b54332c55df72/t/5dd2e2a92e1e1821e328308e/1574101724294/HCP+Toolkit-with+graphics.pdf Manual ]
*** [https://www.bonesource.org/healthcare-professionals-toolkit Toolkit]
*** Don't say osteopenia, say low bone mass
*** Men < 50 yo, children, and premenopausal women have an entirely separate diagnostic rubric (page 14 in manual)
*** Technical osteoporosis criteria aren't required for treatment recommendation (page 50 in manual). Anyone with T-score < -2.5 in spine or hip warrants treatment.
** Several fields (BMDs, trends, and FRAX results) are automatically imported into Epic, and this is dependent on the exact text preceding the values in the report. Be careful when adjusting your template!

Calling severe coronary arterial calcific atherosclerosis triggers cardiology consultation (according to Chip Robertson, cardiology lead)

=== Overnight Prelims ===
* All over-reads go to the RTMC in-basket. So, unless a discrepancy is extremely time-sensitive, you probably don't need to call them about it. It'll be reviewed.
* If there is a major discrepancy and the ordering provider is not available, the RTMC line is the appropriate resource.

=== Incidental Follow-up ===
* See the Track Recs section above
* Incidental findings require follow-up are handled with "yellow dot" (possible cancer) and "red dot" (definite cancer).
* The yellow dot case autotext will flag the study so that administrators ensure the patient gets follow-up.
* The yellow dot can be removed on a subsequent exam with a different autotext.
* The red dot autotext will flag the finding as definitely cancer and (presumbably) trigger referrals.
* There is also a "blue flag" in Powerscribe that helps "yellow dot" cases.

=== Nuclear Medicine ===

* [https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices/SitePages/NM%20-%20Procedure%20Manual.aspx Procedure Manual]

=== Workflows ===
[[Coronary CTA]]

=== Logistics ===
* TIE Lines
** Sunnyside: 31-XXXX in house, 503-571-XXXX from outside
** Westside: 24-XXXX in house, 971-310-XXXX from outside
** Interstate: 16-XXXX in house, 503-331-XXXX from outside
** Salmon Creek: 69-XXXX in house, 360-571-XXXX from outside
** Longview-Kelso: 23-XXXX in house, 360-575-XXXX from outside

[https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices Imaging Services]

[https://sp-cloud.kp.org/sites/KPNWImagingServices/Lists/Facility%20Phone%20List/By%20Facility.aspx?viewid=f8eabea2%2D4bd6%2D4eaf%2Dbe48%2Dfac642b1ada2 Imaging Phone Directory]

[https://cl.kp.org/nw/news/clinavail-new-home1.html Staff Availability NW] - tool for finding on call providers. This is also at [https://mykp.kp.org MyKP] and should be added as a favorite tool. Navigate to ''All Tools'' to find it. The tool is named ''Staff Availability NW'' but the list is alphabetized and only shown partially, so select the range containing ''S'' to find it.

See Outlook or Teams for additional contact information.
* PACS Support Line - For workstation, PACS software, or desk help
* File room - For questions about studies and worklists
* IT Tie Line - Overall KP IT

=== Policies and Practices ===
[[FAQ on FTE and Leave]]
* Tumor Boards
** Worklists are in the "Workqueue List" in Epic. There are many, and you'll have to search for them. Here are two examples:
*** Chest Conference: ID 71818, Name ONC CASE CONF CHEST/THORACIC
*** GI Tumor Board: ID 71810, Name ONC CASE CONF GI
** Compensated by removing studies from your worklist for the day. There's a precedent for 10 CTs for a tumor board. I asked for 6 PETs for a tumor board on my NM days.
*** Helwig clarified that the precedent/agreement is that hours of work should translate to Ws. So, if prep+conference takes 4 hours, that'd be 0.5 W worth of work off the list.
* Call Bonus
** After 52 CT+MRI studies on Reg Call shifts, additional studies can be claimed for SRs (change announced 2/4/26 by Teran's email)

=== Supplemental Reads ===
Supplemental Reads (SRs) are a means of reimbursement for additional work at the following rates (using W as a unit of work). These rates are also useful for converting between types of work and adjusting worklists at rates that are generally acceptable to administration and the file room.
* Time: 4 hours = 1 W
* CT/MR/CT Chest/MR Body: 16 studies = 1 W
* US/US Thyroid: 40 studies = 1 W
* CR/DXA: 90 studies = 1 W
* PET: 8 studies = 1 W

=== Scheduling ===
[https://lblite.lightning-bolt.com/viewer/ Lightning Bolt]

Requests are closed for the next unassigned month as it is being built.
Radiologists should be available for 2 Fridays, 2 Saturdays, and 2 Sundays per month to facilitate scheduling.

Extra compensation:
* Log shift in Lightning Bolt with "Create Fill"
* Assignment: EXTRA COMP
* Custom Time: 4 hours for every W (make sure it doesn't overlap with a shift worked that day)
* Reason: 2 EXTRA CLINIC
* Location: Wherever it was worked (usually home)
* Notes
** If consulted regarding a specific patient, put MRN in
** If just an extra stack, put in "1W - SR READS"

Requests predominantly first come first serve except time around major holidays (Spring Break, Thanksgiving, Christmas)

Request Codes
* EDU ALL DAY - Educational Leave (2 weeks/year for 0.9 FTE)
* OUT OF OFFICE - Self Care
** Must include "Reason" field as 0 SELF CARE
* VAC PTO ALL DAY - PTO

Determining remaining PTO, EDU leave, and Self-Care days
* Workdays are 9 hours, so figuring the number of self-care days and educational leave remaining based on what's in the pay statement requires that conversion.
* Don't forget to look ahead in the schedule to determine how many have been requested but not accounted for on payroll.

== Facilities ==

=== Sunnyside (SMC) ===
* Physician parking is on the roof of the parking garage
* There are other physician parking areas (see the facility map)
* The physician lounge is near 3 South. Go up the F elevator or stairs and the door is nearby.

=== Westside (WMC) ===
* Physician parking is on the top floors of the garage (4 and up).

=== Interstate ===
* Physician parking is on the bottom floor of the garage.

Kaiser

2026-04-04T22:47:38Z

Tyler: /* Logistics */

=== Internal Links ===
* [https://sp-cloud.kp.org/sites/NWPAccounting2 Reimbursement]
* [https://nwpkp.sumtotal.host/Broker/Account/Login.aspx? Training]
* [https://n23.ultipro.com/Login.aspx?ReturnUrl=%2fdefault.aspx HR]
* [https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices Imaging Sharepoint]
** [https://sp-cloud.kp.org/sites/KPNWImagingServices/Lists/Facility%20Phone%20List/By%20Facility.aspx?viewid=f8eabea2%2D4bd6%2D4eaf%2Dbe48%2Dfac642b1ada2 Imaging Phone List]

=== Rotations ===
* [[KP Rotations]]
* [[Weekend Reads Update 5/29/25]]

=== Institutional Guidelines ===
* [[Iliac Artery Aneurysms]]
* [[US Update 6/2025]]

=== PACS ===
* Command line application `swe` can completely kill the application if it freezes.

=== Up To Date ===
* Login via Epic to accrue CME

=== Kaiser Radiology ===
* [[KP Rotations]]
* [https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices Imaging Sharepoint]
* [https://sp-cloud.kp.org/sites/NWImaging/SitePages/Radiologist-QC-Entry-Form.aspx QC Form]

=== Track Recs ===
Some report templates contain specific codes embedded in fill-in fields that trigger entries in databases to ensure appropriate follow-up, but this is not apparent in the macro. The pertinent system macros are:
* "yellow dot" - triggers follow-up of an incidental finding that could be cancer. Encouraged to use the "FollowUp" icon at the top of powerscribe to input specific recs.
* "red dot" - same as "yellow dot" but in cases that are definitely cancer.
* "yellow dot not" - removes a yellow dot case from the track recs system.
* "red dot not" - removes a yellow dot case from the track recs system.
* "AAA" - just contains "AAA" at the very top of the report, which triggers follow-up. The macro also contains recommendations specific to Kaiser, but these are not necessary for the Track Recs system.
* "Lung Rads" - this macro is included at the end of the system LDCT Screening macro and contains necessary codes.

For reference, the embedded codes are put in fill-in fields like so:
[[File:Screenshot 2025-07-01 102848.png|none|thumb|Powerscribe Findings Codes]]

=== Picky System Templates and Reporting ===

Some providers have strong preferences about report format. Those reports include:
* DEXA
** The endocrinologists go by the National Osteoporosis Foundation
***[https://static1.squarespace.com/static/5d7aabc5368b54332c55df72/t/5dd2e2a92e1e1821e328308e/1574101724294/HCP+Toolkit-with+graphics.pdf Manual ]
*** [https://www.bonesource.org/healthcare-professionals-toolkit Toolkit]
*** Don't say osteopenia, say low bone mass
*** Men < 50 yo, children, and premenopausal women have an entirely separate diagnostic rubric (page 14 in manual)
*** Technical osteoporosis criteria aren't required for treatment recommendation (page 50 in manual). Anyone with T-score < -2.5 in spine or hip warrants treatment.
** Several fields (BMDs, trends, and FRAX results) are automatically imported into Epic, and this is dependent on the exact text preceding the values in the report. Be careful when adjusting your template!

Calling severe coronary arterial calcific atherosclerosis triggers cardiology consultation (according to Chip Robertson, cardiology lead)

=== Overnight Prelims ===
* All over-reads go to the RTMC in-basket. So, unless a discrepancy is extremely time-sensitive, you probably don't need to call them about it. It'll be reviewed.
* If there is a major discrepancy and the ordering provider is not available, the RTMC line is the appropriate resource.

=== Incidental Follow-up ===
* See the Track Recs section above
* Incidental findings require follow-up are handled with "yellow dot" (possible cancer) and "red dot" (definite cancer).
* The yellow dot case autotext will flag the study so that administrators ensure the patient gets follow-up.
* The yellow dot can be removed on a subsequent exam with a different autotext.
* The red dot autotext will flag the finding as definitely cancer and (presumbably) trigger referrals.
* There is also a "blue flag" in Powerscribe that helps "yellow dot" cases.

=== Nuclear Medicine ===

* [https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices/SitePages/NM%20-%20Procedure%20Manual.aspx Procedure Manual]

=== Workflows ===
[[Coronary CTA]]

=== Logistics ===

[https://mykp.kp.org MyKP (Intranet)]

* TIE Lines
** Sunnyside: 31-XXXX in house, 503-571-XXXX from outside
** Westside: 24-XXXX in house, 971-310-XXXX from outside
** Interstate: 16-XXXX in house, 503-331-XXXX from outside
** Salmon Creek: 69-XXXX in house, 360-571-XXXX from outside
** Longview-Kelso: 23-XXXX in house, 360-575-XXXX from outside

[https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices Imaging Services]

[https://sp-cloud.kp.org/sites/KPNWImagingServices/Lists/Facility%20Phone%20List/By%20Facility.aspx?viewid=f8eabea2%2D4bd6%2D4eaf%2Dbe48%2Dfac642b1ada2 Imaging Phone Directory]

[https://cl.kp.org/nw/news/clinavail-new-home1.html Staff Availability NW] - tool for finding on call providers. This is also at [https://mykp.kp.org MyKP] and should be added as a favorite tool. Navigate to ''All Tools'' to find it. The tool is named ''Staff Availability NW'' but the list is alphabetized and only shown partially, so select the range containing ''S'' to find it.

See Outlook or Teams for additional contact information.
* PACS Support Line - For workstation, PACS software, or desk help
* File room - For questions about studies and worklists
* IT Tie Line - Overall KP IT

=== Policies and Practices ===
[[FAQ on FTE and Leave]]
* Tumor Boards
** Worklists are in the "Workqueue List" in Epic. There are many, and you'll have to search for them. Here are two examples:
*** Chest Conference: ID 71818, Name ONC CASE CONF CHEST/THORACIC
*** GI Tumor Board: ID 71810, Name ONC CASE CONF GI
** Compensated by removing studies from your worklist for the day. There's a precedent for 10 CTs for a tumor board. I asked for 6 PETs for a tumor board on my NM days.
*** Helwig clarified that the precedent/agreement is that hours of work should translate to Ws. So, if prep+conference takes 4 hours, that'd be 0.5 W worth of work off the list.
* Call Bonus
** After 52 CT+MRI studies on Reg Call shifts, additional studies can be claimed for SRs (change announced 2/4/26 by Teran's email)

=== Supplemental Reads ===
Supplemental Reads (SRs) are a means of reimbursement for additional work at the following rates (using W as a unit of work). These rates are also useful for converting between types of work and adjusting worklists at rates that are generally acceptable to administration and the file room.
* Time: 4 hours = 1 W
* CT/MR/CT Chest/MR Body: 16 studies = 1 W
* US/US Thyroid: 40 studies = 1 W
* CR/DXA: 90 studies = 1 W
* PET: 8 studies = 1 W

=== Scheduling ===
[https://lblite.lightning-bolt.com/viewer/ Lightning Bolt]

Requests are closed for the next unassigned month as it is being built.
Radiologists should be available for 2 Fridays, 2 Saturdays, and 2 Sundays per month to facilitate scheduling.

Extra compensation:
* Log shift in Lightning Bolt with "Create Fill"
* Assignment: EXTRA COMP
* Custom Time: 4 hours for every W (make sure it doesn't overlap with a shift worked that day)
* Reason: 2 EXTRA CLINIC
* Location: Wherever it was worked (usually home)
* Notes
** If consulted regarding a specific patient, put MRN in
** If just an extra stack, put in "1W - SR READS"

Requests predominantly first come first serve except time around major holidays (Spring Break, Thanksgiving, Christmas)

Request Codes
* EDU ALL DAY - Educational Leave (2 weeks/year for 0.9 FTE)
* OUT OF OFFICE - Self Care
** Must include "Reason" field as 0 SELF CARE
* VAC PTO ALL DAY - PTO

Determining remaining PTO, EDU leave, and Self-Care days
* Workdays are 9 hours, so figuring the number of self-care days and educational leave remaining based on what's in the pay statement requires that conversion.
* Don't forget to look ahead in the schedule to determine how many have been requested but not accounted for on payroll.

== Facilities ==

=== Sunnyside (SMC) ===
* Physician parking is on the roof of the parking garage
* There are other physician parking areas (see the facility map)
* The physician lounge is near 3 South. Go up the F elevator or stairs and the door is nearby.

=== Westside (WMC) ===
* Physician parking is on the top floors of the garage (4 and up).

=== Interstate ===
* Physician parking is on the bottom floor of the garage.

Kaiser

2026-03-17T13:35:25Z

Tyler: /* Picky System Templates and Reporting */

=== Internal Links ===
* [https://sp-cloud.kp.org/sites/NWPAccounting2 Reimbursement]
* [https://nwpkp.sumtotal.host/Broker/Account/Login.aspx? Training]
* [https://n23.ultipro.com/Login.aspx?ReturnUrl=%2fdefault.aspx HR]
* [https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices Imaging Sharepoint]
** [https://sp-cloud.kp.org/sites/KPNWImagingServices/Lists/Facility%20Phone%20List/By%20Facility.aspx?viewid=f8eabea2%2D4bd6%2D4eaf%2Dbe48%2Dfac642b1ada2 Imaging Phone List]

=== Rotations ===
* [[KP Rotations]]
* [[Weekend Reads Update 5/29/25]]

=== Institutional Guidelines ===
* [[Iliac Artery Aneurysms]]
* [[US Update 6/2025]]

=== PACS ===
* Command line application `swe` can completely kill the application if it freezes.

=== Up To Date ===
* Login via Epic to accrue CME

=== Kaiser Radiology ===
* [[KP Rotations]]
* [https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices Imaging Sharepoint]
* [https://sp-cloud.kp.org/sites/NWImaging/SitePages/Radiologist-QC-Entry-Form.aspx QC Form]

=== Track Recs ===
Some report templates contain specific codes embedded in fill-in fields that trigger entries in databases to ensure appropriate follow-up, but this is not apparent in the macro. The pertinent system macros are:
* "yellow dot" - triggers follow-up of an incidental finding that could be cancer. Encouraged to use the "FollowUp" icon at the top of powerscribe to input specific recs.
* "red dot" - same as "yellow dot" but in cases that are definitely cancer.
* "yellow dot not" - removes a yellow dot case from the track recs system.
* "red dot not" - removes a yellow dot case from the track recs system.
* "AAA" - just contains "AAA" at the very top of the report, which triggers follow-up. The macro also contains recommendations specific to Kaiser, but these are not necessary for the Track Recs system.
* "Lung Rads" - this macro is included at the end of the system LDCT Screening macro and contains necessary codes.

For reference, the embedded codes are put in fill-in fields like so:
[[File:Screenshot 2025-07-01 102848.png|none|thumb|Powerscribe Findings Codes]]

=== Picky System Templates and Reporting ===

Some providers have strong preferences about report format. Those reports include:
* DEXA
** The endocrinologists go by the National Osteoporosis Foundation
***[https://static1.squarespace.com/static/5d7aabc5368b54332c55df72/t/5dd2e2a92e1e1821e328308e/1574101724294/HCP+Toolkit-with+graphics.pdf Manual ]
*** [https://www.bonesource.org/healthcare-professionals-toolkit Toolkit]
*** Don't say osteopenia, say low bone mass
*** Men < 50 yo, children, and premenopausal women have an entirely separate diagnostic rubric (page 14 in manual)
*** Technical osteoporosis criteria aren't required for treatment recommendation (page 50 in manual). Anyone with T-score < -2.5 in spine or hip warrants treatment.
** Several fields (BMDs, trends, and FRAX results) are automatically imported into Epic, and this is dependent on the exact text preceding the values in the report. Be careful when adjusting your template!

Calling severe coronary arterial calcific atherosclerosis triggers cardiology consultation (according to Chip Robertson, cardiology lead)

=== Overnight Prelims ===
* All over-reads go to the RTMC in-basket. So, unless a discrepancy is extremely time-sensitive, you probably don't need to call them about it. It'll be reviewed.
* If there is a major discrepancy and the ordering provider is not available, the RTMC line is the appropriate resource.

=== Incidental Follow-up ===
* See the Track Recs section above
* Incidental findings require follow-up are handled with "yellow dot" (possible cancer) and "red dot" (definite cancer).
* The yellow dot case autotext will flag the study so that administrators ensure the patient gets follow-up.
* The yellow dot can be removed on a subsequent exam with a different autotext.
* The red dot autotext will flag the finding as definitely cancer and (presumbably) trigger referrals.
* There is also a "blue flag" in Powerscribe that helps "yellow dot" cases.

=== Nuclear Medicine ===

* [https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices/SitePages/NM%20-%20Procedure%20Manual.aspx Procedure Manual]

=== Workflows ===
[[Coronary CTA]]

=== Logistics ===

* TIE Lines
** Sunnyside: 31-XXXX in house, 503-571-XXXX from outside
** Westside: 24-XXXX in house, 971-310-XXXX from outside
** Interstate: 16-XXXX in house, 503-331-XXXX from outside
** Salmon Creek: 69-XXXX in house, 360-571-XXXX from outside
** Longview-Kelso: 23-XXXX in house, 360-575-XXXX from outside

[https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices Imaging Services]

[https://sp-cloud.kp.org/sites/KPNWImagingServices/Lists/Facility%20Phone%20List/By%20Facility.aspx?viewid=f8eabea2%2D4bd6%2D4eaf%2Dbe48%2Dfac642b1ada2 Imaging Phone Directory]

See Outlook or Teams for additional contact information.
* PACS Support Line - For workstation, PACS software, or desk help
* File room - For questions about studies and worklists
* IT Tie Line - Overall KP IT

=== Policies and Practices ===
[[FAQ on FTE and Leave]]
* Tumor Boards
** Worklists are in the "Workqueue List" in Epic. There are many, and you'll have to search for them. Here are two examples:
*** Chest Conference: ID 71818, Name ONC CASE CONF CHEST/THORACIC
*** GI Tumor Board: ID 71810, Name ONC CASE CONF GI
** Compensated by removing studies from your worklist for the day. There's a precedent for 10 CTs for a tumor board. I asked for 6 PETs for a tumor board on my NM days.
*** Helwig clarified that the precedent/agreement is that hours of work should translate to Ws. So, if prep+conference takes 4 hours, that'd be 0.5 W worth of work off the list.
* Call Bonus
** After 52 CT+MRI studies on Reg Call shifts, additional studies can be claimed for SRs (change announced 2/4/26 by Teran's email)

=== Supplemental Reads ===
Supplemental Reads (SRs) are a means of reimbursement for additional work at the following rates (using W as a unit of work). These rates are also useful for converting between types of work and adjusting worklists at rates that are generally acceptable to administration and the file room.
* Time: 4 hours = 1 W
* CT/MR/CT Chest/MR Body: 16 studies = 1 W
* US/US Thyroid: 40 studies = 1 W
* CR/DXA: 90 studies = 1 W
* PET: 8 studies = 1 W

=== Scheduling ===
[https://lblite.lightning-bolt.com/viewer/ Lightning Bolt]

Requests are closed for the next unassigned month as it is being built.
Radiologists should be available for 2 Fridays, 2 Saturdays, and 2 Sundays per month to facilitate scheduling.

Extra compensation:
* Log shift in Lightning Bolt with "Create Fill"
* Assignment: EXTRA COMP
* Custom Time: 4 hours for every W (make sure it doesn't overlap with a shift worked that day)
* Reason: 2 EXTRA CLINIC
* Location: Wherever it was worked (usually home)
* Notes
** If consulted regarding a specific patient, put MRN in
** If just an extra stack, put in "1W - SR READS"

Requests predominantly first come first serve except time around major holidays (Spring Break, Thanksgiving, Christmas)

Request Codes
* EDU ALL DAY - Educational Leave (2 weeks/year for 0.9 FTE)
* OUT OF OFFICE - Self Care
** Must include "Reason" field as 0 SELF CARE
* VAC PTO ALL DAY - PTO

Determining remaining PTO, EDU leave, and Self-Care days
* Workdays are 9 hours, so figuring the number of self-care days and educational leave remaining based on what's in the pay statement requires that conversion.
* Don't forget to look ahead in the schedule to determine how many have been requested but not accounted for on payroll.

== Facilities ==

=== Sunnyside (SMC) ===
* Physician parking is on the roof of the parking garage
* There are other physician parking areas (see the facility map)
* The physician lounge is near 3 South. Go up the F elevator or stairs and the door is nearby.

=== Westside (WMC) ===
* Physician parking is on the top floors of the garage (4 and up).

=== Interstate ===
* Physician parking is on the bottom floor of the garage.

