On the Table: The SPHM Continuity Gap MRI Reveals Across the Patient Journey

The transfer is often treated as the point at which safe patient handling has been accomplished. But what happens after the patient reaches the table?

In radiology and other specialized clinical environments, the physical work may continue long after the transfer is complete. Patients may still need to be lifted, positioned, stabilized, supported, or maintained in position throughout an examination or procedure. These demands can become embedded in routine workflow rather than recognized as patient-handling exposures.

MRI provides a revealing case study. The physical and safety constraints of the MR environment limit conventional positioning and handling options. Technologists can be required to manually position or support patients to accommodate the requirements of the examination. The transfer may have been completed safely, yet the handling exposure has not ended.

This reveals a gap in how SPHM is traditionally considered: the physical work created by the care environment after the transfer.

The presentation calls this the SPHM continuity gap—the space between completing a safe transfer and completing the patient's care, where handling demands can become invisible within clinical workflow, inconsistently documented, and disconnected from SPHM assessment.

The implications extend beyond worker exposure. Post-transfer positioning and support can affect patient comfort, motion artifact, repeat imaging, incomplete examinations, extended exam times, delays, staffing requirements, and ultimately the ability to complete intended diagnostic or therapeutic care. These implications also intersect with the evolving accessibility requirements of HHS Section 504, which establishes enforceable standards governing the accessibility and usability of medical diagnostic equipment by people with disabilities. The question becomes not only whether a patient can be transferred to the equipment, but whether the patient can safely access, use, and complete the examination—and what physical work is required of healthcare workers when the equipment does not accommodate the patient.

Using MRI as the lens, participants will examine how equipment and procedural requirements can create post-transfer handling demands and consider how similar patterns may exist across CT, nuclear medicine, interventional procedures, radiation therapy, and other specialized environments.

The presentation introduces a system-based framework for extending SPHM beyond the transfer, incorporating assessment, documentation, surveillance, workflow design, and engineering controls. Participants will also be introduced to the Post-Transfer SPHM Checklist, a practical, vendor-neutral tool for identifying and documenting handling demands throughout the remainder of the patient's care.

The goal is not to redefine radiology as an SPHM problem. It is to reveal a category of handling exposure that can exist between established SPHM processes and routine clinical care—and give SPHM professionals a framework for seeing and addressing it.