The term "Radiology Department" is one that is rapidly becoming obsolete. What was once defined as a collection of radiologists is now a complex group of interrelated processes with the principal connection between them being the clients they serve. These clients include the patients who utilize the resources of that radiology department, the physicians and other healthcare professionals who rely on information obtained from them, and the hospital administration and staff who operate and function within these systems. 

This collection of radiological processes and the clients they serve make up a functional segment within the healthcare organization that today, can more accurately be called Imaging. Effectively managing an "Imaging Department" requires an understanding of imaging management that includes not only the end product, but also the end-user. Sustained, long-term success is inseparable from the success of the support team driving the patient, referring physician and radiologist experience. 

In any strong radiology practice, the support team begins with the front desk and clerical staff who answer calls and greet patients and referring physicians as they begin their interaction with the department, either in-person or electronically. Next, are the technologists.  They perform the examinations and prepare the cases for interpretation. Finally, we have the billing staff, who are responsible for properly preparing the patient's bill and answering questions from the patient and third party payers. 

With this knowledge as a foundation, any strong radiology practice could approach such a team culture within the Imaging Department in the following ways: 

1. Honesty
Poor senior management and physician leaders will brush off or deflect questions when the answers are negative. Although answers may be hard to come by, providing as much information as possible, no matter how painful, is always better than silence. Imaging team members don't hate bad news as much as they hate no news. Even if they don't want to hear it, they understand tough decisions must sometimes be made. If the team is aware of the difficulties they face, and hear what is being done to prepare for those challenges; they can go to work with greater confidence, even if they are going into a tougher day-to-day job. 

2. A Bottom-Up Action Plan
A specialty as medically and technologically sophisticated as radiology needs to allow room for growth and experimentation. Many managers who find themselves locked in comfort zones will shy away from trying new workflows, adhering to the familiar adage of "this is the way we've always done it." We believe that if a team member comes up with a great idea, validated by those doing the work, it is prudent for the leadership to give it consideration. Keeping everyone in the loop throughout that decision-making process creates transparency. If the answer ends up being a no-go; be sure to give feedback on what didn't work, and why. Knowing this will motivate the team to come up with alternatives or changes to the original suggestion. 

We recognize that not every idea is successful. The team works just as hard trying new things and being open to radical changes; whether they're a home run or not. Ensuring everyone remains open to growth and experimentation depends on whether the senior leadership rolls with the positive, and occasionally negative outcomes of the changes that are implemented. 

3. Encouraging Feedback From All Channels
When we are considering changes, we ask what is going well and what we could  do better. Hearing nothing, or only that we are not doing anything wrong, is not the same as we are doing everything well. If the team believes something can be improved, we discuss those ideas and have the team work out the needed modifications. 

Next, we solicit suggestions from our patients. You would be amazed at how many of them work in similar process-driven environments and can point out areas where their experience could have been improved. This can also be done via online surveys sent to a patient's email following a visit. This information can furnish the practice with critical data for advertising, such as "over 90 percent of our patients are satisfied with our practice." 

Finally, we take time to listen to our referring clinicians and their staff. Remember, with the exception of the patients we serve, referring physicians are our target clients. Their experience in obtaining information or improving their patient's care through our work will impact what they think about our service.

We have support team members in place to investigate and consider any suggestions that are made. We know that the next great workflow idea could be standing next to one of our radiologists or team members, asking about results or making an appointment for a patient.

4. Creating a Reward Culture 
Providing incentives and the potential for upward mobility within the company are paramount to keeping the best team members happy. While no one person is ever more important than the imaging team as a whole, taking time to appreciate "all-star" moments   sets a precedent that hard work and innovation are appreciated and rewarded. When leadership acknowledges a team member’s actions, it not only keeps the staff working hard, but also incentivizes every team member to reach for individual and group goals. 

When a team finds and implements new workflows and changes, these can be tied to performance goals for departments, individuals, or even those across different sections within the imaging department. Whether it's done through bonuses, team target goals or outside the box rewards like additional time off and flex hours, giving team members and managers a goal to strive for will keep the gears moving and promote an entrepreneurial atmosphere. 

Make no mistake—each of these items is difficult. They require extensive commitment, planning and a cultural shift from the top down of an entire organization. Practices that do these things well will have happy, committed team members for the road ahead and the potential for even greater gains in the new business atmosphere of modern radiology. 


A special thanks to Frederic Smith, who is the client operations manager for St. Paul Radiology, for contributing to this piece.