Kaiser

2026-03-17T12:16:52Z

Tyler: /* Picky System Templates and Reporting */

=== Internal Links ===
* [https://sp-cloud.kp.org/sites/NWPAccounting2 Reimbursement]
* [https://nwpkp.sumtotal.host/Broker/Account/Login.aspx? Training]
* [https://n23.ultipro.com/Login.aspx?ReturnUrl=%2fdefault.aspx HR]
* [https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices Imaging Sharepoint]
** [https://sp-cloud.kp.org/sites/KPNWImagingServices/Lists/Facility%20Phone%20List/By%20Facility.aspx?viewid=f8eabea2%2D4bd6%2D4eaf%2Dbe48%2Dfac642b1ada2 Imaging Phone List]

=== Rotations ===
* [[KP Rotations]]
* [[Weekend Reads Update 5/29/25]]

=== Institutional Guidelines ===
* [[Iliac Artery Aneurysms]]
* [[US Update 6/2025]]

=== PACS ===
* Command line application `swe` can completely kill the application if it freezes.

=== Up To Date ===
* Login via Epic to accrue CME

=== Kaiser Radiology ===
* [[KP Rotations]]
* [https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices Imaging Sharepoint]
* [https://sp-cloud.kp.org/sites/NWImaging/SitePages/Radiologist-QC-Entry-Form.aspx QC Form]

=== Track Recs ===
Some report templates contain specific codes embedded in fill-in fields that trigger entries in databases to ensure appropriate follow-up, but this is not apparent in the macro. The pertinent system macros are:
* "yellow dot" - triggers follow-up of an incidental finding that could be cancer. Encouraged to use the "FollowUp" icon at the top of powerscribe to input specific recs.
* "red dot" - same as "yellow dot" but in cases that are definitely cancer.
* "yellow dot not" - removes a yellow dot case from the track recs system.
* "red dot not" - removes a yellow dot case from the track recs system.
* "AAA" - just contains "AAA" at the very top of the report, which triggers follow-up. The macro also contains recommendations specific to Kaiser, but these are not necessary for the Track Recs system.
* "Lung Rads" - this macro is included at the end of the system LDCT Screening macro and contains necessary codes.

For reference, the embedded codes are put in fill-in fields like so:
[[File:Screenshot 2025-07-01 102848.png|none|thumb|Powerscribe Findings Codes]]

=== Picky System Templates and Reporting ===

Some providers have strong preferences about report format. Those reports include:
* DEXA
** The endocrinologists go by the National Osteoporosis Foundation
***[https://static1.squarespace.com/static/5d7aabc5368b54332c55df72/t/5dd2e2a92e1e1821e328308e/1574101724294/HCP+Toolkit-with+graphics.pdf Manual ]
*** [https://www.bonesource.org/healthcare-professionals-toolkit Toolkit]
*** Don't say osteopenia, say low bone mass
*** Men < 50 yo, children, and premenopausal women have an entirely separate diagnostic rubric
** Several fields (BMDs, trends, and FRAX results) are automatically imported into Epic, and this is dependent on the exact text preceding the values in the report. Be careful when adjusting your template!

Calling severe coronary arterial calcific atherosclerosis triggers cardiology consultation (according to Chip Robertson, cardiology lead)

=== Overnight Prelims ===
* All over-reads go to the RTMC in-basket. So, unless a discrepancy is extremely time-sensitive, you probably don't need to call them about it. It'll be reviewed.
* If there is a major discrepancy and the ordering provider is not available, the RTMC line is the appropriate resource.

=== Incidental Follow-up ===
* See the Track Recs section above
* Incidental findings require follow-up are handled with "yellow dot" (possible cancer) and "red dot" (definite cancer).
* The yellow dot case autotext will flag the study so that administrators ensure the patient gets follow-up.
* The yellow dot can be removed on a subsequent exam with a different autotext.
* The red dot autotext will flag the finding as definitely cancer and (presumbably) trigger referrals.
* There is also a "blue flag" in Powerscribe that helps "yellow dot" cases.

=== Nuclear Medicine ===

* [https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices/SitePages/NM%20-%20Procedure%20Manual.aspx Procedure Manual]

=== Workflows ===
[[Coronary CTA]]

=== Logistics ===

* TIE Lines
** Sunnyside: 31-XXXX in house, 503-571-XXXX from outside
** Westside: 24-XXXX in house, 971-310-XXXX from outside
** Interstate: 16-XXXX in house, 503-331-XXXX from outside
** Salmon Creek: 69-XXXX in house, 360-571-XXXX from outside
** Longview-Kelso: 23-XXXX in house, 360-575-XXXX from outside

[https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices Imaging Services]

[https://sp-cloud.kp.org/sites/KPNWImagingServices/Lists/Facility%20Phone%20List/By%20Facility.aspx?viewid=f8eabea2%2D4bd6%2D4eaf%2Dbe48%2Dfac642b1ada2 Imaging Phone Directory]

See Outlook or Teams for additional contact information.
* PACS Support Line - For workstation, PACS software, or desk help
* File room - For questions about studies and worklists
* IT Tie Line - Overall KP IT

=== Policies and Practices ===
[[FAQ on FTE and Leave]]
* Tumor Boards
** Worklists are in the "Workqueue List" in Epic. There are many, and you'll have to search for them. Here are two examples:
*** Chest Conference: ID 71818, Name ONC CASE CONF CHEST/THORACIC
*** GI Tumor Board: ID 71810, Name ONC CASE CONF GI
** Compensated by removing studies from your worklist for the day. There's a precedent for 10 CTs for a tumor board. I asked for 6 PETs for a tumor board on my NM days.
*** Helwig clarified that the precedent/agreement is that hours of work should translate to Ws. So, if prep+conference takes 4 hours, that'd be 0.5 W worth of work off the list.
* Call Bonus
** After 52 CT+MRI studies on Reg Call shifts, additional studies can be claimed for SRs (change announced 2/4/26 by Teran's email)

=== Supplemental Reads ===
Supplemental Reads (SRs) are a means of reimbursement for additional work at the following rates (using W as a unit of work). These rates are also useful for converting between types of work and adjusting worklists at rates that are generally acceptable to administration and the file room.
* Time: 4 hours = 1 W
* CT/MR/CT Chest/MR Body: 16 studies = 1 W
* US/US Thyroid: 40 studies = 1 W
* CR/DXA: 90 studies = 1 W
* PET: 8 studies = 1 W

=== Scheduling ===
[https://lblite.lightning-bolt.com/viewer/ Lightning Bolt]

Requests are closed for the next unassigned month as it is being built.
Radiologists should be available for 2 Fridays, 2 Saturdays, and 2 Sundays per month to facilitate scheduling.

Extra compensation:
* Log shift in Lightning Bolt with "Create Fill"
* Assignment: EXTRA COMP
* Custom Time: 4 hours for every W (make sure it doesn't overlap with a shift worked that day)
* Reason: 2 EXTRA CLINIC
* Location: Wherever it was worked (usually home)
* Notes
** If consulted regarding a specific patient, put MRN in
** If just an extra stack, put in "1W - SR READS"

Requests predominantly first come first serve except time around major holidays (Spring Break, Thanksgiving, Christmas)

Request Codes
* EDU ALL DAY - Educational Leave (2 weeks/year for 0.9 FTE)
* OUT OF OFFICE - Self Care
** Must include "Reason" field as 0 SELF CARE
* VAC PTO ALL DAY - PTO

Determining remaining PTO, EDU leave, and Self-Care days
* Workdays are 9 hours, so figuring the number of self-care days and educational leave remaining based on what's in the pay statement requires that conversion.
* Don't forget to look ahead in the schedule to determine how many have been requested but not accounted for on payroll.

== Facilities ==

=== Sunnyside (SMC) ===
* Physician parking is on the roof of the parking garage
* There are other physician parking areas (see the facility map)
* The physician lounge is near 3 South. Go up the F elevator or stairs and the door is nearby.

=== Westside (WMC) ===
* Physician parking is on the top floors of the garage (4 and up).

=== Interstate ===
* Physician parking is on the bottom floor of the garage.

Workday Links

2026-03-06T16:36:37Z

Tyler:

=== '''[[Contrast Reactions]]''' ===
=== '''[[Contrast Reactions (Children)]]''' ===

=== [https://radiopaedia.org/sessions/new Radiopaedia] ===

=== [[Kaiser]] ===

=== Radiology Tools ===
* [https://radcalc.overdesigned.org RadCalc]
* [https://radiology-universe.org/calculator/ Radiology Universe]
* [https://www.mesa-nhlbi.org/Calcium/input.aspx MESA Calcium Score %]
* [http://radiologyreviewarticles.com/radiology-calculators/spleen-volume-calculator/ Splenic Volume]

=== RADS ===
* [https://nextcloud.overdesigned.org/s/sNDQw4PgseooowP BIRADS Lexicon]
* [https://edge.sitecorecloud.io/americancoldf5f-acrorgf92a-productioncb02-3650/media/ACR/Files/RADS/Lung-RADS/Lung-RADS-2022.pdf LungRADS]
* [https://tiradscalculator.com/wp-content/uploads/2017/05/TIRADS-2017-Flow-Chart.jpg TIRADS]
* [https://edge.sitecorecloud.io/americancoldf5f-acrorgf92a-productioncb02-3650/media/ACR/Files/RADS/LI-RADS/LI-RADS-US-Surveillance-v2024-Core.pdf LI-RADS (US)]
* [https://edge.sitecorecloud.io/americancoldf5f-acrorgf92a-productioncb02-3650/media/ACR/Files/RADS/LI-RADS/LI-RADS-CT-MRI-2018-Core.pdf LI-RADS (CT/MR)]

=== Anatomy ===
* Prostate
** [https://radiologyassistant.nl/assets/tek-sector.jpg Illustration]
** [https://radiologyassistant.nl/assets/prostate-cancer-pi-rads-v2/a5b77f28c41897_Scroll.008.jpeg Peripheral Zone]
** [https://radiologyassistant.nl/assets/prostate-cancer-pi-rads-v2/a5b77f28c43fc1_Scroll.011.jpeg Transition Zone]
** [https://radiologyassistant.nl/assets/prostate-cancer-pi-rads-v2/a5b77f28c4246a_Scroll.009.jpeg Capsule]

=== Normal Measurements ===
* [https://www.ohsu.edu/school-of-medicine/diagnostic-radiology/pediatric-radiology-normal-measurements Pediatrics]
* [https://radres.ucsd.edu/normal_for_age/ Pediatric MSK]

=== Incidental Findings ===
* [https://publish.smartsheet.com/42d18e874a164318a0f702481f2fbb70 All ACR papers]
* [https://nextcloud.overdesigned.org/s/XzZFeGADrstoY6w Pancreatic Cysts]
* [https://pubs.rsna.org/na101/home/literatum/publisher/rsna/journals/content/radiology/2017/radiol.2017.284.issue-1/radiol.2017161659/20170608/images/large/radiol.2017161659.tbl1.jpeg Fleischner Society]
* [https://els-jbs-prod-cdn.jbs.elsevierhealth.com/cms/attachment/264251b7-b546-480e-9a13-fb3bdafeded3/gr1.jpg Adrenal Nodule]
* [https://www.jacr.org/article/S1546-1440(17)30497-0/fulltext Renal Mass]
* [https://www.ahajournals.org/doi/10.1161/CIR.0000000000001106 Aortic Aneurysms]
** [[Aortic Aneurysm Context]]

=== Nucs ===
* [https://docs.google.com/document/d/1XGK-kmIll02jbF1q4PGzd6ZCFtLe-0b3/edit?usp=sharing&ouid=107887909640214305589&rtpof=true&sd=true I-131 Checklist]
* Doses must be within 20% of the prescribed dose or it's a sentinel event ([https://www.nrc.gov/reading-rm/doc-collections/cfr/part035/part035-3045.html See NRC rule here]).
* [[Florbetapir]]
* [https://nextcloud.overdesigned.org/s/dBQRKbxScPfBrFB Pluvicto Dosing]

=== Uncategorized ===
* [https://nextcloud.overdesigned.org/s/mnYARHRwsAFEY53 NCCN NSCLC]
* [https://nextcloud.overdesigned.org/s/qzFg2AbfYBDxXZL IASLC NSCLC Staging]
* [https://nextcloud.overdesigned.org/s/9FzGTQRMANp9TAB Fleischner Terms Thoracic Imaging]
* [https://www.acr.org/Clinical-Resources/Contrast-Manual ACR Contrast Manual]
* [https://docs.google.com/document/d/1Duz1sinAk3v5gfoIRtWa9o9U1GhbzRxkRI_vUvE18Co/edit Guidelines for nonviable pregnancy diagnosis]
* ADPKD Volume Calculation
** [[Media:ADPKD_Volume_Measurements.png|Measurement Technique]]
** [https://www.mayo.edu/research/documents/pkd-center-adpkd-classification/doc-20094754 Calculator]

KP Rotations

2026-02-18T23:44:51Z

Tyler: /* Diagnostic Radiology */

Radiology Rotations 2025

== Diagnostic Radiology ==

*Call
**CT Techs can sometimes bolus exams to the call list, so it's helpful to also filter for Stat CTs assigned to no one
**For other modalities, just wait for techs to push exams to the Reg Call lists
***On weekdays:
****US read by US1 until 1:30
****XR read by US1 until 4pm
*****But apparently ''except'' chest and abdominal inpatient XR after 2 PM (once Gen Rad 1 is done) per Mark Gotauco
****MRI read by MRI1 until 4pm
****CT perfusion read by MRI1
**Techs should stop pushing studies to the call list 30 minutes before the end of the shift (7:00 on weekdays, 10:00 on weekends)

*Regional Call 1 On Site on weekends and holidays
**Traditionally defaults to SMC but can be requested otherwise. The site a radiologist is technically responsible for is in the title of the assignment in the schedule.
**Covers ER/Inpatient exams
**Overreads CT, US and CR overnight StatRad exams (all modalities on Sat and Sun)
***Mon-Thurs 1030-1930
***Fri 1330-2230
***Sat-Sun 1300-2200

*Regional Call 2 On site on weekends and holidays
**Traditionally defaults to WMC but can be requested otherwise. The site a radiologist is technically responsible for is in the title of the assignment in the schedule.
**Covers ER/Inpatient exams
**Overreads CT, US and CR overnight StatRad exams (and all modalities on Sat and Sun)
***Mon-Thurs 1000-1900
***Fri 1100-2000
***Sat-Sun 1100-2100

*Swing
**As a reminder, starting on 12/1/25, we are trialing a Regional Call Swing Shift (REG CALL SWG). This person, who is also assigned to a stack rotation, is going to be helping with the incoming call studies from 3p-6p. They will have a proportional reduction in their stacks that are assigned that morning.
**For example:
***CT or MRI stacks: <s>25 studies, no CR</s>
***US stacks: <s>56 studies, no CR</s>
***GR stacks: <s>130 CR</s>
** The reduction of the routine work was initially 2/3 of a stack but was subsequently reduced to 1/2 of a stack

*CT 1 Filters
**Transcribed (in "Other Lists" dropdown), Filter: Assigned to NSR
**Unread, Filter: Stat/Performed Today (just to see what's being scanned)
**Unread, Filter: Reg Call 1/Reg Call 2/CT1
**Only reading CT. XR, US, and MR generally go to those modality shifts. Once day rotations start to finish, studies will start to go to Reg Call1 and Reg Call2 rotations.
**"Macro Stat Rad" for preliminary reports
**RTMC line (on SharePoint imaging) is for outpatients with urgent findings

*CT 1 Remote (Mon-Thurs)
**Covers ER/Inpatient exams from 0700-1030
**Overreads CT, US and CR overnight StatRad exams

*CT 1 Remote (Fri)
**Covers ER/Inpatient exams from 0700-1100
**Overreads CT, US and CR overnight StatRad exams

*CT 1 Remote (Sat-Sun)
**Covers ER/Inpatient exams from 0700-1200
**Overreads overnight StatRad exams (all modalities)

*SMC RDS LH WH “Weekend Reads”
**Sat-Sun and Holidays 0730-1330
**Reads inpatient CR and may cover SMC fluoro procedures
**Target: 180 CR (subtract 10 CR for each fluoro procedure)

*CT 2-9 “Stacked Rotations”
**Target: 32 CT/MRI and 30 CR

*MRI 1 Stat MRI Coverage
**Overreads MRI overnight StatRad exams
**Target: 20 MRI and 20 CR or 25 MRI

*MRI 2-9 “Stacked Rotations”
**Target: 32 CT/MRI and 30 CR

*US 1
**Covers STAT CR from 0730-1600 (excluding 1130-1230)
**Covers STAT US from 0730-1330 (excluding 1130-1230)
**Target: 30 US (Urgent), 30 CR, 4 CT

*US 2, 3 Stacked Rotations
**Target: 70 US and 30 CR

*Gen Rad 1
**On-Site @ WMC covering Fluoro procedures and sonohyst
**Target: 60 CR (STAT), 6 CT, 10 US (Mon and Fri)
**Covers STAT CR and US from 1130-1230

*Gen Rad 2
**On-Site @ SMC covering fluoro procedures
**Target: 30 CR (STAT), 4 CT, 20 US

*Gen Rad 3
**On-Site @ INT covering fluoro procedures and sonohyst
**CT Protocols
**Target: 40 CR (STAT), 40 US, 6 CT

*Gen Rad 4, 5 Stacked Rotations
**Target: 200 CR

*SKY 2 Stacked Rotation
**Target: 32 CT/MRI and 30 CR

*CEC
**On-Site @ CEC covering contrast injections

*NM 1 & 2
**On-Site if therapy needed
**Target: 12 PET-CT, 20 DEXA, 10 Gen Nucs (per Mirarchi, NM1 reads gen nucs from Sunnyside and NM2 reads gen nucs from Westside)
**From Mirarchi: If there are 2 of us on NM, we're supposed to read 12 PETs each. I think Maureen usually just reads the PETs assigned to her on NM 1 or 2. But, I often read studies not assigned to my list and then leave some that are. For example, there are currently 2 Urgent PETs on the list that aren't assigned so they won't be read until tomorrow. I'll probably preferentially pick those off then leave 2 of the "routine" studies currently assigned to NM 1. Or else sometimes a clinician will call asking for stat results because they're seeing the patient in clinic that day and want the results quickly, so I'll preferentially read that study. As long as you get 12 done no one cares which 12. If you prefer to just read the ones assigned to the rotation that's totally fine - however you want to handle the case load is fine.
** If there is only one rad assigned to NM for the day, read from both NM 1 and NM 2 lists. No DEXAs will be assigned.
** Once you're on the RAM license then Marcia will start scheduling you for therapies. She periodically e-mails a list of the scheduled therapies with the ones you're scheduled to consent in person at the top of the list. That will make more sense when you get the first e-mail. You'll have to pencil those into your personal schedule - they don't show up on the Lightning Bolt schedule.
** If you have a strong preference for which site you do therapies, you should make sure that's known. I've had them reschedule patients to travel to my site, and I haven't had problems or complaints about that so far.
** For NM post-processing, Philips Intellispace Portalnd and Terarecon (aka AquariusNET) are currently available (January 2026).

*Mammography Rotations:
**SKY 1
***On Site @ SKY covering Dx/Locs/Bx
***Target: 30 MG

**SMC Mamm 1Bx
***On Site @ SMC covering Dx/Bx
***Target: 40 MG -or- 35 MG + 1-2 MRI

**SMC Mamm 1
***On Site @ SMC covering Dx AM only
***Target: 20 MG -or- 15 MG + 1-2 MRI

**SMC Mamm 2
***On Site @ SMC covering Dx/Locs/OSF
***Target: 30 MG -or- 25 MG + 1-2 MRI

**INT Mamm 3Bx
***On Site @ INT covering Bx
***Target: 75 MG + 1-2 MRI

**INT Mamm 4
***On Site @ INT covering Dx
***Target: 40 MG -or- 35 MG + 1-2 MRI

**WMC Mamm 5Bx
***On Site @ WMC covering Dx/Locs/Bx
***Target: 40 MG -or- 35 MG + 1-2 MRI

**WMC Mamm 5
***On Site @ WMC covering Dx/Locs
***Target: 40 MG -or- 35 MG + 1-2 MRI

**Sal Mamm 6
***On Site @ Sal Cr covering Dx
***Target: 40 MG -or- 35 MG + 1-2 MRI

**LVK Clinic
***On Site @ LVK covering Dx/Bx
***Target: 25 tomo + 1-2 MRI

**ECG
***On Site @ Eugene covering Dx
***Target: 35 MG

Interventional Radiology
IR 1, 2
On Site @ SMC, CVL
IR 3
On Site @ SMC, US and CT guided procedures
IR 4
On Site @ WMC, US and CT guided procedures
IR 5
On Site @ WMC, CVL
IR 6
Clinic

IR Film Targets:
IR 2, 3, 5
Target: 45 CR
IR 4
Target: 4 CT and 45 CR
IR 6
Target: 70 CR

KP Rotations

2026-02-18T23:37:02Z

Tyler: /* Diagnostic Radiology */

Radiology Rotations 2025

== Diagnostic Radiology ==

*Call
**CT Techs can sometimes bolus exams to the call list, so it's helpful to also filter for Stat CTs assigned to no one
**For other modalities, just wait for techs to push exams to the Reg Call lists
***On weekdays:
****US read by US1 until 1:30
****XR read by US1 until 4pm
*****But apparently ''except'' chest and abdominal inpatient XR
****MRI read by MRI1 until 4pm
****CT perfusion read by MRI1
**Techs should stop pushing studies to the call list 30 minutes before the end of the shift (7:00 on weekdays, 10:00 on weekends)

*Regional Call 1 On Site on weekends and holidays
**Traditionally defaults to SMC but can be requested otherwise. The site a radiologist is technically responsible for is in the title of the assignment in the schedule.
**Covers ER/Inpatient exams
**Overreads CT, US and CR overnight StatRad exams (all modalities on Sat and Sun)
***Mon-Thurs 1030-1930
***Fri 1330-2230
***Sat-Sun 1300-2200

*Regional Call 2 On site on weekends and holidays
**Traditionally defaults to WMC but can be requested otherwise. The site a radiologist is technically responsible for is in the title of the assignment in the schedule.
**Covers ER/Inpatient exams
**Overreads CT, US and CR overnight StatRad exams (and all modalities on Sat and Sun)
***Mon-Thurs 1000-1900
***Fri 1100-2000
***Sat-Sun 1100-2100

*Swing
**As a reminder, starting on 12/1/25, we are trialing a Regional Call Swing Shift (REG CALL SWG). This person, who is also assigned to a stack rotation, is going to be helping with the incoming call studies from 3p-6p. They will have a proportional reduction in their stacks that are assigned that morning.
**For example:
***CT or MRI stacks: <s>25 studies, no CR</s>
***US stacks: <s>56 studies, no CR</s>
***GR stacks: <s>130 CR</s>
** The reduction of the routine work was initially 2/3 of a stack but was subsequently reduced to 1/2 of a stack

