Productivity is a cornerstone of capitalism, even in the field of healthcare, where society is essentially investing in the welfare of its people. Radiologists are faced with the challenge of gauging, achieving and monitoring productivity in practice. Here are five techniques medical imaging departments can utilize for smoother throughput.
#1 – Take a fresh look at metrics
Peter Drucker was known as “the man who invented management.”1 He is credited with the adage, “You can’t manage who you don’t measure.” While the concept remains sound, it is important to be sure of what you measure, in order to manage it effectively.
Traditionally, the influential metric for radiologists has been turnaround time. According to Matthew Brady, MD, president of Roper Radiologists in Charleston, SC, turnaround is, “the timeframe between a study becoming available to be read and when the report is completed.”2
The basis for that measure is evolving. In a modern radiology department, an overall average for turnaround time does not present a clear picture of the organization's commitment to prioritization. An advanced workflow system may assign studies based on a structure of urgency, with STAT studies receiving priority. Then cases are addressed by the subspecialty of the radiologist and followed by general cases or those pushing up against time standard thresholds.
Brady summed up the need for a fresh approach as, “If you think about the list of metrics practices have used in the past—line item count from PACS, dictation count, billed and/or received dollars by the group, total RVU (relative value units) sum, the physician work [PW] RVU sum—some work, some don’t.”2
Select data that serves as the most accurate reflection of what you are called upon to complete in a workday.
#2 – Embrace automated prioritization
At one time, a radiologist’s “worklist” was essentially a stack of films, manually shuffled with those deemed most pressing rising to the top. In some cases, calls from the referring physician constituted that urgency.
Though some radiologists preferred that method, in 2015 Diagnostic Imaging emphasized the benefits to the radiologist of trusting "smart" (automated) worklists, where the next assignment pops up based on AI (artificial intelligence) algorithms. In the article, Mike Esposito, MD, president of Radiology and Imaging Specialists in the southern Tampa Bay area, said, "Now with individualized work lists, it makes you feel like you have your day back again."3
In the absence of an automated worklist, consider these manual prioritization tips:
- Take the most difficult cases first, before you are fatigued or feeling rushed.
- Tackle X-rays next, which are usually the highest volume and quickest to read. You will get an emotional boost as the worklist shrinks.
- Categorize remaining studies (nature of condition or body part) to gain momentum.
#3 – Control interruptions
Interruptions are an accepted element of the radiologist’s work. Technologists need clarifications. Colleagues need second opinions. Referring physicians need updates. Taking interruptions as they come may make the radiologist popular, but it can derail productivity.
In the Diagnostic Imaging article, Judy Capko, author of Take Back Time: Bringing Time Management to Medicine, pointed out the need for radiologists to set boundaries. “If they’re allowed to interrupt they’ll do it. They won’t think about how it impacts you. People learn to solve their own problems if left to it.”3
How does a radiologist stand firm? By remembering that job #1 is providing quality reports. That entails focus in the reading room.
Minimize interruptions by:
- Making a conscious determination of what you feel warrants interruption during exam interpretations.
- Write those specific scenarios down, to solidify them in your own mind.
- Communicate that information to staff, colleagues, and referring physicians, sharing your rationale.
- Set the expectation – times when you are accessible for routine interruptions and when phone calls will be returned.
- Respond by text or email when possible, if these modes of communication are permitted within your organization’s policies and practices.
- Delegate! Request calls can be screened and handled by other members of the staff when possible.
Beware of self-imposed interruptions, too. It is incredibly easy to become absorbed in internet surfing, work-related or personal.
#4 – Manage meetings
Meetings, too, are inevitable and necessary to the radiologist’s role. Meetings are a flattering indication that the organization values your input and wants you to have a say in important decisions. They can be extraordinarily time-consuming, though.
Start with triage – decide if your presence is necessary and beneficial. Politely decline and request an emailed summary, if not.
Become the poster child for meeting efficiency:
- If the organizer does not provide an agenda in advance of the session, ask for it.
- Based on the outline, email your vital comments back to the organizer. Ask that they are taken into consideration in the ensuing discussion. Encourage similar input from others, and that it be shared before the meeting.
- At the outset, make it clear that if the meeting runs long, you must leave at the scheduled stop time – and do it.
#5 – Take breaks
The concentration of a radiologist’s work gives the prefrontal cortex of the brain a workout. The benefit of breaks from that intensity can far exceed the brief downtime.
Psychology Today reports that:
- “Movement breaks” reduce the risk of heart disease, obesity, diabetes, and depression – conditions that eventually take a toll on productivity.
- Breaks fight “decision fatigue,” a tendency to take the easiest option when faced with frequent decisions throughout the day.
- While prolonged attention to a task hinders performance, breaks help to restore motivation.
- Stress and exhaustion kill creativity. Breakthrough thinking often occurs right after a time out.
- Mental rest periods improve memory, giving the brain a chance to review and absorb new information.4
Achieving true productivity, as opposed to being busy, can make a significant difference in job performance, enabling caregivers to serve patients better.
- About Peter Drucker. Drucker Institute. https://www.drucker.institute/perspective/about-peter-drucker/ September 7, 2019.
- Orchestrating Radiology Workflow: Measuring, Managing and Load Balancing. Radiology Business. https://www.radiologybusiness.com/sponsored/10078/topics/radiology-practice/orchestrating-radiology-workflow-measuring-managing-and September 7, 2019.
- Time Management Tips for Radiologists. Diagnostic Imaging. https://www.diagnosticimaging.com/practice-management/time-management-tips-radiologists September 7, 2019.
- How Do Work Breaks Help Your Brain? 5 Surprising Answers. Psychology Today. https://www.psychologytoday.com/us/blog/changepower/201704/how-do-work-breaks-help-your-brain-5-surprising-answers September 7, 2019.