Executive Insight Magazine has published the following article from David Palkovich, Vice President of Radiology for Novant Health/MedQuest Associates and Bruce Elder, Chief Development and Strategy Officer of MedQuest Associates. The article outlines step to take so that busy healthcare systems and hospitals don’t overlook key business principles in the day-to-day bustle of running an radiology department.


Three Steps to Take Today to Achieve Long-term Radiology Success

By David Palkovich, Vice President at Novant Health, and Bruce Elder, Chief Development and Strategy Officer, MedQuest Associates

Shrinking reimbursement and increasing regulatory demands have forced healthcare systems and hospitals to concentrate on the bottom line while still fulfilling their mission of delivering the highest quality care. As a result, hospital organizations have adopted numerous business practices commonly used in other industries and customized them to meet the specific requirements of the complex healthcare environment.

In radiology, where most team members start as technologists, managers frequently have not been trained in broader business practices prior to entering their management roles. Many radiology leaders have learned on the job; as a result, they can potentially overlook some key business principles in the day-to-day bustle of running a radiology department. Among these are three critical actions that can generate a strong pay-off in the near term and produce lasting benefits for imaging operations into the future:

  • Structured, intentional succession planning
  • Providing strong, open communications on metrics to the team
  • Cross-pollinating processes, approaches and best practices between inpatient and outpatient facilities

Succession Planning

Imaging operations in hospitals and health systems often provide high visibility for radiology management personnel from and to other parts of the organization. Imaging leaders interact frequently with almost every area in the delivery system, including working with other departments to determine their imaging needs and reviewing purchasing, facility, equipment and staffing requirements with Human Resources and Finance. Imaging also involves a high volume of interactions with patients and physician practices, making it a key area for patient and physician satisfaction.

Due to this high level of visibility, top-performing radiology leaders are often transferred or promoted into roles representing the next step in career progression, commonly into a parallel department such as an oncology or orthopedic service line. Career options for these leaders increase exponentially within a large, complex health system and in major markets with competing health systems.

This gives rise to the need for an important process that is too often overlooked:  succession planning. The unexpected departure of a key leader can cause every imaging metric – from quality to financial – to suffer. The need for succession planning is particularly acute in a large tertiary hospital, where the imaging department is large and complex. Not only does a strong, intentional succession plan help prevent an operational “swoon” should the radiology leader leave, but it also recognizes employees who are delivering exemplary work. Being identified as a potential manager and participating in leadership training often serves as a retention tool that prevents key employees from seeking other outside opportunities to advance their career.

Keeping a “Compelling Scoreboard”

Communicating relevant performance metrics to and among the radiology team is another best practice from the broader business world that translates into the healthcare environment. While metrics are often gathered and reported upwards to system management, they are less commonly shared among staff in meaningful ways that influence behaviors.

In The Four Disciplines of Execution, the authors describe the benefits of “keeping a compelling scoreboard” in achieving important goals. Regularly and clearly communicating simple, practical performance metrics gives staff at all levels insight into performance and identifies areas for improvement. One of the key goals of this communication should be demonstrating to radiology staff that quality and financial performance are not mutually exclusive objectives. This helps combat the erroneous perception that as volume and financial vitality increase, patient satisfaction and quality decline. In addition, publishing relevant metrics allows team members to experience a clear sense of success, which drives higher levels of engagement.

At Novant Health, we actively seek to live our vision, which reads: “We, the Novant Health team, will deliver the most remarkable patient experience, in every dimension, every time.” We post patient satisfaction scores in the break room where all staff can see them, and managers send out congratulatory messages when those scores increase. Being able to simultaneously see increases in volume and patient satisfaction offers very positive reinforcement that these goals can be achieved simultaneously, and in fact, in concert with one another.

It’s critical to include several different metrics that are relevant to different team members. It’s the same as a vacation – one person may think lying on the beach doing absolutely nothing is ideal, while another’s idea of fun is revving up a speed boat. Employing a range of metrics allows each team member to find one or more that are particularly meaningful to them. Some key metrics that might be considered are scan or procedure volume, patient satisfaction scores, quality indicators and safety measures.

Bringing the Outside In

As an increasing number of hospitals and health systems operate both inpatient and outpatient facilities, a dichotomy arises between the two environments. Outpatient centers focus on filling the daily schedule and offering innovative services to attract referring physicians and patients. Acute care imaging departments tend to be more focused on meeting the needs of internal clients, and because patient care tends to be more complex, imaging procedures within the hospital can consume more time and resources.

Acute care radiology departments are finding that by employing successful processes and approaches from outpatient centers, they can become more competitive and productive in a healthcare environment that demands efficiency and productivity. This includes placing a greater emphasis on sales and marketing (which also includes greatly enhanced service recovery efforts) and streamlining scheduling, scan protocols and workflows.  Maximizing daily schedules, applying enhanced order management efforts, aggressively managing cancellations and no-show’s and “order scrubbing” are additional key processes that can be successfully ported from outpatient to inpatient environments.

The Business of Healthcare

An increasing number of current and potential managers are seeking graduate degrees that focus on business practices or include management components. Additionally, health systems may offer training programs in management principles and practices. For those in imaging who would like to assume or increase a leadership role, adding an MBA or management training course to their medical and technical training will likely pay dividends in this new age of healthcare operations. And, regardless of the level of formal business training radiology leaders may have, employing effective succession planning, communicating key relevant metrics to staff and adapting outpatient approaches to the hospital environment will help keep them and their departments competitive in a rapidly changing healthcare landscape.