*CT 1 Filters
**Transcribed (in "Other Lists" dropdown), Filter: Assigned to NSR
**Unread, Filter: Stat/Performed Today (just to see what's being scanned)
**Unread, Filter: Reg Call 1/Reg Call 2/CT1
**Only reading CT. XR, US, and MR generally go to those modality shifts. Once day rotations start to finish, studies will start to go to Reg Call1 and Reg Call2 rotations.
**"Macro Stat Rad" for preliminary reports
**RTMC line (on SharePoint imaging) is for outpatients with urgent findings

*CT 1 Remote (Mon-Thurs)
**Covers ER/Inpatient exams from 0700-1030
**Overreads CT, US and CR overnight StatRad exams

*CT 1 Remote (Fri)
**Covers ER/Inpatient exams from 0700-1100
**Overreads CT, US and CR overnight StatRad exams

*CT 1 Remote (Sat-Sun)
**Covers ER/Inpatient exams from 0700-1200
**Overreads overnight StatRad exams (all modalities)

*SMC RDS LH WH “Weekend Reads”
**Sat-Sun and Holidays 0730-1330
**Reads inpatient CR and may cover SMC fluoro procedures
**Target: 180 CR (subtract 10 CR for each fluoro procedure)

*CT 2-9 “Stacked Rotations”
**Target: 32 CT/MRI and 30 CR

*MRI 1 Stat MRI Coverage
**Overreads MRI overnight StatRad exams
**Target: 20 MRI and 20 CR or 25 MRI

*MRI 2-9 “Stacked Rotations”
**Target: 32 CT/MRI and 30 CR

*US 1
**Covers STAT CR from 0730-1600 (excluding 1130-1230)
**Covers STAT US from 0730-1330 (excluding 1130-1230)
**Target: 30 US (Urgent), 30 CR, 4 CT

*US 2, 3 Stacked Rotations
**Target: 70 US and 30 CR

*Gen Rad 1
**On-Site @ WMC covering Fluoro procedures and sonohyst
**Target: 60 CR (STAT), 6 CT, 10 US (Mon and Fri)
**Covers STAT CR and US from 1130-1230

*Gen Rad 2
**On-Site @ SMC covering fluoro procedures
**Target: 30 CR (STAT), 4 CT, 20 US

*Gen Rad 3
**On-Site @ INT covering fluoro procedures and sonohyst
**CT Protocols
**Target: 40 CR (STAT), 40 US, 6 CT

*Gen Rad 4, 5 Stacked Rotations
**Target: 200 CR

*SKY 2 Stacked Rotation
**Target: 32 CT/MRI and 30 CR

*CEC
**On-Site @ CEC covering contrast injections

*NM 1 & 2
**On-Site if therapy needed
**Target: 12 PET-CT, 20 DEXA, 10 Gen Nucs (per Mirarchi, NM1 reads gen nucs from Sunnyside and NM2 reads gen nucs from Westside)
**From Mirarchi: If there are 2 of us on NM, we're supposed to read 12 PETs each. I think Maureen usually just reads the PETs assigned to her on NM 1 or 2. But, I often read studies not assigned to my list and then leave some that are. For example, there are currently 2 Urgent PETs on the list that aren't assigned so they won't be read until tomorrow. I'll probably preferentially pick those off then leave 2 of the "routine" studies currently assigned to NM 1. Or else sometimes a clinician will call asking for stat results because they're seeing the patient in clinic that day and want the results quickly, so I'll preferentially read that study. As long as you get 12 done no one cares which 12. If you prefer to just read the ones assigned to the rotation that's totally fine - however you want to handle the case load is fine.
** If there is only one rad assigned to NM for the day, read from both NM 1 and NM 2 lists. No DEXAs will be assigned.
** Once you're on the RAM license then Marcia will start scheduling you for therapies. She periodically e-mails a list of the scheduled therapies with the ones you're scheduled to consent in person at the top of the list. That will make more sense when you get the first e-mail. You'll have to pencil those into your personal schedule - they don't show up on the Lightning Bolt schedule.
** If you have a strong preference for which site you do therapies, you should make sure that's known. I've had them reschedule patients to travel to my site, and I haven't had problems or complaints about that so far.
** For NM post-processing, Philips Intellispace Portalnd and Terarecon (aka AquariusNET) are currently available (January 2026).

*Mammography Rotations:
**SKY 1
***On Site @ SKY covering Dx/Locs/Bx
***Target: 30 MG

**SMC Mamm 1Bx
***On Site @ SMC covering Dx/Bx
***Target: 40 MG -or- 35 MG + 1-2 MRI

**SMC Mamm 1
***On Site @ SMC covering Dx AM only
***Target: 20 MG -or- 15 MG + 1-2 MRI

**SMC Mamm 2
***On Site @ SMC covering Dx/Locs/OSF
***Target: 30 MG -or- 25 MG + 1-2 MRI

**INT Mamm 3Bx
***On Site @ INT covering Bx
***Target: 75 MG + 1-2 MRI

**INT Mamm 4
***On Site @ INT covering Dx
***Target: 40 MG -or- 35 MG + 1-2 MRI

**WMC Mamm 5Bx
***On Site @ WMC covering Dx/Locs/Bx
***Target: 40 MG -or- 35 MG + 1-2 MRI

**WMC Mamm 5
***On Site @ WMC covering Dx/Locs
***Target: 40 MG -or- 35 MG + 1-2 MRI

**Sal Mamm 6
***On Site @ Sal Cr covering Dx
***Target: 40 MG -or- 35 MG + 1-2 MRI

**LVK Clinic
***On Site @ LVK covering Dx/Bx
***Target: 25 tomo + 1-2 MRI

**ECG
***On Site @ Eugene covering Dx
***Target: 35 MG

Interventional Radiology
IR 1, 2
On Site @ SMC, CVL
IR 3
On Site @ SMC, US and CT guided procedures
IR 4
On Site @ WMC, US and CT guided procedures
IR 5
On Site @ WMC, CVL
IR 6
Clinic

IR Film Targets:
IR 2, 3, 5
Target: 45 CR
IR 4
Target: 4 CT and 45 CR
IR 6
Target: 70 CR

Kaiser

2026-02-04T19:11:09Z

Tyler: /* Policies and Practices */

=== Internal Links ===
* [https://sp-cloud.kp.org/sites/NWPAccounting2 Reimbursement]
* [https://nwpkp.sumtotal.host/Broker/Account/Login.aspx? Training]
* [https://n23.ultipro.com/Login.aspx?ReturnUrl=%2fdefault.aspx HR]
* [https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices Imaging Sharepoint]
** [https://sp-cloud.kp.org/sites/KPNWImagingServices/Lists/Facility%20Phone%20List/By%20Facility.aspx?viewid=f8eabea2%2D4bd6%2D4eaf%2Dbe48%2Dfac642b1ada2 Imaging Phone List]

=== Rotations ===
* [[KP Rotations]]
* [[Weekend Reads Update 5/29/25]]

=== Institutional Guidelines ===
* [[Iliac Artery Aneurysms]]
* [[US Update 6/2025]]

=== PACS ===
* Command line application `swe` can completely kill the application if it freezes.

=== Up To Date ===
* Login via Epic to accrue CME

=== Kaiser Radiology ===
* [[KP Rotations]]
* [https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices Imaging Sharepoint]
* [https://sp-cloud.kp.org/sites/NWImaging/SitePages/Radiologist-QC-Entry-Form.aspx QC Form]

=== Track Recs ===
Some report templates contain specific codes embedded in fill-in fields that trigger entries in databases to ensure appropriate follow-up, but this is not apparent in the macro. The pertinent system macros are:
* "yellow dot" - triggers follow-up of an incidental finding that could be cancer. Encouraged to use the "FollowUp" icon at the top of powerscribe to input specific recs.
* "red dot" - same as "yellow dot" but in cases that are definitely cancer.
* "yellow dot not" - removes a yellow dot case from the track recs system.
* "red dot not" - removes a yellow dot case from the track recs system.
* "AAA" - just contains "AAA" at the very top of the report, which triggers follow-up. The macro also contains recommendations specific to Kaiser, but these are not necessary for the Track Recs system.
* "Lung Rads" - this macro is included at the end of the system LDCT Screening macro and contains necessary codes.

For reference, the embedded codes are put in fill-in fields like so:
[[File:Screenshot 2025-07-01 102848.png|none|thumb|Powerscribe Findings Codes]]

=== Picky System Templates and Reporting ===

Some providers have strong preferences about report format. Those reports include:
* DEXA
** The endocrinologists go by the National Osteoporosis Foundation
***[https://static1.squarespace.com/static/5d7aabc5368b54332c55df72/t/5dd2e2a92e1e1821e328308e/1574101724294/HCP+Toolkit-with+graphics.pdf Manual ]
*** [https://www.bonesource.org/healthcare-professionals-toolkit Toolkit]
*** Don't say osteopenia, say low bone mass
*** Men, children, and women < 50 yo have an entirely separate diagnostic rubric
** Several fields (BMDs, trends, and FRAX results) are automatically imported into Epic, and this is dependent on the exact text preceding the values in the report. Be careful when adjusting your template!

Calling severe coronary arterial calcific atherosclerosis triggers cardiology consultation (according to Chip Robertson, cardiology lead)

=== Overnight Prelims ===
* All over-reads go to the RTMC in-basket. So, unless a discrepancy is extremely time-sensitive, you probably don't need to call them about it. It'll be reviewed.
* If there is a major discrepancy and the ordering provider is not available, the RTMC line is the appropriate resource.

=== Incidental Follow-up ===
* See the Track Recs section above
* Incidental findings require follow-up are handled with "yellow dot" (possible cancer) and "red dot" (definite cancer).
* The yellow dot case autotext will flag the study so that administrators ensure the patient gets follow-up.
* The yellow dot can be removed on a subsequent exam with a different autotext.
* The red dot autotext will flag the finding as definitely cancer and (presumbably) trigger referrals.
* There is also a "blue flag" in Powerscribe that helps "yellow dot" cases.

=== Nuclear Medicine ===

* [https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices/SitePages/NM%20-%20Procedure%20Manual.aspx Procedure Manual]

=== Workflows ===
[[Coronary CTA]]

=== Logistics ===

* TIE Lines
** Sunnyside: 31-XXXX in house, 503-571-XXXX from outside
** Westside: 24-XXXX in house, 971-310-XXXX from outside
** Interstate: 16-XXXX in house, 503-331-XXXX from outside
** Salmon Creek: 69-XXXX in house, 360-571-XXXX from outside
** Longview-Kelso: 23-XXXX in house, 360-575-XXXX from outside

[https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices Imaging Services]

[https://sp-cloud.kp.org/sites/KPNWImagingServices/Lists/Facility%20Phone%20List/By%20Facility.aspx?viewid=f8eabea2%2D4bd6%2D4eaf%2Dbe48%2Dfac642b1ada2 Imaging Phone Directory]

See Outlook or Teams for additional contact information.
* PACS Support Line - For workstation, PACS software, or desk help
* File room - For questions about studies and worklists
* IT Tie Line - Overall KP IT

=== Policies and Practices ===
[[FAQ on FTE and Leave]]
* Tumor Boards
** Worklists are in the "Workqueue List" in Epic. There are many, and you'll have to search for them. Here are two examples:
*** Chest Conference: ID 71818, Name ONC CASE CONF CHEST/THORACIC
*** GI Tumor Board: ID 71810, Name ONC CASE CONF GI
** Compensated by removing studies from your worklist for the day. There's a precedent for 10 CTs for a tumor board. I asked for 6 PETs for a tumor board on my NM days.
*** Helwig clarified that the precedent/agreement is that hours of work should translate to Ws. So, if prep+conference takes 4 hours, that'd be 0.5 W worth of work off the list.
* Call Bonus
** After 52 CT+MRI studies on Reg Call shifts, additional studies can be claimed for SRs (change announced 2/4/26 by Teran's email)

=== Supplemental Reads ===
Supplemental Reads (SRs) are a means of reimbursement for additional work at the following rates (using W as a unit of work). These rates are also useful for converting between types of work and adjusting worklists at rates that are generally acceptable to administration and the file room.
* Time: 4 hours = 1 W
* CT/MR/CT Chest/MR Body: 16 studies = 1 W
* US/US Thyroid: 40 studies = 1 W
* CR/DXA: 90 studies = 1 W
* PET: 8 studies = 1 W

=== Scheduling ===
[https://lblite.lightning-bolt.com/viewer/ Lightning Bolt]

Requests are closed for the next unassigned month as it is being built.
Radiologists should be available for 2 Fridays, 2 Saturdays, and 2 Sundays per month to facilitate scheduling.

Extra compensation:
* Log shift in Lightning Bolt with "Create Fill"
* Assignment: EXTRA COMP
* Custom Time: 4 hours for every W (make sure it doesn't overlap with a shift worked that day)
* Reason: 2 EXTRA CLINIC
* Location: Wherever it was worked (usually home)
* Notes
** If consulted regarding a specific patient, put MRN in
** If just an extra stack, put in "1W - SR READS"

Requests predominantly first come first serve except time around major holidays (Spring Break, Thanksgiving, Christmas)

Request Codes
* EDU ALL DAY - Educational Leave (2 weeks/year for 0.9 FTE)
* OUT OF OFFICE - Self Care
** Must include "Reason" field as 0 SELF CARE
* VAC PTO ALL DAY - PTO

Determining remaining PTO, EDU leave, and Self-Care days
* Workdays are 9 hours, so figuring the number of self-care days and educational leave remaining based on what's in the pay statement requires that conversion.
* Don't forget to look ahead in the schedule to determine how many have been requested but not accounted for on payroll.

== Facilities ==

=== Sunnyside (SMC) ===
* Physician parking is on the roof of the parking garage
* There are other physician parking areas (see the facility map)
* The physician lounge is near 3 South. Go up the F elevator or stairs and the door is nearby.

=== Westside (WMC) ===
* Physician parking is on the top floors of the garage (4 and up).

=== Interstate ===
* Physician parking is on the bottom floor of the garage.

Workday Links

2026-01-27T18:02:05Z

Tyler:

=== '''[[Contrast Reactions]]''' ===
=== '''[[Contrast Reactions (Children)]]''' ===

=== [https://radiopaedia.org/sessions/new Radiopaedia] ===

=== [[Kaiser]] ===

=== Radiology Tools ===
* [https://radcalc.overdesigned.org RadCalc]
* [https://radiology-universe.org/calculator/ Radiology Universe]
* [https://www.mesa-nhlbi.org/Calcium/input.aspx MESA Calcium Score %]
* [http://radiologyreviewarticles.com/radiology-calculators/spleen-volume-calculator/ Splenic Volume]

=== RADS ===
* [https://nextcloud.overdesigned.org/s/sNDQw4PgseooowP BIRADS Lexicon]
* [https://edge.sitecorecloud.io/americancoldf5f-acrorgf92a-productioncb02-3650/media/ACR/Files/RADS/Lung-RADS/Lung-RADS-2022.pdf LungRADS]
* [https://tiradscalculator.com/wp-content/uploads/2017/05/TIRADS-2017-Flow-Chart.jpg TIRADS]
* [https://edge.sitecorecloud.io/americancoldf5f-acrorgf92a-productioncb02-3650/media/ACR/Files/RADS/LI-RADS/LI-RADS-US-Surveillance-v2024-Core.pdf LI-RADS (US)]
* [https://edge.sitecorecloud.io/americancoldf5f-acrorgf92a-productioncb02-3650/media/ACR/Files/RADS/LI-RADS/LI-RADS-CT-MRI-2018-Core.pdf LI-RADS (CT/MR)]

=== Anatomy ===
* Prostate
** [https://radiologyassistant.nl/assets/tek-sector.jpg Illustration]
** [https://radiologyassistant.nl/assets/prostate-cancer-pi-rads-v2/a5b77f28c41897_Scroll.008.jpeg Peripheral Zone]
** [https://radiologyassistant.nl/assets/prostate-cancer-pi-rads-v2/a5b77f28c43fc1_Scroll.011.jpeg Transition Zone]
** [https://radiologyassistant.nl/assets/prostate-cancer-pi-rads-v2/a5b77f28c4246a_Scroll.009.jpeg Capsule]

=== Normal Measurements ===
* [https://www.ohsu.edu/school-of-medicine/diagnostic-radiology/pediatric-radiology-normal-measurements Pediatrics]

=== Incidental Findings ===
* [https://publish.smartsheet.com/42d18e874a164318a0f702481f2fbb70 All ACR papers]
* [https://nextcloud.overdesigned.org/s/XzZFeGADrstoY6w Pancreatic Cysts]
* [https://pubs.rsna.org/na101/home/literatum/publisher/rsna/journals/content/radiology/2017/radiol.2017.284.issue-1/radiol.2017161659/20170608/images/large/radiol.2017161659.tbl1.jpeg Fleischner Society]
* [https://els-jbs-prod-cdn.jbs.elsevierhealth.com/cms/attachment/264251b7-b546-480e-9a13-fb3bdafeded3/gr1.jpg Adrenal Nodule]
* [https://www.jacr.org/article/S1546-1440(17)30497-0/fulltext Renal Mass]
* [https://www.ahajournals.org/doi/10.1161/CIR.0000000000001106 Aortic Aneurysms]
** [[Aortic Aneurysm Context]]

=== Nucs ===
* [https://docs.google.com/document/d/1XGK-kmIll02jbF1q4PGzd6ZCFtLe-0b3/edit?usp=sharing&ouid=107887909640214305589&rtpof=true&sd=true I-131 Checklist]
* Doses must be within 20% of the prescribed dose or it's a sentinel event ([https://www.nrc.gov/reading-rm/doc-collections/cfr/part035/part035-3045.html See NRC rule here]).
* [[Florbetapir]]
* [https://nextcloud.overdesigned.org/s/dBQRKbxScPfBrFB Pluvicto Dosing]

=== Uncategorized ===
* [https://nextcloud.overdesigned.org/s/mnYARHRwsAFEY53 NCCN NSCLC]
* [https://nextcloud.overdesigned.org/s/qzFg2AbfYBDxXZL IASLC NSCLC Staging]
* [https://nextcloud.overdesigned.org/s/9FzGTQRMANp9TAB Fleischner Terms Thoracic Imaging]
* [https://www.acr.org/Clinical-Resources/Contrast-Manual ACR Contrast Manual]
* [https://docs.google.com/document/d/1Duz1sinAk3v5gfoIRtWa9o9U1GhbzRxkRI_vUvE18Co/edit Guidelines for nonviable pregnancy diagnosis]
* ADPKD Volume Calculation
** [[Media:ADPKD_Volume_Measurements.png|Measurement Technique]]
** [https://www.mayo.edu/research/documents/pkd-center-adpkd-classification/doc-20094754 Calculator]

Kaiser

2026-01-12T16:40:52Z

Tyler: /* Picky System Templates and Reporting */

=== Internal Links ===
* [https://sp-cloud.kp.org/sites/NWPAccounting2 Reimbursement]
* [https://nwpkp.sumtotal.host/Broker/Account/Login.aspx? Training]
* [https://n23.ultipro.com/Login.aspx?ReturnUrl=%2fdefault.aspx HR]
* [https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices Imaging Sharepoint]
** [https://sp-cloud.kp.org/sites/KPNWImagingServices/Lists/Facility%20Phone%20List/By%20Facility.aspx?viewid=f8eabea2%2D4bd6%2D4eaf%2Dbe48%2Dfac642b1ada2 Imaging Phone List]

=== Rotations ===
* [[KP Rotations]]
* [[Weekend Reads Update 5/29/25]]

=== Institutional Guidelines ===
* [[Iliac Artery Aneurysms]]
* [[US Update 6/2025]]

=== PACS ===
* Command line application `swe` can completely kill the application if it freezes.

=== Up To Date ===
* Login via Epic to accrue CME

=== Kaiser Radiology ===
* [[KP Rotations]]
* [https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices Imaging Sharepoint]
* [https://sp-cloud.kp.org/sites/NWImaging/SitePages/Radiologist-QC-Entry-Form.aspx QC Form]

=== Track Recs ===
Some report templates contain specific codes embedded in fill-in fields that trigger entries in databases to ensure appropriate follow-up, but this is not apparent in the macro. The pertinent system macros are:
* "yellow dot" - triggers follow-up of an incidental finding that could be cancer. Encouraged to use the "FollowUp" icon at the top of powerscribe to input specific recs.
* "red dot" - same as "yellow dot" but in cases that are definitely cancer.
* "yellow dot not" - removes a yellow dot case from the track recs system.
* "red dot not" - removes a yellow dot case from the track recs system.
* "AAA" - just contains "AAA" at the very top of the report, which triggers follow-up. The macro also contains recommendations specific to Kaiser, but these are not necessary for the Track Recs system.
* "Lung Rads" - this macro is included at the end of the system LDCT Screening macro and contains necessary codes.

For reference, the embedded codes are put in fill-in fields like so:
[[File:Screenshot 2025-07-01 102848.png|none|thumb|Powerscribe Findings Codes]]

=== Picky System Templates and Reporting ===

Some providers have strong preferences about report format. Those reports include:
* DEXA
** The endocrinologists go by the National Osteoporosis Foundation
***[https://static1.squarespace.com/static/5d7aabc5368b54332c55df72/t/5dd2e2a92e1e1821e328308e/1574101724294/HCP+Toolkit-with+graphics.pdf Manual ]
*** [https://www.bonesource.org/healthcare-professionals-toolkit Toolkit]
*** Don't say osteopenia, say low bone mass
*** Men, children, and women < 50 yo have an entirely separate diagnostic rubric
** Several fields (BMDs, trends, and FRAX results) are automatically imported into Epic, and this is dependent on the exact text preceding the values in the report. Be careful when adjusting your template!

Calling severe coronary arterial calcific atherosclerosis triggers cardiology consultation (according to Chip Robertson, cardiology lead)

=== Overnight Prelims ===
* All over-reads go to the RTMC in-basket. So, unless a discrepancy is extremely time-sensitive, you probably don't need to call them about it. It'll be reviewed.
* If there is a major discrepancy and the ordering provider is not available, the RTMC line is the appropriate resource.

=== Incidental Follow-up ===
* See the Track Recs section above
* Incidental findings require follow-up are handled with "yellow dot" (possible cancer) and "red dot" (definite cancer).
* The yellow dot case autotext will flag the study so that administrators ensure the patient gets follow-up.
* The yellow dot can be removed on a subsequent exam with a different autotext.
* The red dot autotext will flag the finding as definitely cancer and (presumbably) trigger referrals.
* There is also a "blue flag" in Powerscribe that helps "yellow dot" cases.

=== Nuclear Medicine ===

* [https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices/SitePages/NM%20-%20Procedure%20Manual.aspx Procedure Manual]

=== Workflows ===
[[Coronary CTA]]

=== Logistics ===

* TIE Lines
** Sunnyside: 31-XXXX in house, 503-571-XXXX from outside
** Westside: 24-XXXX in house, 971-310-XXXX from outside
** Interstate: 16-XXXX in house, 503-331-XXXX from outside
** Salmon Creek: 69-XXXX in house, 360-571-XXXX from outside
** Longview-Kelso: 23-XXXX in house, 360-575-XXXX from outside

[https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices Imaging Services]

[https://sp-cloud.kp.org/sites/KPNWImagingServices/Lists/Facility%20Phone%20List/By%20Facility.aspx?viewid=f8eabea2%2D4bd6%2D4eaf%2Dbe48%2Dfac642b1ada2 Imaging Phone Directory]

See Outlook or Teams for additional contact information.
* PACS Support Line - For workstation, PACS software, or desk help
* File room - For questions about studies and worklists
* IT Tie Line - Overall KP IT

=== Policies and Practices ===
[[FAQ on FTE and Leave]]
* Tumor Boards
** Worklists are in the "Workqueue List" in Epic. There are many, and you'll have to search for them. Here are two examples:
*** Chest Conference: ID 71818, Name ONC CASE CONF CHEST/THORACIC
*** GI Tumor Board: ID 71810, Name ONC CASE CONF GI
** Compensated by removing studies from your worklist for the day. There's a precedent for 10 CTs for a tumor board. I asked for 6 PETs for a tumor board on my NM days.
*** Helwig clarified that the precedent/agreement is that hours of work should translate to Ws. So, if prep+conference takes 4 hours, that'd be 0.5 W worth of work off the list.
* Call Bonus
** After 60 CT+MRI studies on Reg Call shifts, additional studies can be claimed for SRs.

=== Supplemental Reads ===
Supplemental Reads (SRs) are a means of reimbursement for additional work at the following rates (using W as a unit of work). These rates are also useful for converting between types of work and adjusting worklists at rates that are generally acceptable to administration and the file room.
* Time: 4 hours = 1 W
* CT/MR/CT Chest/MR Body: 16 studies = 1 W
* US/US Thyroid: 40 studies = 1 W
* CR/DXA: 90 studies = 1 W
* PET: 8 studies = 1 W

=== Scheduling ===
[https://lblite.lightning-bolt.com/viewer/ Lightning Bolt]

Requests are closed for the next unassigned month as it is being built.
Radiologists should be available for 2 Fridays, 2 Saturdays, and 2 Sundays per month to facilitate scheduling.

Extra compensation:
* Log shift in Lightning Bolt with "Create Fill"
* Assignment: EXTRA COMP
* Custom Time: 4 hours for every W (make sure it doesn't overlap with a shift worked that day)
* Reason: 2 EXTRA CLINIC
* Location: Wherever it was worked (usually home)
* Notes
** If consulted regarding a specific patient, put MRN in
** If just an extra stack, put in "1W - SR READS"

Requests predominantly first come first serve except time around major holidays (Spring Break, Thanksgiving, Christmas)

Request Codes
* EDU ALL DAY - Educational Leave (2 weeks/year for 0.9 FTE)
* OUT OF OFFICE - Self Care
** Must include "Reason" field as 0 SELF CARE
* VAC PTO ALL DAY - PTO

Determining remaining PTO, EDU leave, and Self-Care days
* Workdays are 9 hours, so figuring the number of self-care days and educational leave remaining based on what's in the pay statement requires that conversion.
* Don't forget to look ahead in the schedule to determine how many have been requested but not accounted for on payroll.

== Facilities ==

=== Sunnyside (SMC) ===
* Physician parking is on the roof of the parking garage
* There are other physician parking areas (see the facility map)
* The physician lounge is near 3 South. Go up the F elevator or stairs and the door is nearby.

=== Westside (WMC) ===
* Physician parking is on the top floors of the garage (4 and up).

=== Interstate ===
* Physician parking is on the bottom floor of the garage.

Kaiser

2026-01-12T16:39:30Z

Tyler: /* Picky System Templates and Reporting */

=== Internal Links ===
* [https://sp-cloud.kp.org/sites/NWPAccounting2 Reimbursement]
* [https://nwpkp.sumtotal.host/Broker/Account/Login.aspx? Training]
* [https://n23.ultipro.com/Login.aspx?ReturnUrl=%2fdefault.aspx HR]
* [https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices Imaging Sharepoint]
** [https://sp-cloud.kp.org/sites/KPNWImagingServices/Lists/Facility%20Phone%20List/By%20Facility.aspx?viewid=f8eabea2%2D4bd6%2D4eaf%2Dbe48%2Dfac642b1ada2 Imaging Phone List]

=== Rotations ===
* [[KP Rotations]]
* [[Weekend Reads Update 5/29/25]]

=== Institutional Guidelines ===
* [[Iliac Artery Aneurysms]]
* [[US Update 6/2025]]

=== PACS ===
* Command line application `swe` can completely kill the application if it freezes.

=== Up To Date ===
* Login via Epic to accrue CME

=== Kaiser Radiology ===
* [[KP Rotations]]
* [https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices Imaging Sharepoint]
* [https://sp-cloud.kp.org/sites/NWImaging/SitePages/Radiologist-QC-Entry-Form.aspx QC Form]

=== Track Recs ===
Some report templates contain specific codes embedded in fill-in fields that trigger entries in databases to ensure appropriate follow-up, but this is not apparent in the macro. The pertinent system macros are:
* "yellow dot" - triggers follow-up of an incidental finding that could be cancer. Encouraged to use the "FollowUp" icon at the top of powerscribe to input specific recs.
* "red dot" - same as "yellow dot" but in cases that are definitely cancer.
* "yellow dot not" - removes a yellow dot case from the track recs system.
* "red dot not" - removes a yellow dot case from the track recs system.
* "AAA" - just contains "AAA" at the very top of the report, which triggers follow-up. The macro also contains recommendations specific to Kaiser, but these are not necessary for the Track Recs system.
* "Lung Rads" - this macro is included at the end of the system LDCT Screening macro and contains necessary codes.

For reference, the embedded codes are put in fill-in fields like so:
[[File:Screenshot 2025-07-01 102848.png|none|thumb|Powerscribe Findings Codes]]

=== Picky System Templates and Reporting ===

Some providers have strong preferences about report format. Those reports include:
* DEXA
** The endocrinologists go by the National Osteoporosis Foundation
*** [Manual https://static1.squarespace.com/static/5d7aabc5368b54332c55df72/t/5dd2e2a92e1e1821e328308e/1574101724294/HCP+Toolkit-with+graphics.pdf]
*** [Toolkit https://www.bonesource.org/healthcare-professionals-toolkit]
*** Don't say osteopenia, say low bone mass
*** Men, children, and women < 50 yo have an entirely separate diagnostic rubric

Calling severe coronary arterial calcific atherosclerosis triggers cardiology consultation (according to Chip Robertson, cardiology lead)

=== Overnight Prelims ===
* All over-reads go to the RTMC in-basket. So, unless a discrepancy is extremely time-sensitive, you probably don't need to call them about it. It'll be reviewed.
* If there is a major discrepancy and the ordering provider is not available, the RTMC line is the appropriate resource.

=== Incidental Follow-up ===
* See the Track Recs section above
* Incidental findings require follow-up are handled with "yellow dot" (possible cancer) and "red dot" (definite cancer).
* The yellow dot case autotext will flag the study so that administrators ensure the patient gets follow-up.
* The yellow dot can be removed on a subsequent exam with a different autotext.
* The red dot autotext will flag the finding as definitely cancer and (presumbably) trigger referrals.
* There is also a "blue flag" in Powerscribe that helps "yellow dot" cases.

=== Nuclear Medicine ===

* [https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices/SitePages/NM%20-%20Procedure%20Manual.aspx Procedure Manual]

=== Workflows ===
[[Coronary CTA]]

=== Logistics ===

* TIE Lines
** Sunnyside: 31-XXXX in house, 503-571-XXXX from outside
** Westside: 24-XXXX in house, 971-310-XXXX from outside
** Interstate: 16-XXXX in house, 503-331-XXXX from outside
** Salmon Creek: 69-XXXX in house, 360-571-XXXX from outside
** Longview-Kelso: 23-XXXX in house, 360-575-XXXX from outside

[https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices Imaging Services]

[https://sp-cloud.kp.org/sites/KPNWImagingServices/Lists/Facility%20Phone%20List/By%20Facility.aspx?viewid=f8eabea2%2D4bd6%2D4eaf%2Dbe48%2Dfac642b1ada2 Imaging Phone Directory]

See Outlook or Teams for additional contact information.
* PACS Support Line - For workstation, PACS software, or desk help
* File room - For questions about studies and worklists
* IT Tie Line - Overall KP IT

=== Policies and Practices ===
[[FAQ on FTE and Leave]]
* Tumor Boards
** Worklists are in the "Workqueue List" in Epic. There are many, and you'll have to search for them. Here are two examples:
*** Chest Conference: ID 71818, Name ONC CASE CONF CHEST/THORACIC
*** GI Tumor Board: ID 71810, Name ONC CASE CONF GI
** Compensated by removing studies from your worklist for the day. There's a precedent for 10 CTs for a tumor board. I asked for 6 PETs for a tumor board on my NM days.
*** Helwig clarified that the precedent/agreement is that hours of work should translate to Ws. So, if prep+conference takes 4 hours, that'd be 0.5 W worth of work off the list.
* Call Bonus
** After 60 CT+MRI studies on Reg Call shifts, additional studies can be claimed for SRs.

=== Supplemental Reads ===
Supplemental Reads (SRs) are a means of reimbursement for additional work at the following rates (using W as a unit of work). These rates are also useful for converting between types of work and adjusting worklists at rates that are generally acceptable to administration and the file room.
* Time: 4 hours = 1 W
* CT/MR/CT Chest/MR Body: 16 studies = 1 W
* US/US Thyroid: 40 studies = 1 W
* CR/DXA: 90 studies = 1 W
* PET: 8 studies = 1 W

=== Scheduling ===
[https://lblite.lightning-bolt.com/viewer/ Lightning Bolt]

Requests are closed for the next unassigned month as it is being built.
Radiologists should be available for 2 Fridays, 2 Saturdays, and 2 Sundays per month to facilitate scheduling.

Extra compensation:
* Log shift in Lightning Bolt with "Create Fill"
* Assignment: EXTRA COMP
* Custom Time: 4 hours for every W (make sure it doesn't overlap with a shift worked that day)
* Reason: 2 EXTRA CLINIC
* Location: Wherever it was worked (usually home)
* Notes
** If consulted regarding a specific patient, put MRN in
** If just an extra stack, put in "1W - SR READS"

Requests predominantly first come first serve except time around major holidays (Spring Break, Thanksgiving, Christmas)

Request Codes
* EDU ALL DAY - Educational Leave (2 weeks/year for 0.9 FTE)
* OUT OF OFFICE - Self Care
** Must include "Reason" field as 0 SELF CARE
* VAC PTO ALL DAY - PTO

Determining remaining PTO, EDU leave, and Self-Care days
* Workdays are 9 hours, so figuring the number of self-care days and educational leave remaining based on what's in the pay statement requires that conversion.
* Don't forget to look ahead in the schedule to determine how many have been requested but not accounted for on payroll.

== Facilities ==

=== Sunnyside (SMC) ===
* Physician parking is on the roof of the parking garage
* There are other physician parking areas (see the facility map)
* The physician lounge is near 3 South. Go up the F elevator or stairs and the door is nearby.

=== Westside (WMC) ===
* Physician parking is on the top floors of the garage (4 and up).

=== Interstate ===
* Physician parking is on the bottom floor of the garage.

Kaiser

2026-01-12T16:39:01Z

Tyler: /* Picky System Templates and Reporting */

=== Internal Links ===
* [https://sp-cloud.kp.org/sites/NWPAccounting2 Reimbursement]
* [https://nwpkp.sumtotal.host/Broker/Account/Login.aspx? Training]
* [https://n23.ultipro.com/Login.aspx?ReturnUrl=%2fdefault.aspx HR]
* [https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices Imaging Sharepoint]
** [https://sp-cloud.kp.org/sites/KPNWImagingServices/Lists/Facility%20Phone%20List/By%20Facility.aspx?viewid=f8eabea2%2D4bd6%2D4eaf%2Dbe48%2Dfac642b1ada2 Imaging Phone List]

=== Rotations ===
* [[KP Rotations]]
* [[Weekend Reads Update 5/29/25]]

=== Institutional Guidelines ===
* [[Iliac Artery Aneurysms]]
* [[US Update 6/2025]]

=== PACS ===
* Command line application `swe` can completely kill the application if it freezes.

=== Up To Date ===
* Login via Epic to accrue CME

=== Kaiser Radiology ===
* [[KP Rotations]]
* [https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices Imaging Sharepoint]
* [https://sp-cloud.kp.org/sites/NWImaging/SitePages/Radiologist-QC-Entry-Form.aspx QC Form]

=== Track Recs ===
Some report templates contain specific codes embedded in fill-in fields that trigger entries in databases to ensure appropriate follow-up, but this is not apparent in the macro. The pertinent system macros are:
* "yellow dot" - triggers follow-up of an incidental finding that could be cancer. Encouraged to use the "FollowUp" icon at the top of powerscribe to input specific recs.
* "red dot" - same as "yellow dot" but in cases that are definitely cancer.
* "yellow dot not" - removes a yellow dot case from the track recs system.
* "red dot not" - removes a yellow dot case from the track recs system.
* "AAA" - just contains "AAA" at the very top of the report, which triggers follow-up. The macro also contains recommendations specific to Kaiser, but these are not necessary for the Track Recs system.
* "Lung Rads" - this macro is included at the end of the system LDCT Screening macro and contains necessary codes.

For reference, the embedded codes are put in fill-in fields like so:
[[File:Screenshot 2025-07-01 102848.png|none|thumb|Powerscribe Findings Codes]]

=== Picky System Templates and Reporting ===

Some providers have strong preferences about report format. Those reports include:
* DEXA
** The endocrinologists have strong opinions about the phrasing and ranges for diagnoses and go by the National Osteoporosis Foundation [Manual https://static1.squarespace.com/static/5d7aabc5368b54332c55df72/t/5dd2e2a92e1e1821e328308e/1574101724294/HCP+Toolkit-with+graphics.pdf] [Toolkit https://www.bonesource.org/healthcare-professionals-toolkit]
*** Don't say osteopenia, say low bone mass
*** Men, children, and women < 50 yo have an entirely separate diagnostic rubric

Calling severe coronary arterial calcific atherosclerosis triggers cardiology consultation (according to Chip Robertson, cardiology lead)

=== Overnight Prelims ===
* All over-reads go to the RTMC in-basket. So, unless a discrepancy is extremely time-sensitive, you probably don't need to call them about it. It'll be reviewed.
* If there is a major discrepancy and the ordering provider is not available, the RTMC line is the appropriate resource.

=== Incidental Follow-up ===
* See the Track Recs section above
* Incidental findings require follow-up are handled with "yellow dot" (possible cancer) and "red dot" (definite cancer).
* The yellow dot case autotext will flag the study so that administrators ensure the patient gets follow-up.
* The yellow dot can be removed on a subsequent exam with a different autotext.
* The red dot autotext will flag the finding as definitely cancer and (presumbably) trigger referrals.
* There is also a "blue flag" in Powerscribe that helps "yellow dot" cases.

=== Nuclear Medicine ===

* [https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices/SitePages/NM%20-%20Procedure%20Manual.aspx Procedure Manual]

=== Workflows ===
[[Coronary CTA]]

=== Logistics ===

* TIE Lines
** Sunnyside: 31-XXXX in house, 503-571-XXXX from outside
** Westside: 24-XXXX in house, 971-310-XXXX from outside
** Interstate: 16-XXXX in house, 503-331-XXXX from outside
** Salmon Creek: 69-XXXX in house, 360-571-XXXX from outside
** Longview-Kelso: 23-XXXX in house, 360-575-XXXX from outside

[https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices Imaging Services]

[https://sp-cloud.kp.org/sites/KPNWImagingServices/Lists/Facility%20Phone%20List/By%20Facility.aspx?viewid=f8eabea2%2D4bd6%2D4eaf%2Dbe48%2Dfac642b1ada2 Imaging Phone Directory]

See Outlook or Teams for additional contact information.
* PACS Support Line - For workstation, PACS software, or desk help
* File room - For questions about studies and worklists
* IT Tie Line - Overall KP IT

=== Policies and Practices ===
[[FAQ on FTE and Leave]]
* Tumor Boards
** Worklists are in the "Workqueue List" in Epic. There are many, and you'll have to search for them. Here are two examples:
*** Chest Conference: ID 71818, Name ONC CASE CONF CHEST/THORACIC
*** GI Tumor Board: ID 71810, Name ONC CASE CONF GI
** Compensated by removing studies from your worklist for the day. There's a precedent for 10 CTs for a tumor board. I asked for 6 PETs for a tumor board on my NM days.
*** Helwig clarified that the precedent/agreement is that hours of work should translate to Ws. So, if prep+conference takes 4 hours, that'd be 0.5 W worth of work off the list.
* Call Bonus
** After 60 CT+MRI studies on Reg Call shifts, additional studies can be claimed for SRs.

=== Supplemental Reads ===
Supplemental Reads (SRs) are a means of reimbursement for additional work at the following rates (using W as a unit of work). These rates are also useful for converting between types of work and adjusting worklists at rates that are generally acceptable to administration and the file room.
* Time: 4 hours = 1 W
* CT/MR/CT Chest/MR Body: 16 studies = 1 W
* US/US Thyroid: 40 studies = 1 W
* CR/DXA: 90 studies = 1 W
* PET: 8 studies = 1 W

=== Scheduling ===
[https://lblite.lightning-bolt.com/viewer/ Lightning Bolt]

Requests are closed for the next unassigned month as it is being built.
Radiologists should be available for 2 Fridays, 2 Saturdays, and 2 Sundays per month to facilitate scheduling.

Extra compensation:
* Log shift in Lightning Bolt with "Create Fill"
* Assignment: EXTRA COMP
* Custom Time: 4 hours for every W (make sure it doesn't overlap with a shift worked that day)
* Reason: 2 EXTRA CLINIC
* Location: Wherever it was worked (usually home)
* Notes
** If consulted regarding a specific patient, put MRN in
** If just an extra stack, put in "1W - SR READS"

Requests predominantly first come first serve except time around major holidays (Spring Break, Thanksgiving, Christmas)

Request Codes
* EDU ALL DAY - Educational Leave (2 weeks/year for 0.9 FTE)
* OUT OF OFFICE - Self Care
** Must include "Reason" field as 0 SELF CARE
* VAC PTO ALL DAY - PTO

Determining remaining PTO, EDU leave, and Self-Care days
* Workdays are 9 hours, so figuring the number of self-care days and educational leave remaining based on what's in the pay statement requires that conversion.
* Don't forget to look ahead in the schedule to determine how many have been requested but not accounted for on payroll.

== Facilities ==

=== Sunnyside (SMC) ===
* Physician parking is on the roof of the parking garage
* There are other physician parking areas (see the facility map)
* The physician lounge is near 3 South. Go up the F elevator or stairs and the door is nearby.

=== Westside (WMC) ===
* Physician parking is on the top floors of the garage (4 and up).

=== Interstate ===
* Physician parking is on the bottom floor of the garage.

KP Rotations

2026-01-12T16:22:43Z

Tyler:

Radiology Rotations 2025

== Diagnostic Radiology ==

*Call
**CT Techs can sometimes bolus exams to the call list, so it's helpful to also filter for Stat CTs assigned to no one
**For other modalities, just wait for techs to push exams to the Reg Call lists
***On weekdays:
****US read by US1 until 1:30
****XR read by US1 until 4pm
****MRI read by MRI1 until 4pm
****CT perfusion read by MRI1
**Techs should stop pushing studies to the call list 30 minutes before the end of the shift (7:00 on weekdays, 10:00 on weekends)

*Regional Call 1 On Site on weekends and holidays
**Traditionally defaults to SMC but can be requested otherwise. The site a radiologist is technically responsible for is in the title of the assignment in the schedule.
**Covers ER/Inpatient exams
**Overreads CT, US and CR overnight StatRad exams (all modalities on Sat and Sun)
***Mon-Thurs 1030-1930
***Fri 1330-2230
***Sat-Sun 1300-2200

*Regional Call 2 On site on weekends and holidays
**Traditionally defaults to WMC but can be requested otherwise. The site a radiologist is technically responsible for is in the title of the assignment in the schedule.
**Covers ER/Inpatient exams
**Overreads CT, US and CR overnight StatRad exams (and all modalities on Sat and Sun)
***Mon-Thurs 1000-1900
***Fri 1100-2000
***Sat-Sun 1100-2100

*Swing
**As a reminder, starting on 12/1/25, we are trialing a Regional Call Swing Shift (REG CALL SWG). This person, who is also assigned to a stack rotation, is going to be helping with the incoming call studies from 3p-6p. They will have a proportional reduction in their stacks that are assigned that morning.
**For example:
***CT or MRI stacks: <s>25 studies, no CR</s>
***US stacks: <s>56 studies, no CR</s>
***GR stacks: <s>130 CR</s>
** The reduction of the routine work was initially 2/3 of a stack but was subsequently reduced to 1/2 of a stack

*CT 1 Filters
**Transcribed (in "Other Lists" dropdown), Filter: Assigned to NSR
**Unread, Filter: Stat/Performed Today (just to see what's being scanned)
**Unread, Filter: Reg Call 1/Reg Call 2/CT1
**Only reading CT. XR, US, and MR generally go to those modality shifts. Once day rotations start to finish, studies will start to go to Reg Call1 and Reg Call2 rotations.
**"Macro Stat Rad" for preliminary reports
**RTMC line (on SharePoint imaging) is for outpatients with urgent findings

*CT 1 Remote (Mon-Thurs)
**Covers ER/Inpatient exams from 0700-1030
**Overreads CT, US and CR overnight StatRad exams

*CT 1 Remote (Fri)
**Covers ER/Inpatient exams from 0700-1100
**Overreads CT, US and CR overnight StatRad exams

*CT 1 Remote (Sat-Sun)
**Covers ER/Inpatient exams from 0700-1200
**Overreads overnight StatRad exams (all modalities)

*SMC RDS LH WH “Weekend Reads”
**Sat-Sun and Holidays 0730-1330
**Reads inpatient CR and may cover SMC fluoro procedures
**Target: 180 CR (subtract 10 CR for each fluoro procedure)

*CT 2-9 “Stacked Rotations”
**Target: 32 CT/MRI and 30 CR

*MRI 1 Stat MRI Coverage
**Overreads MRI overnight StatRad exams
**Target: 20 MRI and 20 CR or 25 MRI

*MRI 2-9 “Stacked Rotations”
**Target: 32 CT/MRI and 30 CR

*US 1
**Covers STAT CR from 0730-1600 (excluding 1130-1230)
**Covers STAT US from 0730-1330 (excluding 1130-1230)
**Target: 30 US (Urgent), 30 CR, 4 CT

*US 2, 3 Stacked Rotations
**Target: 70 US and 30 CR

*Gen Rad 1
**On-Site @ WMC covering Fluoro procedures and sonohyst
**Target: 60 CR (STAT), 6 CT, 10 US (Mon and Fri)
**Covers STAT CR and US from 1130-1230

*Gen Rad 2
**On-Site @ SMC covering fluoro procedures
**Target: 30 CR (STAT), 4 CT, 20 US

*Gen Rad 3
**On-Site @ INT covering fluoro procedures and sonohyst
**CT Protocols
**Target: 40 CR (STAT), 40 US, 6 CT

*Gen Rad 4, 5 Stacked Rotations
**Target: 200 CR

*SKY 2 Stacked Rotation
**Target: 32 CT/MRI and 30 CR

*CEC
**On-Site @ CEC covering contrast injections

*NM 1 & 2
**On-Site if therapy needed
**Target: 12 PET-CT, 20 DEXA, 10 Gen Nucs (per Mirarchi, NM1 reads gen nucs from Sunnyside and NM2 reads gen nucs from Westside)
**From Mirarchi: If there are 2 of us on NM, we're supposed to read 12 PETs each. I think Maureen usually just reads the PETs assigned to her on NM 1 or 2. But, I often read studies not assigned to my list and then leave some that are. For example, there are currently 2 Urgent PETs on the list that aren't assigned so they won't be read until tomorrow. I'll probably preferentially pick those off then leave 2 of the "routine" studies currently assigned to NM 1. Or else sometimes a clinician will call asking for stat results because they're seeing the patient in clinic that day and want the results quickly, so I'll preferentially read that study. As long as you get 12 done no one cares which 12. If you prefer to just read the ones assigned to the rotation that's totally fine - however you want to handle the case load is fine.
** If there is only one rad assigned to NM for the day, read from both NM 1 and NM 2 lists. No DEXAs will be assigned.
** Once you're on the RAM license then Marcia will start scheduling you for therapies. She periodically e-mails a list of the scheduled therapies with the ones you're scheduled to consent in person at the top of the list. That will make more sense when you get the first e-mail. You'll have to pencil those into your personal schedule - they don't show up on the Lightning Bolt schedule.
** If you have a strong preference for which site you do therapies, you should make sure that's known. I've had them reschedule patients to travel to my site, and I haven't had problems or complaints about that so far.
** For NM post-processing, Philips Intellispace Portalnd and Terarecon (aka AquariusNET) are currently available (January 2026).

*Mammography Rotations:
**SKY 1
***On Site @ SKY covering Dx/Locs/Bx
***Target: 30 MG

**SMC Mamm 1Bx
***On Site @ SMC covering Dx/Bx
***Target: 40 MG -or- 35 MG + 1-2 MRI

**SMC Mamm 1
***On Site @ SMC covering Dx AM only
***Target: 20 MG -or- 15 MG + 1-2 MRI

**SMC Mamm 2
***On Site @ SMC covering Dx/Locs/OSF
***Target: 30 MG -or- 25 MG + 1-2 MRI

**INT Mamm 3Bx
***On Site @ INT covering Bx
***Target: 75 MG + 1-2 MRI

**INT Mamm 4
***On Site @ INT covering Dx
***Target: 40 MG -or- 35 MG + 1-2 MRI

**WMC Mamm 5Bx
***On Site @ WMC covering Dx/Locs/Bx
***Target: 40 MG -or- 35 MG + 1-2 MRI

**WMC Mamm 5
***On Site @ WMC covering Dx/Locs
***Target: 40 MG -or- 35 MG + 1-2 MRI

**Sal Mamm 6
***On Site @ Sal Cr covering Dx
***Target: 40 MG -or- 35 MG + 1-2 MRI

**LVK Clinic
***On Site @ LVK covering Dx/Bx
***Target: 25 tomo + 1-2 MRI

**ECG
***On Site @ Eugene covering Dx
***Target: 35 MG

Interventional Radiology
IR 1, 2
On Site @ SMC, CVL
IR 3
On Site @ SMC, US and CT guided procedures
IR 4
On Site @ WMC, US and CT guided procedures
IR 5
On Site @ WMC, CVL
IR 6
Clinic

IR Film Targets:
IR 2, 3, 5
Target: 45 CR
IR 4
Target: 4 CT and 45 CR
IR 6
Target: 70 CR

Kaiser

2026-01-02T16:02:10Z

Tyler:

=== Internal Links ===
* [https://sp-cloud.kp.org/sites/NWPAccounting2 Reimbursement]
* [https://nwpkp.sumtotal.host/Broker/Account/Login.aspx? Training]
* [https://n23.ultipro.com/Login.aspx?ReturnUrl=%2fdefault.aspx HR]
* [https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices Imaging Sharepoint]
** [https://sp-cloud.kp.org/sites/KPNWImagingServices/Lists/Facility%20Phone%20List/By%20Facility.aspx?viewid=f8eabea2%2D4bd6%2D4eaf%2Dbe48%2Dfac642b1ada2 Imaging Phone List]

=== Rotations ===
* [[KP Rotations]]
* [[Weekend Reads Update 5/29/25]]

=== Institutional Guidelines ===
* [[Iliac Artery Aneurysms]]
* [[US Update 6/2025]]

=== PACS ===
* Command line application `swe` can completely kill the application if it freezes.

=== Up To Date ===
* Login via Epic to accrue CME

=== Kaiser Radiology ===
* [[KP Rotations]]
* [https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices Imaging Sharepoint]
* [https://sp-cloud.kp.org/sites/NWImaging/SitePages/Radiologist-QC-Entry-Form.aspx QC Form]

=== Track Recs ===
Some report templates contain specific codes embedded in fill-in fields that trigger entries in databases to ensure appropriate follow-up, but this is not apparent in the macro. The pertinent system macros are:
* "yellow dot" - triggers follow-up of an incidental finding that could be cancer. Encouraged to use the "FollowUp" icon at the top of powerscribe to input specific recs.
* "red dot" - same as "yellow dot" but in cases that are definitely cancer.
* "yellow dot not" - removes a yellow dot case from the track recs system.
* "red dot not" - removes a yellow dot case from the track recs system.
* "AAA" - just contains "AAA" at the very top of the report, which triggers follow-up. The macro also contains recommendations specific to Kaiser, but these are not necessary for the Track Recs system.
* "Lung Rads" - this macro is included at the end of the system LDCT Screening macro and contains necessary codes.

For reference, the embedded codes are put in fill-in fields like so:
[[File:Screenshot 2025-07-01 102848.png|none|thumb|Powerscribe Findings Codes]]

=== Picky System Templates and Reporting ===

Some providers have strong preferences about report format. Those reports include:
* DEXA

Calling severe coronary arterial calcific atherosclerosis triggers cardiology consultation (according to Chip Robertson, cardiology lead)

=== Overnight Prelims ===
* All over-reads go to the RTMC in-basket. So, unless a discrepancy is extremely time-sensitive, you probably don't need to call them about it. It'll be reviewed.
* If there is a major discrepancy and the ordering provider is not available, the RTMC line is the appropriate resource.

=== Incidental Follow-up ===
* See the Track Recs section above
* Incidental findings require follow-up are handled with "yellow dot" (possible cancer) and "red dot" (definite cancer).
* The yellow dot case autotext will flag the study so that administrators ensure the patient gets follow-up.
* The yellow dot can be removed on a subsequent exam with a different autotext.
* The red dot autotext will flag the finding as definitely cancer and (presumbably) trigger referrals.
* There is also a "blue flag" in Powerscribe that helps "yellow dot" cases.

=== Nuclear Medicine ===

* [https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices/SitePages/NM%20-%20Procedure%20Manual.aspx Procedure Manual]

=== Workflows ===
[[Coronary CTA]]

=== Logistics ===

* TIE Lines
** Sunnyside: 31-XXXX in house, 503-571-XXXX from outside
** Westside: 24-XXXX in house, 971-310-XXXX from outside
** Interstate: 16-XXXX in house, 503-331-XXXX from outside
** Salmon Creek: 69-XXXX in house, 360-571-XXXX from outside
** Longview-Kelso: 23-XXXX in house, 360-575-XXXX from outside

[https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices Imaging Services]

[https://sp-cloud.kp.org/sites/KPNWImagingServices/Lists/Facility%20Phone%20List/By%20Facility.aspx?viewid=f8eabea2%2D4bd6%2D4eaf%2Dbe48%2Dfac642b1ada2 Imaging Phone Directory]

See Outlook or Teams for additional contact information.
* PACS Support Line - For workstation, PACS software, or desk help
* File room - For questions about studies and worklists
* IT Tie Line - Overall KP IT

=== Policies and Practices ===
[[FAQ on FTE and Leave]]
* Tumor Boards
** Worklists are in the "Workqueue List" in Epic. There are many, and you'll have to search for them. Here are two examples:
*** Chest Conference: ID 71818, Name ONC CASE CONF CHEST/THORACIC
*** GI Tumor Board: ID 71810, Name ONC CASE CONF GI
** Compensated by removing studies from your worklist for the day. There's a precedent for 10 CTs for a tumor board. I asked for 6 PETs for a tumor board on my NM days.
*** Helwig clarified that the precedent/agreement is that hours of work should translate to Ws. So, if prep+conference takes 4 hours, that'd be 0.5 W worth of work off the list.
* Call Bonus
** After 60 CT+MRI studies on Reg Call shifts, additional studies can be claimed for SRs.

=== Supplemental Reads ===
Supplemental Reads (SRs) are a means of reimbursement for additional work at the following rates (using W as a unit of work). These rates are also useful for converting between types of work and adjusting worklists at rates that are generally acceptable to administration and the file room.
* Time: 4 hours = 1 W
* CT/MR/CT Chest/MR Body: 16 studies = 1 W
* US/US Thyroid: 40 studies = 1 W
* CR/DXA: 90 studies = 1 W
* PET: 8 studies = 1 W

=== Scheduling ===
[https://lblite.lightning-bolt.com/viewer/ Lightning Bolt]

Requests are closed for the next unassigned month as it is being built.
Radiologists should be available for 2 Fridays, 2 Saturdays, and 2 Sundays per month to facilitate scheduling.

Extra compensation:
* Log shift in Lightning Bolt with "Create Fill"
* Assignment: EXTRA COMP
* Custom Time: 4 hours for every W (make sure it doesn't overlap with a shift worked that day)
* Reason: 2 EXTRA CLINIC
* Location: Wherever it was worked (usually home)
* Notes
** If consulted regarding a specific patient, put MRN in
** If just an extra stack, put in "1W - SR READS"

Requests predominantly first come first serve except time around major holidays (Spring Break, Thanksgiving, Christmas)

Request Codes
* EDU ALL DAY - Educational Leave (2 weeks/year for 0.9 FTE)
* OUT OF OFFICE - Self Care
** Must include "Reason" field as 0 SELF CARE
* VAC PTO ALL DAY - PTO

Determining remaining PTO, EDU leave, and Self-Care days
* Workdays are 9 hours, so figuring the number of self-care days and educational leave remaining based on what's in the pay statement requires that conversion.
* Don't forget to look ahead in the schedule to determine how many have been requested but not accounted for on payroll.

== Facilities ==

=== Sunnyside (SMC) ===
* Physician parking is on the roof of the parking garage
* There are other physician parking areas (see the facility map)
* The physician lounge is near 3 South. Go up the F elevator or stairs and the door is nearby.

=== Westside (WMC) ===
* Physician parking is on the top floors of the garage (4 and up).

=== Interstate ===
* Physician parking is on the bottom floor of the garage.

Kaiser

2026-01-02T16:00:44Z

Tyler:

=== Internal Links ===
* [https://sp-cloud.kp.org/sites/NWPAccounting2 Reimbursement]
* [https://nwpkp.sumtotal.host/Broker/Account/Login.aspx? Training]
* [https://n23.ultipro.com/Login.aspx?ReturnUrl=%2fdefault.aspx HR]
* [https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices Imaging Sharepoint]
** [https://sp-cloud.kp.org/sites/KPNWImagingServices/Lists/Facility%20Phone%20List/By%20Facility.aspx?viewid=f8eabea2%2D4bd6%2D4eaf%2Dbe48%2Dfac642b1ada2 Imaging Phone List]

=== Rotations ===
* [[KP Rotations]]
* [[Weekend Reads Update 5/29/25]]

=== Institutional Guidelines ===
* [[Iliac Artery Aneurysms]]
* [[US Update 6/2025]]

=== PACS ===
* Command line application `swe` can completely kill the application if it freezes.

=== Up To Date ===
* Login via Epic to accrue CME

=== Kaiser Radiology ===
* [[KP Rotations]]
* [https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices Imaging Sharepoint]
* [https://sp-cloud.kp.org/sites/NWImaging/SitePages/Radiologist-QC-Entry-Form.aspx QC Form]

=== Track Recs ===
Some report templates contain specific codes embedded in fill-in fields that trigger entries in databases to ensure appropriate follow-up, but this is not apparent in the macro. The pertinent system macros are:
* "yellow dot" - triggers follow-up of an incidental finding that could be cancer. Encouraged to use the "FollowUp" icon at the top of powerscribe to input specific recs.
* "red dot" - same as "yellow dot" but in cases that are definitely cancer.
* "yellow dot not" - removes a yellow dot case from the track recs system.
* "red dot not" - removes a yellow dot case from the track recs system.
* "AAA" - just contains "AAA" at the very top of the report, which triggers follow-up. The macro also contains recommendations specific to Kaiser, but these are not necessary for the Track Recs system.
* "Lung Rads" - this macro is included at the end of the system LDCT Screening macro and contains necessary codes.

For reference, the embedded codes are put in fill-in fields like so:
[[File:Screenshot 2025-07-01 102848.png|none|thumb|Powerscribe Findings Codes]]

=== Picky System Templates and Reporting ===

Some providers have strong preferences about report format. Those reports include:
* DEXA

Calling severe coronary arterial calcific atherosclerosis triggers cardiology consultation (according to Chip Robertson, cardiology lead)

=== Overnight Prelims ===
* All over-reads go to the RTMC in-basket. So, unless a discrepancy is extremely time-sensitive, you probably don't need to call them about it. It'll be reviewed.
* If there is a major discrepancy and the ordering provider is not available, the RTMC line is the appropriate resource.

=== Incidental Follow-up ===
* See the Track Recs section above
* Incidental findings require follow-up are handled with "yellow dot" (possible cancer) and "red dot" (definite cancer).
* The yellow dot case autotext will flag the study so that administrators ensure the patient gets follow-up.
* The yellow dot can be removed on a subsequent exam with a different autotext.
* The red dot autotext will flag the finding as definitely cancer and (presumbably) trigger referrals.
* There is also a "blue flag" in Powerscribe that helps "yellow dot" cases.

=== Nuclear Medicine ===

* [https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices/SitePages/NM%20-%20Procedure%20Manual.aspx Procedure Manual]

=== Workflows ===
[[Coronary CTA]]

=== Logistics ===

* TIE Lines
** Sunnyside: 31-XXXX in house, 503-571-XXXX from outside
** Westside: 24-XXXX in house, 971-310-XXXX from outside
** Interstate: 16-XXXX in house, 503-331-XXXX from outside
** Salmon Creek: 69-XXXX in house, 360-571-XXXX from outside
** Longview-Kelso: 23-XXXX in house, 360-575-XXXX from outside

[https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices Imaging Services]

[https://sp-cloud.kp.org/sites/KPNWImagingServices/Lists/Facility%20Phone%20List/By%20Facility.aspx?viewid=f8eabea2%2D4bd6%2D4eaf%2Dbe48%2Dfac642b1ada2 Imaging Phone Directory]

See Outlook or Teams for additional contact information.
* PACS Support Line - For workstation, PACS software, or desk help
* File room - For questions about studies and worklists
* IT Tie Line - Overall KP IT

=== Policies and Practices ===
[[FAQ on FTE and Leave]]
* Tumor Boards
** Worklists are in the "Workqueue List" in Epic. There are many, and you'll have to search for them. Here are two examples:
*** Chest Conference: ID 71818, Name ONC CASE CONF CHEST/THORACIC
*** GI Tumor Board: ID 71810, Name ONC CASE CONF GI
** Compensated by removing studies from your worklist for the day. There's a precedent for 10 CTs for a tumor board. I asked for 6 PETs for a tumor board on my NM days.
*** Helwig clarified that the precedent/agreement is that hours of work should translate to Ws. So, if prep+conference takes 4 hours, that'd be 0.5 W worth of work off the list.
* Call Bonus
** After 60 CT+MRI studies on Reg Call shifts, additional studies can be claimed for SRs.
* Supplemental Reads (SRs) are a means of reimbursement for additional work at the following rates (using W as a unit of work)
** Time: 4 hours = 1 W
** CT/MR/CT Chest/MR Body: 16 studies = 1 W
** US/US Thyroid: 40 studies = 1 W
** CR/DXA: 90 studies = 1 W
** PET: 8 studies = 1 W

=== Scheduling ===
[https://lblite.lightning-bolt.com/viewer/ Lightning Bolt]

Requests are closed for the next unassigned month as it is being built.
Radiologists should be available for 2 Fridays, 2 Saturdays, and 2 Sundays per month to facilitate scheduling.

Extra compensation:
* Log shift in Lightning Bolt with "Create Fill"
* Assignment: EXTRA COMP
* Custom Time: 4 hours for every W (make sure it doesn't overlap with a shift worked that day)
* Reason: 2 EXTRA CLINIC
* Location: Wherever it was worked (usually home)
* Notes
** If consulted regarding a specific patient, put MRN in
** If just an extra stack, put in "1W - SR READS"

Requests predominantly first come first serve except time around major holidays (Spring Break, Thanksgiving, Christmas)

Request Codes
* EDU ALL DAY - Educational Leave (2 weeks/year for 0.9 FTE)
* OUT OF OFFICE - Self Care
** Must include "Reason" field as 0 SELF CARE
* VAC PTO ALL DAY - PTO

Determining remaining PTO, EDU leave, and Self-Care days
* Workdays are 9 hours, so figuring the number of self-care days and educational leave remaining based on what's in the pay statement requires that conversion.
* Don't forget to look ahead in the schedule to determine how many have been requested but not accounted for on payroll.

== Facilities ==

=== Sunnyside (SMC) ===
* Physician parking is on the roof of the parking garage
* There are other physician parking areas (see the facility map)
* The physician lounge is near 3 South. Go up the F elevator or stairs and the door is nearby.

=== Westside (WMC) ===
* Physician parking is on the top floors of the garage (4 and up).

=== Interstate ===
* Physician parking is on the bottom floor of the garage.

KP Rotations

2025-12-19T00:57:10Z

Tyler:

Radiology Rotations 2025

== Diagnostic Radiology ==

*Call
**CT Techs can sometimes bolus exams to the call list, so it's helpful to also filter for Stat CTs assigned to no one
**For other modalities, just wait for techs to push exams to the Reg Call lists
***On weekdays:
****US read by US1 until 1:30
****XR read by US1 until 4pm
****MRI read by MRI1 until 4pm
****CT perfusion read by MRI1
**Techs should stop pushing studies to the call list 30 minutes before the end of the shift (7:00 on weekdays, 10:00 on weekends)

*Regional Call 1 On Site on weekends and holidays
**Traditionally defaults to SMC but can be requested otherwise. The site a radiologist is technically responsible for is in the title of the assignment in the schedule.
**Covers ER/Inpatient exams
**Overreads CT, US and CR overnight StatRad exams (all modalities on Sat and Sun)
***Mon-Thurs 1030-1930
***Fri 1330-2230
***Sat-Sun 1300-2200

*Regional Call 2 On site on weekends and holidays
**Traditionally defaults to WMC but can be requested otherwise. The site a radiologist is technically responsible for is in the title of the assignment in the schedule.
**Covers ER/Inpatient exams
**Overreads CT, US and CR overnight StatRad exams (and all modalities on Sat and Sun)
***Mon-Thurs 1000-1900
***Fri 1100-2000
***Sat-Sun 1100-2100

*Swing
**As a reminder, starting on 12/1/25, we are trialing a Regional Call Swing Shift (REG CALL SWG). This person, who is also assigned to a stack rotation, is going to be helping with the incoming call studies from 3p-6p. They will have a proportional reduction in their stacks that are assigned that morning.
**For example:
***CT or MRI stacks: <s>25 studies, no CR</s>
***US stacks: <s>56 studies, no CR</s>
***GR stacks: <s>130 CR</s>
** The reduction of the routine work was initially 2/3 of a stack but was subsequently reduced to 1/2 of a stack

*CT 1 Filters
**Transcribed (in "Other Lists" dropdown), Filter: Assigned to NSR
**Unread, Filter: Stat/Performed Today (just to see what's being scanned)
**Unread, Filter: Reg Call 1/Reg Call 2/CT1
**Only reading CT. XR, US, and MR generally go to those modality shifts. Once day rotations start to finish, studies will start to go to Reg Call1 and Reg Call2 rotations.
**"Macro Stat Rad" for preliminary reports
**RTMC line (on SharePoint imaging) is for outpatients with urgent findings

*CT 1 Remote (Mon-Thurs)
**Covers ER/Inpatient exams from 0700-1030
**Overreads CT, US and CR overnight StatRad exams

*CT 1 Remote (Fri)
**Covers ER/Inpatient exams from 0700-1100
**Overreads CT, US and CR overnight StatRad exams

*CT 1 Remote (Sat-Sun)
**Covers ER/Inpatient exams from 0700-1200
**Overreads overnight StatRad exams (all modalities)

*SMC RDS LH WH “Weekend Reads”
**Sat-Sun and Holidays 0730-1330
**Reads inpatient CR and may cover SMC fluoro procedures
**Target: 180 CR (subtract 10 CR for each fluoro procedure)

*CT 2-9 “Stacked Rotations”
**Target: 32 CT/MRI and 30 CR

*MRI 1 Stat MRI Coverage
**Overreads MRI overnight StatRad exams
**Target: 20 MRI and 20 CR or 25 MRI

*MRI 2-9 “Stacked Rotations”
**Target: 32 CT/MRI and 30 CR

*US 1
**Covers STAT CR from 0730-1600 (excluding 1130-1230)
**Covers STAT US from 0730-1330 (excluding 1130-1230)
**Target: 30 US (Urgent), 30 CR, 4 CT

*US 2, 3 Stacked Rotations
**Target: 70 US and 30 CR

*Gen Rad 1
**On-Site @ WMC covering Fluoro procedures and sonohyst
**Target: 60 CR (STAT), 6 CT, 10 US (Mon and Fri)
**Covers STAT CR and US from 1130-1230

*Gen Rad 2
**On-Site @ SMC covering fluoro procedures
**Target: 30 CR (STAT), 4 CT, 20 US

*Gen Rad 3
**On-Site @ INT covering fluoro procedures and sonohyst
**CT Protocols
**Target: 40 CR (STAT), 40 US, 6 CT

*Gen Rad 4, 5 Stacked Rotations
**Target: 200 CR

*SKY 2 Stacked Rotation
**Target: 32 CT/MRI and 30 CR

*CEC
**On-Site @ CEC covering contrast injections

*NM 1 & 2
**On-Site if therapy needed
**Target: 12 PET-CT, 20 DEXA, 10 Gen Nucs (per Mirarchi, NM1 reads gen nucs from Sunnyside and NM2 reads gen nucs from Westside)
**From Mirarchi: If there are 2 of us on NM, we're supposed to read 12 PETs each. I think Maureen usually just reads the PETs assigned to her on NM 1 or 2. But, I often read studies not assigned to my list and then leave some that are. For example, there are currently 2 Urgent PETs on the list that aren't assigned so they won't be read until tomorrow. I'll probably preferentially pick those off then leave 2 of the "routine" studies currently assigned to NM 1. Or else sometimes a clinician will call asking for stat results because they're seeing the patient in clinic that day and want the results quickly, so I'll preferentially read that study. As long as you get 12 done no one cares which 12. If you prefer to just read the ones assigned to the rotation that's totally fine - however you want to handle the case load is fine.
** If there is only one rad assigned to NM for the day, read from both NM 1 and NM 2 lists. No DEXAs will be assigned.

*Mammography Rotations:
**SKY 1
***On Site @ SKY covering Dx/Locs/Bx
***Target: 30 MG

**SMC Mamm 1Bx
***On Site @ SMC covering Dx/Bx
***Target: 40 MG -or- 35 MG + 1-2 MRI

**SMC Mamm 1
***On Site @ SMC covering Dx AM only
***Target: 20 MG -or- 15 MG + 1-2 MRI

**SMC Mamm 2
***On Site @ SMC covering Dx/Locs/OSF
***Target: 30 MG -or- 25 MG + 1-2 MRI

**INT Mamm 3Bx
***On Site @ INT covering Bx
***Target: 75 MG + 1-2 MRI

**INT Mamm 4
***On Site @ INT covering Dx
***Target: 40 MG -or- 35 MG + 1-2 MRI

**WMC Mamm 5Bx
***On Site @ WMC covering Dx/Locs/Bx
***Target: 40 MG -or- 35 MG + 1-2 MRI

**WMC Mamm 5
***On Site @ WMC covering Dx/Locs
***Target: 40 MG -or- 35 MG + 1-2 MRI

**Sal Mamm 6
***On Site @ Sal Cr covering Dx
***Target: 40 MG -or- 35 MG + 1-2 MRI

**LVK Clinic
***On Site @ LVK covering Dx/Bx
***Target: 25 tomo + 1-2 MRI

**ECG
***On Site @ Eugene covering Dx
***Target: 35 MG

Interventional Radiology
IR 1, 2
On Site @ SMC, CVL
IR 3
On Site @ SMC, US and CT guided procedures
IR 4
On Site @ WMC, US and CT guided procedures
IR 5
On Site @ WMC, CVL
IR 6
Clinic

IR Film Targets:
IR 2, 3, 5
Target: 45 CR
IR 4
Target: 4 CT and 45 CR
IR 6
Target: 70 CR

Aortic Aneurysm Context

2025-12-15T16:46:25Z

Tyler: Created page with "I usually provide adjusted 95th percentiles when I provide an ascending aortic measurement to convey context. The threshold for calling the aorta aneurysmal elsewhere is very different, so it helps to appropriately provide reassurance for patients with ascending aortas > 3 cm but less than their adjusted 95th percentile. For patients with an ascending aortic diameter greater than the adjusted 95th percentile, I typically try to get a measurement from a prior to assess fo..."

I usually provide adjusted 95th percentiles when I provide an ascending aortic measurement to convey context. The threshold for calling the aorta aneurysmal elsewhere is very different, so it helps to appropriately provide reassurance for patients with ascending aortas > 3 cm but less than their adjusted 95th percentile. For patients with an ascending aortic diameter greater than the adjusted 95th percentile, I typically try to get a measurement from a prior to assess for rapid growth.

Kaiser has a straightforward monitoring system for AAAs, but ascending thoracic aneurysm management is complicated, and there just aren't any simple societal recommendations about this. AHA's recommendations on the topic are comprehensive but hardly simple.
https://www.ahajournals.org/doi/10.1161/CIR.0000000000001106

Threshold for prophylactic repair varies but is generally 5.0-5.5 cm or a growth rate of 3 mm/yr (over 1-3 years). There are different recommendations for patients with hereditary aortopathies as well as other connective tissue diseases and syndromes, and these generally decrease the threshold to 4.5 cm. For surveillance of patients who haven't reached the surgical threshold, the most specific recommendation from AHA is still quite vague:

"Patients with stable aortic dimensions can be observed longitudinally with TTE, CT, or MRI. The frequency of surveillance imaging should be individualized and informed by the aneurysm cause, aortic diameter, historical rate of aortic growth, how close the diameter is to the surgical threshold, and the patient's age.8,9 In general, in patients with nongenetic and syndromic causes, the rate of aortic growth is relatively slow, so the interval for surveillance imaging may be increased."

So, I typically don't try to put a specific recommendation into my reports since shared decision-making is best. The most aggressive surveillance would be some kind of surveillance (echo, CT, or MRI) every one or two years. If a patient said they weren't interested in surveillance, that would be reasonable as well.

Workday Links

2025-12-15T16:34:24Z

Tyler:

=== '''[[Contrast Reactions]]''' ===
=== '''[[Contrast Reactions (Children)]]''' ===

=== [https://radiopaedia.org/sessions/new Radiopaedia] ===

=== [[Kaiser]] ===

=== Radiology Tools ===
* [https://radcalc.overdesigned.org RadCalc]
* [https://radiology-universe.org/calculator/ Radiology Universe]
* [https://www.mesa-nhlbi.org/Calcium/input.aspx MESA Calcium Score %]
* [http://radiologyreviewarticles.com/radiology-calculators/spleen-volume-calculator/ Splenic Volume]

=== RADS ===
* [https://nextcloud.overdesigned.org/s/sNDQw4PgseooowP BIRADS Lexicon]
* [https://edge.sitecorecloud.io/americancoldf5f-acrorgf92a-productioncb02-3650/media/ACR/Files/RADS/Lung-RADS/Lung-RADS-2022.pdf LungRADS]
* [https://tiradscalculator.com/wp-content/uploads/2017/05/TIRADS-2017-Flow-Chart.jpg TIRADS]
* [https://edge.sitecorecloud.io/americancoldf5f-acrorgf92a-productioncb02-3650/media/ACR/Files/RADS/LI-RADS/LI-RADS-US-Surveillance-v2024-Core.pdf LI-RADS (US)]
* [https://edge.sitecorecloud.io/americancoldf5f-acrorgf92a-productioncb02-3650/media/ACR/Files/RADS/LI-RADS/LI-RADS-CT-MRI-2018-Core.pdf LI-RADS (CT/MR)]

=== Anatomy ===
* Prostate
** [https://radiologyassistant.nl/assets/tek-sector.jpg Illustration]
** [https://radiologyassistant.nl/assets/prostate-cancer-pi-rads-v2/a5b77f28c41897_Scroll.008.jpeg Peripheral Zone]
** [https://radiologyassistant.nl/assets/prostate-cancer-pi-rads-v2/a5b77f28c43fc1_Scroll.011.jpeg Transition Zone]
** [https://radiologyassistant.nl/assets/prostate-cancer-pi-rads-v2/a5b77f28c4246a_Scroll.009.jpeg Capsule]

=== Normal Measurements ===
* [https://www.ohsu.edu/school-of-medicine/diagnostic-radiology/pediatric-radiology-normal-measurements Pediatrics]

=== Incidental Findings ===
* [https://publish.smartsheet.com/42d18e874a164318a0f702481f2fbb70 All ACR papers]
* [https://nextcloud.overdesigned.org/s/XzZFeGADrstoY6w Pancreatic Cysts]
* [https://pubs.rsna.org/na101/home/literatum/publisher/rsna/journals/content/radiology/2017/radiol.2017.284.issue-1/radiol.2017161659/20170608/images/large/radiol.2017161659.tbl1.jpeg Fleischner Society]
* [https://els-jbs-prod-cdn.jbs.elsevierhealth.com/cms/attachment/264251b7-b546-480e-9a13-fb3bdafeded3/gr1.jpg Adrenal Nodule]
* [https://www.jacr.org/article/S1546-1440(17)30497-0/fulltext Renal Mass]
* [https://www.ahajournals.org/doi/10.1161/CIR.0000000000001106 Aortic Aneurysms]
** [[Aortic Aneurysm Context]]

=== Nucs ===
* [https://docs.google.com/document/d/1XGK-kmIll02jbF1q4PGzd6ZCFtLe-0b3/edit?usp=sharing&ouid=107887909640214305589&rtpof=true&sd=true I-131 Checklist]
* Doses must be within 20% of the prescribed dose or it's a sentinel event ([https://www.nrc.gov/reading-rm/doc-collections/cfr/part035/part035-3045.html See NRC rule here]).
* [[Florbetapir]]

=== Uncategorized ===
* [https://www.acr.org/Clinical-Resources/Contrast-Manual ACR Contrast Manual]
* [https://docs.google.com/document/d/1Duz1sinAk3v5gfoIRtWa9o9U1GhbzRxkRI_vUvE18Co/edit Guidelines for nonviable pregnancy diagnosis]
* ADPKD Volume Calculation
** [[Media:ADPKD_Volume_Measurements.png|Measurement Technique]]
** [https://www.mayo.edu/research/documents/pkd-center-adpkd-classification/doc-20094754 Calculator]

KP Rotations

2025-12-01T16:12:00Z

Tyler:

Radiology Rotations 2025

== Diagnostic Radiology ==

*Call
**CT Techs can sometimes bolus exams to the call list, so it's helpful to also filter for Stat CTs assigned to no one
**For other modalities, just wait for techs to push exams to the Reg Call lists
***On weekdays:
****US read by US1 until 1:30
****XR read by US1 until 4pm
****MRI read by MRI1 until 4pm
****CT perfusion read by MRI1
**Techs should stop pushing studies to the call list 30 minutes before the end of the shift (7:00 on weekdays, 10:00 on weekends)

*Regional Call 1 On Site on weekends and holidays
**Traditionally defaults to SMC but can be requested otherwise. The site a radiologist is technically responsible for is in the title of the assignment in the schedule.
**Covers ER/Inpatient exams
**Overreads CT, US and CR overnight StatRad exams (all modalities on Sat and Sun)
***Mon-Thurs 1030-1930
***Fri 1330-2230
***Sat-Sun 1300-2200

*Regional Call 2 On site on weekends and holidays
**Traditionally defaults to WMC but can be requested otherwise. The site a radiologist is technically responsible for is in the title of the assignment in the schedule.
**Covers ER/Inpatient exams
**Overreads CT, US and CR overnight StatRad exams (and all modalities on Sat and Sun)
***Mon-Thurs 1000-1900
***Fri 1100-2000
***Sat-Sun 1100-2100

*Swing
**As a reminder, starting on 12/1/25, we are trialing a Regional Call Swing Shift (REG CALL SWG). This person, who is also assigned to a stack rotation, is going to be helping with the incoming call studies from 3p-6p. They will have a proportional reduction in their stacks that are assigned that morning.
**For example:
***CT or MRI stacks: 25 studies, no CR
***US stacks: 56 studies, no CR
***GR stacks: 130 CR

*CT 1 Filters
**Transcribed (in "Other Lists" dropdown), Filter: Assigned to NSR
**Unread, Filter: Stat/Performed Today (just to see what's being scanned)
**Unread, Filter: Reg Call 1/Reg Call 2/CT1
**Only reading CT. XR, US, and MR generally go to those modality shifts. Once day rotations start to finish, studies will start to go to Reg Call1 and Reg Call2 rotations.
**"Macro Stat Rad" for preliminary reports
**RTMC line (on SharePoint imaging) is for outpatients with urgent findings

*CT 1 Remote (Mon-Thurs)
**Covers ER/Inpatient exams from 0700-1030
**Overreads CT, US and CR overnight StatRad exams

*CT 1 Remote (Fri)
**Covers ER/Inpatient exams from 0700-1100
**Overreads CT, US and CR overnight StatRad exams

*CT 1 Remote (Sat-Sun)
**Covers ER/Inpatient exams from 0700-1200
**Overreads overnight StatRad exams (all modalities)

*SMC RDS LH WH “Weekend Reads”
**Sat-Sun and Holidays 0730-1330
**Reads inpatient CR and may cover SMC fluoro procedures
**Target: 180 CR (subtract 10 CR for each fluoro procedure)

*CT 2-9 “Stacked Rotations”
**Target: 32 CT/MRI and 30 CR

*MRI 1 Stat MRI Coverage
**Overreads MRI overnight StatRad exams
**Target: 20 MRI and 20 CR or 25 MRI

*MRI 2-9 “Stacked Rotations”
**Target: 32 CT/MRI and 30 CR

*US 1
**Covers STAT CR from 0730-1600 (excluding 1130-1230)
**Covers STAT US from 0730-1330 (excluding 1130-1230)
**Target: 30 US (Urgent), 30 CR, 4 CT

*US 2, 3 Stacked Rotations
**Target: 70 US and 30 CR

*Gen Rad 1
**On-Site @ WMC covering Fluoro procedures and sonohyst
**Target: 60 CR (STAT), 6 CT, 10 US (Mon and Fri)
**Covers STAT CR and US from 1130-1230

*Gen Rad 2
**On-Site @ SMC covering fluoro procedures
**Target: 30 CR (STAT), 4 CT, 20 US

*Gen Rad 3
**On-Site @ INT covering fluoro procedures and sonohyst
**CT Protocols
**Target: 40 CR (STAT), 40 US, 6 CT

*Gen Rad 4, 5 Stacked Rotations
**Target: 200 CR

*SKY 2 Stacked Rotation
**Target: 32 CT/MRI and 30 CR

*CEC
**On-Site @ CEC covering contrast injections

*NM 1 & 2
**On-Site if therapy needed
**Target: 12 PET-CT, 20 DEXA, 10 Gen Nucs (per Mirarchi, NM1 reads gen nucs from Sunnyside and NM2 reads gen nucs from Westside)
**From Mirarchi: If there are 2 of us on NM, we're supposed to read 12 PETs each. I think Maureen usually just reads the PETs assigned to her on NM 1 or 2. But, I often read studies not assigned to my list and then leave some that are. For example, there are currently 2 Urgent PETs on the list that aren't assigned so they won't be read until tomorrow. I'll probably preferentially pick those off then leave 2 of the "routine" studies currently assigned to NM 1. Or else sometimes a clinician will call asking for stat results because they're seeing the patient in clinic that day and want the results quickly, so I'll preferentially read that study. As long as you get 12 done no one cares which 12. If you prefer to just read the ones assigned to the rotation that's totally fine - however you want to handle the case load is fine.
** If there is only one rad assigned to NM for the day, read from both NM 1 and NM 2 lists. No DEXAs will be assigned.

*Mammography Rotations:
**SKY 1
***On Site @ SKY covering Dx/Locs/Bx
***Target: 30 MG

**SMC Mamm 1Bx
***On Site @ SMC covering Dx/Bx
***Target: 40 MG -or- 35 MG + 1-2 MRI

**SMC Mamm 1
***On Site @ SMC covering Dx AM only
***Target: 20 MG -or- 15 MG + 1-2 MRI

**SMC Mamm 2
***On Site @ SMC covering Dx/Locs/OSF
***Target: 30 MG -or- 25 MG + 1-2 MRI

**INT Mamm 3Bx
***On Site @ INT covering Bx
***Target: 75 MG + 1-2 MRI

**INT Mamm 4
***On Site @ INT covering Dx
***Target: 40 MG -or- 35 MG + 1-2 MRI

**WMC Mamm 5Bx
***On Site @ WMC covering Dx/Locs/Bx
***Target: 40 MG -or- 35 MG + 1-2 MRI

**WMC Mamm 5
***On Site @ WMC covering Dx/Locs
***Target: 40 MG -or- 35 MG + 1-2 MRI

**Sal Mamm 6
***On Site @ Sal Cr covering Dx
***Target: 40 MG -or- 35 MG + 1-2 MRI

**LVK Clinic
***On Site @ LVK covering Dx/Bx
***Target: 25 tomo + 1-2 MRI

**ECG
***On Site @ Eugene covering Dx
***Target: 35 MG

Interventional Radiology
IR 1, 2
On Site @ SMC, CVL
IR 3
On Site @ SMC, US and CT guided procedures
IR 4
On Site @ WMC, US and CT guided procedures
IR 5
On Site @ WMC, CVL
IR 6
Clinic

IR Film Targets:
IR 2, 3, 5
Target: 45 CR
IR 4
Target: 4 CT and 45 CR
IR 6
Target: 70 CR

Kaiser

2025-11-28T17:53:50Z

Tyler:

=== Internal Links ===
* [https://sp-cloud.kp.org/sites/NWPAccounting2 Reimbursement]
* [https://nwpkp.sumtotal.host/Broker/Account/Login.aspx? Training]
* [https://n23.ultipro.com/Login.aspx?ReturnUrl=%2fdefault.aspx HR]
* [https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices Imaging Sharepoint]
** [https://sp-cloud.kp.org/sites/KPNWImagingServices/Lists/Facility%20Phone%20List/By%20Facility.aspx?viewid=f8eabea2%2D4bd6%2D4eaf%2Dbe48%2Dfac642b1ada2 Imaging Phone List]

=== Rotations ===
* [[KP Rotations]]
* [[Weekend Reads Update 5/29/25]]

=== Institutional Guidelines ===
* [[Iliac Artery Aneurysms]]
* [[US Update 6/2025]]

=== PACS ===
* Command line application `swe` can completely kill the application if it freezes.

=== Up To Date ===
* Login via Epic to accrue CME

=== Kaiser Radiology ===
* [[KP Rotations]]
* [https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices Imaging Sharepoint]
* [https://sp-cloud.kp.org/sites/NWImaging/SitePages/Radiologist-QC-Entry-Form.aspx QC Form]

=== Track Recs ===
Some report templates contain specific codes embedded in fill-in fields that trigger entries in databases to ensure appropriate follow-up, but this is not apparent in the macro. The pertinent system macros are:
* "yellow dot" - triggers follow-up of an incidental finding that could be cancer. Encouraged to use the "FollowUp" icon at the top of powerscribe to input specific recs.
* "red dot" - same as "yellow dot" but in cases that are definitely cancer.
* "yellow dot not" - removes a yellow dot case from the track recs system.
* "red dot not" - removes a yellow dot case from the track recs system.
* "AAA" - just contains "AAA" at the very top of the report, which triggers follow-up. The macro also contains recommendations specific to Kaiser, but these are not necessary for the Track Recs system.
* "Lung Rads" - this macro is included at the end of the system LDCT Screening macro and contains necessary codes.

For reference, the embedded codes are put in fill-in fields like so:
[[File:Screenshot 2025-07-01 102848.png|none|thumb|Powerscribe Findings Codes]]

=== Picky System Templates and Reporting ===

Some providers have strong preferences about report format. Those reports include:
* DEXA

Calling severe coronary arterial calcific atherosclerosis triggers cardiology consultation (according to Chip Robertson, cardiology lead)

=== Overnight Prelims ===
* All over-reads go to the RTMC in-basket. So, unless a discrepancy is extremely time-sensitive, you probably don't need to call them about it. It'll be reviewed.
* If there is a major discrepancy and the ordering provider is not available, the RTMC line is the appropriate resource.

=== Incidental Follow-up ===
* See the Track Recs section above
* Incidental findings require follow-up are handled with "yellow dot" (possible cancer) and "red dot" (definite cancer).
* The yellow dot case autotext will flag the study so that administrators ensure the patient gets follow-up.
* The yellow dot can be removed on a subsequent exam with a different autotext.
* The red dot autotext will flag the finding as definitely cancer and (presumbably) trigger referrals.
* There is also a "blue flag" in Powerscribe that helps "yellow dot" cases.

=== Nuclear Medicine ===

* [https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices/SitePages/NM%20-%20Procedure%20Manual.aspx Procedure Manual]

=== Workflows ===
[[Coronary CTA]]

=== Logistics ===

* TIE Lines
** Sunnyside: 31-XXXX in house, 503-571-XXXX from outside
** Westside: 24-XXXX in house, 971-310-XXXX from outside
** Interstate: 16-XXXX in house, 503-331-XXXX from outside
** Salmon Creek: 69-XXXX in house, 360-571-XXXX from outside
** Longview-Kelso: 23-XXXX in house, 360-575-XXXX from outside

[https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices Imaging Services]

[https://sp-cloud.kp.org/sites/KPNWImagingServices/Lists/Facility%20Phone%20List/By%20Facility.aspx?viewid=f8eabea2%2D4bd6%2D4eaf%2Dbe48%2Dfac642b1ada2 Imaging Phone Directory]

See Outlook or Teams for additional contact information.
* PACS Support Line - For workstation, PACS software, or desk help
* File room - For questions about studies and worklists
* IT Tie Line - Overall KP IT

=== Policies and Practices ===
[[FAQ on FTE and Leave]]
* Tumor Boards
** Worklists are in the "Workqueue List" in Epic. There are many, and you'll have to search for them. Here are two examples:
*** Chest Conference: ID 71818, Name ONC CASE CONF CHEST/THORACIC
*** GI Tumor Board: ID 71810, Name ONC CASE CONF GI
** Compensated by removing studies from your worklist for the day. There's a precedent for 10 CTs for a tumor board. I asked for 6 PETs for a tumor board on my NM days.
*** Helwig clarified that the precedent/agreement is that hours of work should translate to Ws. So, if prep+conference takes 4 hours, that'd be 0.5 W worth of work off the list.
* Call Bonus
** After 60 CT+MRI studies on Reg Call shifts, additional studies can be claimed for SRs.

=== Scheduling ===
[https://lblite.lightning-bolt.com/viewer/ Lightning Bolt]

Requests are closed for the next unassigned month as it is being built.
Radiologists should be available for 2 Fridays, 2 Saturdays, and 2 Sundays per month to facilitate scheduling.

Extra compensation:
* Log shift in Lightning Bolt with "Create Fill"
* Assignment: EXTRA COMP
* Custom Time: 4 hours for every W (make sure it doesn't overlap with a shift worked that day)
* Reason: 2 EXTRA CLINIC
* Location: Wherever it was worked (usually home)
* Notes
** If consulted regarding a specific patient, put MRN in
** If just an extra stack, put in "1W - SR READS"

Requests predominantly first come first serve except time around major holidays (Spring Break, Thanksgiving, Christmas)

Request Codes
* EDU ALL DAY - Educational Leave (2 weeks/year for 0.9 FTE)
* OUT OF OFFICE - Self Care
** Must include "Reason" field as 0 SELF CARE
* VAC PTO ALL DAY - PTO

Determining remaining PTO, EDU leave, and Self-Care days
* Workdays are 9 hours, so figuring the number of self-care days and educational leave remaining based on what's in the pay statement requires that conversion.
* Don't forget to look ahead in the schedule to determine how many have been requested but not accounted for on payroll.

== Facilities ==

=== Sunnyside (SMC) ===
* Physician parking is on the roof of the parking garage
* There are other physician parking areas (see the facility map)
* The physician lounge is near 3 South. Go up the F elevator or stairs and the door is nearby.

=== Westside (WMC) ===
* Physician parking is on the top floors of the garage (4 and up).

=== Interstate ===
* Physician parking is on the bottom floor of the garage.

Kaiser

2025-11-20T18:34:32Z

Tyler: /* Policies and Practices */

=== Internal Links ===
* [https://sp-cloud.kp.org/sites/NWPAccounting2 Reimbursement]
* [https://nwpkp.sumtotal.host/Broker/Account/Login.aspx? Training]
* [https://n23.ultipro.com/Login.aspx?ReturnUrl=%2fdefault.aspx HR]
* [https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices Imaging Sharepoint]
** [https://sp-cloud.kp.org/sites/KPNWImagingServices/Lists/Facility%20Phone%20List/By%20Facility.aspx?viewid=f8eabea2%2D4bd6%2D4eaf%2Dbe48%2Dfac642b1ada2 Imaging Phone List]

=== Rotations ===
* [[KP Rotations]]
* [[Weekend Reads Update 5/29/25]]

=== Institutional Guidelines ===
* [[Iliac Artery Aneurysms]]
* [[US Update 6/2025]]

=== PACS ===
* Command line application `swe` can completely kill the application if it freezes.

=== Up To Date ===
* Login via Epic to accrue CME

=== Kaiser Radiology ===
* [[KP Rotations]]
* [https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices Imaging Sharepoint]
* [https://sp-cloud.kp.org/sites/NWImaging/SitePages/Radiologist-QC-Entry-Form.aspx QC Form]

=== Track Recs ===
Some report templates contain specific codes embedded in fill-in fields that trigger entries in databases to ensure appropriate follow-up, but this is not apparent in the macro. The pertinent system macros are:
* "yellow dot" - triggers follow-up of an incidental finding that could be cancer. Encouraged to use the "FollowUp" icon at the top of powerscribe to input specific recs.
* "red dot" - same as "yellow dot" but in cases that are definitely cancer.
* "yellow dot not" - removes a yellow dot case from the track recs system.
* "red dot not" - removes a yellow dot case from the track recs system.
* "AAA" - just contains "AAA" at the very top of the report, which triggers follow-up. The macro also contains recommendations specific to Kaiser, but these are not necessary for the Track Recs system.
* "Lung Rads" - this macro is included at the end of the system LDCT Screening macro and contains necessary codes.

For reference, the embedded codes are put in fill-in fields like so:
[[File:Screenshot 2025-07-01 102848.png|none|thumb|Powerscribe Findings Codes]]

=== Picky System Templates and Reporting ===

Some providers have strong preferences about report format. Those reports include:
* DEXA

Calling severe coronary arterial calcific atherosclerosis triggers cardiology consultation (according to Chip Robertson, cardiology lead)

=== Overnight Prelims ===
* All over-reads go to the RTMC in-basket. So, unless a discrepancy is extremely time-sensitive, you probably don't need to call them about it. It'll be reviewed.
* If there is a major discrepancy and the ordering provider is not available, the RTMC line is the appropriate resource.

=== Incidental Follow-up ===
* See the Track Recs section above
* Incidental findings require follow-up are handled with "yellow dot" (possible cancer) and "red dot" (definite cancer).
* The yellow dot case autotext will flag the study so that administrators ensure the patient gets follow-up.
* The yellow dot can be removed on a subsequent exam with a different autotext.
* The red dot autotext will flag the finding as definitely cancer and (presumbably) trigger referrals.
* There is also a "blue flag" in Powerscribe that helps "yellow dot" cases.

=== Nuclear Medicine ===

* [https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices/SitePages/NM%20-%20Procedure%20Manual.aspx Procedure Manual]

=== Workflows ===
[[Coronary CTA]]

=== Logistics ===

* TIE Lines
** Sunnyside: 31-XXXX in house, 503-571-XXXX from outside
** Westside: 24-XXXX in house, 971-310-XXXX from outside
** Interstate: 16-XXXX in house, 503-331-XXXX from outside
** Salmon Creek: 69-XXXX in house, 360-571-XXXX from outside
** Longview-Kelso: 23-XXXX in house, 360-575-XXXX from outside

[https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices Imaging Services]

[https://sp-cloud.kp.org/sites/KPNWImagingServices/Lists/Facility%20Phone%20List/By%20Facility.aspx?viewid=f8eabea2%2D4bd6%2D4eaf%2Dbe48%2Dfac642b1ada2 Imaging Phone Directory]

See Outlook or Teams for additional contact information.
* PACS Support Line - For workstation, PACS software, or desk help
* File room - For questions about studies and worklists
* IT Tie Line - Overall KP IT

=== Policies and Practices ===
[[FAQ on FTE and Leave]]
* Tumor Boards
** Worklists are in the "Workqueue List" in Epic. There are many, and you'll have to search for them. Here are two examples:
*** Chest Conference: ID 71818, Name ONC CASE CONF CHEST/THORACIC
*** GI Tumor Board: ID 71810, Name ONC CASE CONF GI
** Compensated by removing studies from your worklist for the day. There's a precedent for 10 CTs for a tumor board. I asked for 6 PETs for a tumor board on my NM days.
*** Helwig clarified that the precedent/agreement is that hours of work should translate to Ws. So, if prep+conference takes 4 hours, that'd be 0.5 W worth of work off the list.

=== Scheduling ===
[https://lblite.lightning-bolt.com/viewer/ Lightning Bolt]

Requests are closed for the next unassigned month as it is being built.
Radiologists should be available for 2 Fridays, 2 Saturdays, and 2 Sundays per month to facilitate scheduling.

Extra compensation:
* Log shift in Lightning Bolt with "Create Fill"
* Assignment: EXTRA COMP
* Custom Time: 4 hours for every W (make sure it doesn't overlap with a shift worked that day)
* Reason: 2 EXTRA CLINIC
* Location: Wherever it was worked (usually home)
* Notes
** If consulted regarding a specific patient, put MRN in
** If just an extra stack, put in "1W - SR READS"

Requests predominantly first come first serve except time around major holidays (Spring Break, Thanksgiving, Christmas)

Request Codes
* EDU ALL DAY - Educational Leave (2 weeks/year for 0.9 FTE)
* OUT OF OFFICE - Self Care
** Must include "Reason" field as 0 SELF CARE
* VAC PTO ALL DAY - PTO

Determining remaining PTO, EDU leave, and Self-Care days
* Workdays are 9 hours, so figuring the number of self-care days and educational leave remaining based on what's in the pay statement requires that conversion.
* Don't forget to look ahead in the schedule to determine how many have been requested but not accounted for on payroll.

== Facilities ==

=== Sunnyside (SMC) ===
* Physician parking is on the roof of the parking garage
* There are other physician parking areas (see the facility map)
* The physician lounge is near 3 South. Go up the F elevator or stairs and the door is nearby.

=== Westside (WMC) ===
* Physician parking is on the top floors of the garage (4 and up).

=== Interstate ===
* Physician parking is on the bottom floor of the garage.

Kaiser

2025-10-30T18:36:28Z

Tyler: /* Westside (WMC) */

=== Internal Links ===
* [https://sp-cloud.kp.org/sites/NWPAccounting2 Reimbursement]
* [https://nwpkp.sumtotal.host/Broker/Account/Login.aspx? Training]
* [https://n23.ultipro.com/Login.aspx?ReturnUrl=%2fdefault.aspx HR]
* [https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices Imaging Sharepoint]
** [https://sp-cloud.kp.org/sites/KPNWImagingServices/Lists/Facility%20Phone%20List/By%20Facility.aspx?viewid=f8eabea2%2D4bd6%2D4eaf%2Dbe48%2Dfac642b1ada2 Imaging Phone List]

=== Rotations ===
* [[KP Rotations]]
* [[Weekend Reads Update 5/29/25]]

=== Institutional Guidelines ===
* [[Iliac Artery Aneurysms]]
* [[US Update 6/2025]]

=== PACS ===
* Command line application `swe` can completely kill the application if it freezes.

=== Up To Date ===
* Login via Epic to accrue CME

=== Kaiser Radiology ===
* [[KP Rotations]]
* [https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices Imaging Sharepoint]
* [https://sp-cloud.kp.org/sites/NWImaging/SitePages/Radiologist-QC-Entry-Form.aspx QC Form]

=== Track Recs ===
Some report templates contain specific codes embedded in fill-in fields that trigger entries in databases to ensure appropriate follow-up, but this is not apparent in the macro. The pertinent system macros are:
* "yellow dot" - triggers follow-up of an incidental finding that could be cancer. Encouraged to use the "FollowUp" icon at the top of powerscribe to input specific recs.
* "red dot" - same as "yellow dot" but in cases that are definitely cancer.
* "yellow dot not" - removes a yellow dot case from the track recs system.
* "red dot not" - removes a yellow dot case from the track recs system.
* "AAA" - just contains "AAA" at the very top of the report, which triggers follow-up. The macro also contains recommendations specific to Kaiser, but these are not necessary for the Track Recs system.
* "Lung Rads" - this macro is included at the end of the system LDCT Screening macro and contains necessary codes.

For reference, the embedded codes are put in fill-in fields like so:
[[File:Screenshot 2025-07-01 102848.png|none|thumb|Powerscribe Findings Codes]]

=== Picky System Templates and Reporting ===

Some providers have strong preferences about report format. Those reports include:
* DEXA

Calling severe coronary arterial calcific atherosclerosis triggers cardiology consultation (according to Chip Robertson, cardiology lead)

=== Overnight Prelims ===
* All over-reads go to the RTMC in-basket. So, unless a discrepancy is extremely time-sensitive, you probably don't need to call them about it. It'll be reviewed.
* If there is a major discrepancy and the ordering provider is not available, the RTMC line is the appropriate resource.

=== Incidental Follow-up ===
* See the Track Recs section above
* Incidental findings require follow-up are handled with "yellow dot" (possible cancer) and "red dot" (definite cancer).
* The yellow dot case autotext will flag the study so that administrators ensure the patient gets follow-up.
* The yellow dot can be removed on a subsequent exam with a different autotext.
* The red dot autotext will flag the finding as definitely cancer and (presumbably) trigger referrals.
* There is also a "blue flag" in Powerscribe that helps "yellow dot" cases.

=== Nuclear Medicine ===

* [https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices/SitePages/NM%20-%20Procedure%20Manual.aspx Procedure Manual]

=== Workflows ===
[[Coronary CTA]]

=== Logistics ===

* TIE Lines
** Sunnyside: 31-XXXX in house, 503-571-XXXX from outside
** Westside: 24-XXXX in house, 971-310-XXXX from outside
** Interstate: 16-XXXX in house, 503-331-XXXX from outside
** Salmon Creek: 69-XXXX in house, 360-571-XXXX from outside
** Longview-Kelso: 23-XXXX in house, 360-575-XXXX from outside

[https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices Imaging Services]

[https://sp-cloud.kp.org/sites/KPNWImagingServices/Lists/Facility%20Phone%20List/By%20Facility.aspx?viewid=f8eabea2%2D4bd6%2D4eaf%2Dbe48%2Dfac642b1ada2 Imaging Phone Directory]

See Outlook or Teams for additional contact information.
* PACS Support Line - For workstation, PACS software, or desk help
* File room - For questions about studies and worklists
* IT Tie Line - Overall KP IT

=== Policies and Practices ===
[[FAQ on FTE and Leave]]
* Tumor Boards
** Worklists are in the "Workqueue List" in Epic. There are many, and you'll have to search for them. Here are two examples:
*** Chest Conference: ID 71818, Name ONC CASE CONF CHEST/THORACIC
*** GI Tumor Board: ID 71810, Name ONC CASE CONF GI
** Compensated by removing studies from your worklist for the day. There's a precedent for 10 CTs for a tumor board. I asked for 6 PETs for a tumor board on my NM days.

=== Scheduling ===
[https://lblite.lightning-bolt.com/viewer/ Lightning Bolt]

Requests are closed for the next unassigned month as it is being built.
Radiologists should be available for 2 Fridays, 2 Saturdays, and 2 Sundays per month to facilitate scheduling.

Extra compensation:
* Log shift in Lightning Bolt with "Create Fill"
* Assignment: EXTRA COMP
* Custom Time: 4 hours for every W (make sure it doesn't overlap with a shift worked that day)
* Reason: 2 EXTRA CLINIC
* Location: Wherever it was worked (usually home)
* Notes
** If consulted regarding a specific patient, put MRN in
** If just an extra stack, put in "1W - SR READS"

Requests predominantly first come first serve except time around major holidays (Spring Break, Thanksgiving, Christmas)

Request Codes
* EDU ALL DAY - Educational Leave (2 weeks/year for 0.9 FTE)
* OUT OF OFFICE - Self Care
** Must include "Reason" field as 0 SELF CARE
* VAC PTO ALL DAY - PTO

Determining remaining PTO, EDU leave, and Self-Care days
* Workdays are 9 hours, so figuring the number of self-care days and educational leave remaining based on what's in the pay statement requires that conversion.
* Don't forget to look ahead in the schedule to determine how many have been requested but not accounted for on payroll.

== Facilities ==

=== Sunnyside (SMC) ===
* Physician parking is on the roof of the parking garage
* There are other physician parking areas (see the facility map)
* The physician lounge is near 3 South. Go up the F elevator or stairs and the door is nearby.

=== Westside (WMC) ===
* Physician parking is on the top floors of the garage (4 and up).

=== Interstate ===
* Physician parking is on the bottom floor of the garage.

Kaiser

2025-10-28T20:06:58Z

Tyler: /* Logistics */

=== Internal Links ===
* [https://sp-cloud.kp.org/sites/NWPAccounting2 Reimbursement]
* [https://nwpkp.sumtotal.host/Broker/Account/Login.aspx? Training]
* [https://n23.ultipro.com/Login.aspx?ReturnUrl=%2fdefault.aspx HR]
* [https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices Imaging Sharepoint]
** [https://sp-cloud.kp.org/sites/KPNWImagingServices/Lists/Facility%20Phone%20List/By%20Facility.aspx?viewid=f8eabea2%2D4bd6%2D4eaf%2Dbe48%2Dfac642b1ada2 Imaging Phone List]

=== Rotations ===
* [[KP Rotations]]
* [[Weekend Reads Update 5/29/25]]

=== Institutional Guidelines ===
* [[Iliac Artery Aneurysms]]
* [[US Update 6/2025]]

=== PACS ===
* Command line application `swe` can completely kill the application if it freezes.

=== Up To Date ===
* Login via Epic to accrue CME

=== Kaiser Radiology ===
* [[KP Rotations]]
* [https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices Imaging Sharepoint]
* [https://sp-cloud.kp.org/sites/NWImaging/SitePages/Radiologist-QC-Entry-Form.aspx QC Form]

=== Track Recs ===
Some report templates contain specific codes embedded in fill-in fields that trigger entries in databases to ensure appropriate follow-up, but this is not apparent in the macro. The pertinent system macros are:
* "yellow dot" - triggers follow-up of an incidental finding that could be cancer. Encouraged to use the "FollowUp" icon at the top of powerscribe to input specific recs.
* "red dot" - same as "yellow dot" but in cases that are definitely cancer.
* "yellow dot not" - removes a yellow dot case from the track recs system.
* "red dot not" - removes a yellow dot case from the track recs system.
* "AAA" - just contains "AAA" at the very top of the report, which triggers follow-up. The macro also contains recommendations specific to Kaiser, but these are not necessary for the Track Recs system.
* "Lung Rads" - this macro is included at the end of the system LDCT Screening macro and contains necessary codes.

For reference, the embedded codes are put in fill-in fields like so:
[[File:Screenshot 2025-07-01 102848.png|none|thumb|Powerscribe Findings Codes]]

=== Picky System Templates and Reporting ===

Some providers have strong preferences about report format. Those reports include:
* DEXA

Calling severe coronary arterial calcific atherosclerosis triggers cardiology consultation (according to Chip Robertson, cardiology lead)

=== Overnight Prelims ===
* All over-reads go to the RTMC in-basket. So, unless a discrepancy is extremely time-sensitive, you probably don't need to call them about it. It'll be reviewed.
* If there is a major discrepancy and the ordering provider is not available, the RTMC line is the appropriate resource.

=== Incidental Follow-up ===
* See the Track Recs section above
* Incidental findings require follow-up are handled with "yellow dot" (possible cancer) and "red dot" (definite cancer).
* The yellow dot case autotext will flag the study so that administrators ensure the patient gets follow-up.
* The yellow dot can be removed on a subsequent exam with a different autotext.
* The red dot autotext will flag the finding as definitely cancer and (presumbably) trigger referrals.
* There is also a "blue flag" in Powerscribe that helps "yellow dot" cases.

=== Nuclear Medicine ===

* [https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices/SitePages/NM%20-%20Procedure%20Manual.aspx Procedure Manual]

=== Workflows ===
[[Coronary CTA]]

=== Logistics ===

* TIE Lines
** Sunnyside: 31-XXXX in house, 503-571-XXXX from outside
** Westside: 24-XXXX in house, 971-310-XXXX from outside
** Interstate: 16-XXXX in house, 503-331-XXXX from outside
** Salmon Creek: 69-XXXX in house, 360-571-XXXX from outside
** Longview-Kelso: 23-XXXX in house, 360-575-XXXX from outside

[https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices Imaging Services]

[https://sp-cloud.kp.org/sites/KPNWImagingServices/Lists/Facility%20Phone%20List/By%20Facility.aspx?viewid=f8eabea2%2D4bd6%2D4eaf%2Dbe48%2Dfac642b1ada2 Imaging Phone Directory]

See Outlook or Teams for additional contact information.
* PACS Support Line - For workstation, PACS software, or desk help
* File room - For questions about studies and worklists
* IT Tie Line - Overall KP IT

=== Policies and Practices ===
[[FAQ on FTE and Leave]]
* Tumor Boards
** Worklists are in the "Workqueue List" in Epic. There are many, and you'll have to search for them. Here are two examples:
*** Chest Conference: ID 71818, Name ONC CASE CONF CHEST/THORACIC
*** GI Tumor Board: ID 71810, Name ONC CASE CONF GI
** Compensated by removing studies from your worklist for the day. There's a precedent for 10 CTs for a tumor board. I asked for 6 PETs for a tumor board on my NM days.

=== Scheduling ===
[https://lblite.lightning-bolt.com/viewer/ Lightning Bolt]

Requests are closed for the next unassigned month as it is being built.
Radiologists should be available for 2 Fridays, 2 Saturdays, and 2 Sundays per month to facilitate scheduling.

Extra compensation:
* Log shift in Lightning Bolt with "Create Fill"
* Assignment: EXTRA COMP
* Custom Time: 4 hours for every W (make sure it doesn't overlap with a shift worked that day)
* Reason: 2 EXTRA CLINIC
* Location: Wherever it was worked (usually home)
* Notes
** If consulted regarding a specific patient, put MRN in
** If just an extra stack, put in "1W - SR READS"

Requests predominantly first come first serve except time around major holidays (Spring Break, Thanksgiving, Christmas)

Request Codes
* EDU ALL DAY - Educational Leave (2 weeks/year for 0.9 FTE)
* OUT OF OFFICE - Self Care
** Must include "Reason" field as 0 SELF CARE
* VAC PTO ALL DAY - PTO

Determining remaining PTO, EDU leave, and Self-Care days
* Workdays are 9 hours, so figuring the number of self-care days and educational leave remaining based on what's in the pay statement requires that conversion.
* Don't forget to look ahead in the schedule to determine how many have been requested but not accounted for on payroll.

== Facilities ==

=== Sunnyside (SMC) ===
* Physician parking is on the roof of the parking garage
* There are other physician parking areas (see the facility map)
* The physician lounge is near 3 South. Go up the F elevator or stairs and the door is nearby.

=== Westside (WMC) ===
* Physician parking is on the top floors of the garage.

=== Interstate ===
* Physician parking is on the bottom floor of the garage.

Contrast Reactions (Children)

2025-10-02T23:37:29Z

Tyler: Created page with "none none none none none none none"

[[File:Contrast Reaction - Children - 01.png|none]]
[[File:Contrast Reaction - Children - 02.png|none]]
[[File:Contrast Reaction - Children - 03.png|none]]
[[File:Contrast Reaction - Children - 04.png|none]]
[[File:Contrast Reaction - Children - 05.png|none]]
[[File:Contrast Reaction - Children - 06.png|none]]
[[File:Contrast Reaction - Children - 07.png|none]]

Workday Links

2025-10-02T23:37:23Z

Tyler: /* Contrast Reactions */

=== '''[[Contrast Reactions]]''' ===
=== '''[[Contrast Reactions (Children)]]''' ===

=== [https://radiopaedia.org/sessions/new Radiopaedia] ===

=== [[Kaiser]] ===

=== Radiology Tools ===
* [https://radcalc.overdesigned.org RadCalc]
* [https://radiology-universe.org/calculator/ Radiology Universe]
* [https://www.mesa-nhlbi.org/Calcium/input.aspx MESA Calcium Score %]
* [http://radiologyreviewarticles.com/radiology-calculators/spleen-volume-calculator/ Splenic Volume]

=== RADS ===
* [https://nextcloud.overdesigned.org/s/sNDQw4PgseooowP BIRADS Lexicon]
* [https://edge.sitecorecloud.io/americancoldf5f-acrorgf92a-productioncb02-3650/media/ACR/Files/RADS/Lung-RADS/Lung-RADS-2022.pdf LungRADS]
* [https://tiradscalculator.com/wp-content/uploads/2017/05/TIRADS-2017-Flow-Chart.jpg TIRADS]
* [https://edge.sitecorecloud.io/americancoldf5f-acrorgf92a-productioncb02-3650/media/ACR/Files/RADS/LI-RADS/LI-RADS-US-Surveillance-v2024-Core.pdf LI-RADS (US)]
* [https://edge.sitecorecloud.io/americancoldf5f-acrorgf92a-productioncb02-3650/media/ACR/Files/RADS/LI-RADS/LI-RADS-CT-MRI-2018-Core.pdf LI-RADS (CT/MR)]

=== Anatomy ===
* Prostate
** [https://radiologyassistant.nl/assets/tek-sector.jpg Illustration]
** [https://radiologyassistant.nl/assets/prostate-cancer-pi-rads-v2/a5b77f28c41897_Scroll.008.jpeg Peripheral Zone]
** [https://radiologyassistant.nl/assets/prostate-cancer-pi-rads-v2/a5b77f28c43fc1_Scroll.011.jpeg Transition Zone]
** [https://radiologyassistant.nl/assets/prostate-cancer-pi-rads-v2/a5b77f28c4246a_Scroll.009.jpeg Capsule]

=== Normal Measurements ===
* [https://www.ohsu.edu/school-of-medicine/diagnostic-radiology/pediatric-radiology-normal-measurements Pediatrics]

=== Incidental Findings ===
* [https://publish.smartsheet.com/42d18e874a164318a0f702481f2fbb70 All ACR papers]
* [https://nextcloud.overdesigned.org/s/XzZFeGADrstoY6w Pancreatic Cysts]
* [https://pubs.rsna.org/na101/home/literatum/publisher/rsna/journals/content/radiology/2017/radiol.2017.284.issue-1/radiol.2017161659/20170608/images/large/radiol.2017161659.tbl1.jpeg Fleischner Society]
* [https://els-jbs-prod-cdn.jbs.elsevierhealth.com/cms/attachment/264251b7-b546-480e-9a13-fb3bdafeded3/gr1.jpg Adrenal Nodule]
* [https://www.jacr.org/article/S1546-1440(17)30497-0/fulltext Renal Mass]

=== Nucs ===
* [https://docs.google.com/document/d/1XGK-kmIll02jbF1q4PGzd6ZCFtLe-0b3/edit?usp=sharing&ouid=107887909640214305589&rtpof=true&sd=true I-131 Checklist]
* Doses must be within 20% of the prescribed dose or it's a sentinel event ([https://www.nrc.gov/reading-rm/doc-collections/cfr/part035/part035-3045.html See NRC rule here]).
* [[Florbetapir]]

=== Uncategorized ===
* [https://www.acr.org/Clinical-Resources/Contrast-Manual ACR Contrast Manual]
* [https://docs.google.com/document/d/1Duz1sinAk3v5gfoIRtWa9o9U1GhbzRxkRI_vUvE18Co/edit Guidelines for nonviable pregnancy diagnosis]
* ADPKD Volume Calculation
** [[Media:ADPKD_Volume_Measurements.png|Measurement Technique]]
** [https://www.mayo.edu/research/documents/pkd-center-adpkd-classification/doc-20094754 Calculator]

Contrast Reactions

2025-10-02T23:36:49Z

Tyler:

[[File:Contrast Reaction - Adults - 01.png|none]]
[[File:Contrast Reaction - Adults - 02.png|none]]
[[File:Contrast Reaction - Adults - 03.png|none]]
[[File:Contrast Reaction - Adults - 04.png|none]]
[[File:Contrast Reaction - Adults - 05.png|none]]
[[File:Contrast Reaction - Adults - 06.png|none]]
[[File:Contrast Reaction - Adults - 07.png|none]]
[[File:Contrast Reaction - Adults - 08.png|none]]

Contrast Reactions

2025-10-02T23:36:28Z

Tyler: Created page with "=== Adults === none none none none none none none none === Children === File:Contrast Reaction - Children - 01.p..."

=== Adults ===
[[File:Contrast Reaction - Adults - 01.png|none]]
[[File:Contrast Reaction - Adults - 02.png|none]]
[[File:Contrast Reaction - Adults - 03.png|none]]
[[File:Contrast Reaction - Adults - 04.png|none]]
[[File:Contrast Reaction - Adults - 05.png|none]]
[[File:Contrast Reaction - Adults - 06.png|none]]
[[File:Contrast Reaction - Adults - 07.png|none]]
[[File:Contrast Reaction - Adults - 08.png|none]]

=== Children ===
[[File:Contrast Reaction - Children - 01.png|none]]
[[File:Contrast Reaction - Children - 02.png|none]]
[[File:Contrast Reaction - Children - 03.png|none]]
[[File:Contrast Reaction - Children - 04.png|none]]
[[File:Contrast Reaction - Children - 05.png|none]]
[[File:Contrast Reaction - Children - 06.png|none]]
[[File:Contrast Reaction - Children - 07.png|none]]

File:Contrast Reaction - Children - 07.png

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Tyler:

File:Contrast Reaction - Children - 06.png

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File:Contrast Reaction - Children - 04.png

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File:Contrast Reaction - Children - 03.png

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File:Contrast Reaction - Children - 02.png

2025-10-02T23:33:57Z

Tyler:

File:Contrast Reaction - Children - 01.png

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Tyler:

File:Contrast Reaction - Adults - 08.png

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File:Contrast Reaction - Adults - 07.png

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File:Contrast Reaction - Adults - 06.png

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File:Contrast Reaction - Adults - 05.png

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File:Contrast Reaction - Adults - 04.png

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File:Contrast Reaction - Adults - 03.png

2025-10-02T23:32:53Z

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File:Contrast Reaction - Adults - 02.png

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File:Contrast Reaction - Adults - 01.png

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Workday Links

2025-10-02T23:06:02Z

Tyler:

=== '''[[Contrast Reactions]]''' ===

=== [https://radiopaedia.org/sessions/new Radiopaedia] ===

=== [[Kaiser]] ===

=== Radiology Tools ===
* [https://radcalc.overdesigned.org RadCalc]
* [https://radiology-universe.org/calculator/ Radiology Universe]
* [https://www.mesa-nhlbi.org/Calcium/input.aspx MESA Calcium Score %]
* [http://radiologyreviewarticles.com/radiology-calculators/spleen-volume-calculator/ Splenic Volume]

=== RADS ===
* [https://nextcloud.overdesigned.org/s/sNDQw4PgseooowP BIRADS Lexicon]
* [https://edge.sitecorecloud.io/americancoldf5f-acrorgf92a-productioncb02-3650/media/ACR/Files/RADS/Lung-RADS/Lung-RADS-2022.pdf LungRADS]
* [https://tiradscalculator.com/wp-content/uploads/2017/05/TIRADS-2017-Flow-Chart.jpg TIRADS]
* [https://edge.sitecorecloud.io/americancoldf5f-acrorgf92a-productioncb02-3650/media/ACR/Files/RADS/LI-RADS/LI-RADS-US-Surveillance-v2024-Core.pdf LI-RADS (US)]
* [https://edge.sitecorecloud.io/americancoldf5f-acrorgf92a-productioncb02-3650/media/ACR/Files/RADS/LI-RADS/LI-RADS-CT-MRI-2018-Core.pdf LI-RADS (CT/MR)]

=== Anatomy ===
* Prostate
** [https://radiologyassistant.nl/assets/tek-sector.jpg Illustration]
** [https://radiologyassistant.nl/assets/prostate-cancer-pi-rads-v2/a5b77f28c41897_Scroll.008.jpeg Peripheral Zone]
** [https://radiologyassistant.nl/assets/prostate-cancer-pi-rads-v2/a5b77f28c43fc1_Scroll.011.jpeg Transition Zone]
** [https://radiologyassistant.nl/assets/prostate-cancer-pi-rads-v2/a5b77f28c4246a_Scroll.009.jpeg Capsule]

=== Normal Measurements ===
* [https://www.ohsu.edu/school-of-medicine/diagnostic-radiology/pediatric-radiology-normal-measurements Pediatrics]

=== Incidental Findings ===
* [https://publish.smartsheet.com/42d18e874a164318a0f702481f2fbb70 All ACR papers]
* [https://nextcloud.overdesigned.org/s/XzZFeGADrstoY6w Pancreatic Cysts]
* [https://pubs.rsna.org/na101/home/literatum/publisher/rsna/journals/content/radiology/2017/radiol.2017.284.issue-1/radiol.2017161659/20170608/images/large/radiol.2017161659.tbl1.jpeg Fleischner Society]
* [https://els-jbs-prod-cdn.jbs.elsevierhealth.com/cms/attachment/264251b7-b546-480e-9a13-fb3bdafeded3/gr1.jpg Adrenal Nodule]
* [https://www.jacr.org/article/S1546-1440(17)30497-0/fulltext Renal Mass]

=== Nucs ===
* [https://docs.google.com/document/d/1XGK-kmIll02jbF1q4PGzd6ZCFtLe-0b3/edit?usp=sharing&ouid=107887909640214305589&rtpof=true&sd=true I-131 Checklist]
* Doses must be within 20% of the prescribed dose or it's a sentinel event ([https://www.nrc.gov/reading-rm/doc-collections/cfr/part035/part035-3045.html See NRC rule here]).
* [[Florbetapir]]

=== Uncategorized ===
* [https://www.acr.org/Clinical-Resources/Contrast-Manual ACR Contrast Manual]
* [https://docs.google.com/document/d/1Duz1sinAk3v5gfoIRtWa9o9U1GhbzRxkRI_vUvE18Co/edit Guidelines for nonviable pregnancy diagnosis]
* ADPKD Volume Calculation
** [[Media:ADPKD_Volume_Measurements.png|Measurement Technique]]
** [https://www.mayo.edu/research/documents/pkd-center-adpkd-classification/doc-20094754 Calculator]

Kaiser

2025-09-26T15:05:49Z

Tyler:

=== Internal Links ===
* [https://sp-cloud.kp.org/sites/NWPAccounting2 Reimbursement]
* [https://nwpkp.sumtotal.host/Broker/Account/Login.aspx? Training]
* [https://n23.ultipro.com/Login.aspx?ReturnUrl=%2fdefault.aspx HR]
* [https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices Imaging Sharepoint]
** [https://sp-cloud.kp.org/sites/KPNWImagingServices/Lists/Facility%20Phone%20List/By%20Facility.aspx?viewid=f8eabea2%2D4bd6%2D4eaf%2Dbe48%2Dfac642b1ada2 Imaging Phone List]

=== Rotations ===
* [[KP Rotations]]
* [[Weekend Reads Update 5/29/25]]

=== Institutional Guidelines ===
* [[Iliac Artery Aneurysms]]
* [[US Update 6/2025]]

=== PACS ===
* Command line application `swe` can completely kill the application if it freezes.

=== Up To Date ===
* Login via Epic to accrue CME

=== Kaiser Radiology ===
* [[KP Rotations]]
* [https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices Imaging Sharepoint]
* [https://sp-cloud.kp.org/sites/NWImaging/SitePages/Radiologist-QC-Entry-Form.aspx QC Form]

=== Track Recs ===
Some report templates contain specific codes embedded in fill-in fields that trigger entries in databases to ensure appropriate follow-up, but this is not apparent in the macro. The pertinent system macros are:
* "yellow dot" - triggers follow-up of an incidental finding that could be cancer. Encouraged to use the "FollowUp" icon at the top of powerscribe to input specific recs.
* "red dot" - same as "yellow dot" but in cases that are definitely cancer.
* "yellow dot not" - removes a yellow dot case from the track recs system.
* "red dot not" - removes a yellow dot case from the track recs system.
* "AAA" - just contains "AAA" at the very top of the report, which triggers follow-up. The macro also contains recommendations specific to Kaiser, but these are not necessary for the Track Recs system.
* "Lung Rads" - this macro is included at the end of the system LDCT Screening macro and contains necessary codes.

For reference, the embedded codes are put in fill-in fields like so:
[[File:Screenshot 2025-07-01 102848.png|none|thumb|Powerscribe Findings Codes]]

=== Picky System Templates and Reporting ===

Some providers have strong preferences about report format. Those reports include:
* DEXA

Calling severe coronary arterial calcific atherosclerosis triggers cardiology consultation (according to Chip Robertson, cardiology lead)

=== Overnight Prelims ===
* All over-reads go to the RTMC in-basket. So, unless a discrepancy is extremely time-sensitive, you probably don't need to call them about it. It'll be reviewed.
* If there is a major discrepancy and the ordering provider is not available, the RTMC line is the appropriate resource.

=== Incidental Follow-up ===
* See the Track Recs section above
* Incidental findings require follow-up are handled with "yellow dot" (possible cancer) and "red dot" (definite cancer).
* The yellow dot case autotext will flag the study so that administrators ensure the patient gets follow-up.
* The yellow dot can be removed on a subsequent exam with a different autotext.
* The red dot autotext will flag the finding as definitely cancer and (presumbably) trigger referrals.
* There is also a "blue flag" in Powerscribe that helps "yellow dot" cases.

=== Nuclear Medicine ===

* [https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices/SitePages/NM%20-%20Procedure%20Manual.aspx Procedure Manual]

=== Workflows ===
[[Coronary CTA]]

=== Logistics ===

* TIE Lines
** Sunnyside: 31-XXXX in house, 503-571-XXXX from outside
** Westside: 24-XXXX in house, 971-310-XXXX from outside
** Interstate: 16-XXXX in house, 503-331-XXXX from outside
** Salmon Creek: 69-XXXX in house, 360-571-XXXX from outside

[https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices Imaging Services]

[https://sp-cloud.kp.org/sites/KPNWImagingServices/Lists/Facility%20Phone%20List/By%20Facility.aspx?viewid=f8eabea2%2D4bd6%2D4eaf%2Dbe48%2Dfac642b1ada2 Imaging Phone Directory]

See Outlook or Teams for additional contact information.
* PACS Support Line - For workstation, PACS software, or desk help
* File room - For questions about studies and worklists
* IT Tie Line - Overall KP IT

=== Policies and Practices ===
[[FAQ on FTE and Leave]]
* Tumor Boards
** Worklists are in the "Workqueue List" in Epic. There are many, and you'll have to search for them. Here are two examples:
*** Chest Conference: ID 71818, Name ONC CASE CONF CHEST/THORACIC
*** GI Tumor Board: ID 71810, Name ONC CASE CONF GI
** Compensated by removing studies from your worklist for the day. There's a precedent for 10 CTs for a tumor board. I asked for 6 PETs for a tumor board on my NM days.

=== Scheduling ===
[https://lblite.lightning-bolt.com/viewer/ Lightning Bolt]

Requests are closed for the next unassigned month as it is being built.
Radiologists should be available for 2 Fridays, 2 Saturdays, and 2 Sundays per month to facilitate scheduling.

Extra compensation:
* Log shift in Lightning Bolt with "Create Fill"
* Assignment: EXTRA COMP
* Custom Time: 4 hours for every W (make sure it doesn't overlap with a shift worked that day)
* Reason: 2 EXTRA CLINIC
* Location: Wherever it was worked (usually home)
* Notes
** If consulted regarding a specific patient, put MRN in
** If just an extra stack, put in "1W - SR READS"

Requests predominantly first come first serve except time around major holidays (Spring Break, Thanksgiving, Christmas)

Request Codes
* EDU ALL DAY - Educational Leave (2 weeks/year for 0.9 FTE)
* OUT OF OFFICE - Self Care
** Must include "Reason" field as 0 SELF CARE
* VAC PTO ALL DAY - PTO

Determining remaining PTO, EDU leave, and Self-Care days
* Workdays are 9 hours, so figuring the number of self-care days and educational leave remaining based on what's in the pay statement requires that conversion.
* Don't forget to look ahead in the schedule to determine how many have been requested but not accounted for on payroll.

== Facilities ==

=== Sunnyside (SMC) ===
* Physician parking is on the roof of the parking garage
* There are other physician parking areas (see the facility map)
* The physician lounge is near 3 South. Go up the F elevator or stairs and the door is nearby.

=== Westside (WMC) ===
* Physician parking is on the top floors of the garage.

=== Interstate ===
* Physician parking is on the bottom floor of the garage.

Kaiser

2025-09-25T21:51:20Z

Tyler:

=== Internal Links ===
* [https://sp-cloud.kp.org/sites/NWPAccounting2 Reimbursement]
* [https://nwpkp.sumtotal.host/Broker/Account/Login.aspx? Training]
* [https://n23.ultipro.com/Login.aspx?ReturnUrl=%2fdefault.aspx HR]
* [https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices Imaging Sharepoint]
** [https://sp-cloud.kp.org/sites/KPNWImagingServices/Lists/Facility%20Phone%20List/By%20Facility.aspx?viewid=f8eabea2%2D4bd6%2D4eaf%2Dbe48%2Dfac642b1ada2 Imaging Phone List]

=== Rotations ===
* [[KP Rotations]]
* [[Weekend Reads Update 5/29/25]]

=== Institutional Guidelines ===
* [[Iliac Artery Aneurysms]]
* [[US Update 6/2025]]

=== PACS ===
* Command line application `swe` can completely kill the application if it freezes.

=== Up To Date ===
* Login via Epic to accrue CME

=== Kaiser Radiology ===
* [[KP Rotations]]
* [https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices Imaging Sharepoint]
* [https://sp-cloud.kp.org/sites/NWImaging/SitePages/Radiologist-QC-Entry-Form.aspx QC Form]

=== Track Recs ===
Some report templates contain specific codes embedded in fill-in fields that trigger entries in databases to ensure appropriate follow-up, but this is not apparent in the macro. The pertinent system macros are:
* "yellow dot" - triggers follow-up of an incidental finding that could be cancer. Encouraged to use the "FollowUp" icon at the top of powerscribe to input specific recs.
* "red dot" - same as "yellow dot" but in cases that are definitely cancer.
* "yellow dot not" - removes a yellow dot case from the track recs system.
* "red dot not" - removes a yellow dot case from the track recs system.
* "AAA" - just contains "AAA" at the very top of the report, which triggers follow-up. The macro also contains recommendations specific to Kaiser, but these are not necessary for the Track Recs system.
* "Lung Rads" - this macro is included at the end of the system LDCT Screening macro and contains necessary codes.

For reference, the embedded codes are put in fill-in fields like so:
[[File:Screenshot 2025-07-01 102848.png|none|thumb|Powerscribe Findings Codes]]

=== Picky System Templates and Reporting ===

Some providers have strong preferences about report format. Those reports include:
* DEXA

Calling severe coronary arterial calcific atherosclerosis triggers cardiology consultation (according to Chip Robertson, cardiology lead)

=== Overnight Prelims ===
* All over-reads go to the RTMC in-basket. So, unless a discrepancy is extremely time-sensitive, you probably don't need to call them about it. It'll be reviewed.
* If there is a major discrepancy and the ordering provider is not available, the RTMC line is the appropriate resource.

=== Incidental Follow-up ===
* See the Track Recs section above
* Incidental findings require follow-up are handled with "yellow dot" (possible cancer) and "red dot" (definite cancer).
* The yellow dot case autotext will flag the study so that administrators ensure the patient gets follow-up.
* The yellow dot can be removed on a subsequent exam with a different autotext.
* The red dot autotext will flag the finding as definitely cancer and (presumbably) trigger referrals.
* There is also a "blue flag" in Powerscribe that helps "yellow dot" cases.

=== Nuclear Medicine ===

* [https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices/SitePages/NM%20-%20Procedure%20Manual.aspx Procedure Manual]

=== Workflows ===
[[Coronary CTA]]

=== Logistics ===

* TIE Lines
** Sunnyside: 31-XXXX in house, 503-571-XXXX from outside
** Westside: 24-XXXX in house, 971-310-XXXX from outside
** Interstate: 16-XXXX in hours, 503-331-XXXX from outside

[https://sp-cloud.kp.org/sites/KPNWRegionalImagingServices Imaging Services]

[https://sp-cloud.kp.org/sites/KPNWImagingServices/Lists/Facility%20Phone%20List/By%20Facility.aspx?viewid=f8eabea2%2D4bd6%2D4eaf%2Dbe48%2Dfac642b1ada2 Imaging Phone Directory]

See Outlook or Teams for additional contact information.
* PACS Support Line - For workstation, PACS software, or desk help
* File room - For questions about studies and worklists
* IT Tie Line - Overall KP IT

=== Policies and Practices ===
[[FAQ on FTE and Leave]]
* Tumor Boards
** Worklists are in the "Workqueue List" in Epic. There are many, and you'll have to search for them. Here are two examples:
*** Chest Conference: ID 71818, Name ONC CASE CONF CHEST/THORACIC
*** GI Tumor Board: ID 71810, Name ONC CASE CONF GI
** Compensated by removing studies from your worklist for the day. There's a precedent for 10 CTs for a tumor board. I asked for 6 PETs for a tumor board on my NM days.

=== Scheduling ===
[https://lblite.lightning-bolt.com/viewer/ Lightning Bolt]

Requests are closed for the next unassigned month as it is being built.
Radiologists should be available for 2 Fridays, 2 Saturdays, and 2 Sundays per month to facilitate scheduling.

Extra compensation:
* Log shift in Lightning Bolt with "Create Fill"
* Assignment: EXTRA COMP
* Custom Time: 4 hours for every W (make sure it doesn't overlap with a shift worked that day)
* Reason: 2 EXTRA CLINIC
* Location: Wherever it was worked (usually home)
* Notes
** If consulted regarding a specific patient, put MRN in
** If just an extra stack, put in "1W - SR READS"

Requests predominantly first come first serve except time around major holidays (Spring Break, Thanksgiving, Christmas)

Request Codes
* EDU ALL DAY - Educational Leave (2 weeks/year for 0.9 FTE)
* OUT OF OFFICE - Self Care
** Must include "Reason" field as 0 SELF CARE
* VAC PTO ALL DAY - PTO

Determining remaining PTO, EDU leave, and Self-Care days
* Workdays are 9 hours, so figuring the number of self-care days and educational leave remaining based on what's in the pay statement requires that conversion.
* Don't forget to look ahead in the schedule to determine how many have been requested but not accounted for on payroll.

== Facilities ==

=== Sunnyside (SMC) ===
* Physician parking is on the roof of the parking garage
* There are other physician parking areas (see the facility map)
* The physician lounge is near 3 South. Go up the F elevator or stairs and the door is nearby.

=== Westside (WMC) ===
* Physician parking is on the top floors of the garage.

=== Interstate ===
* Physician parking is on the bottom floor of the garage.

Kaiser

2025-08-28T14:18:41Z

Tyler:

Kaiser

2025-08-27T22:32:42Z

Tyler: /* Logistics */