7 Staff Management Steps to Improve Safety and Quality Issues

As reimbursement shrinks and imaging providers are called on to do more procedures with fewer people, time for training and development of your technologist staff may be suffering warns a new white paper from the American Society of Radiologic Technologists (ASRT) Foundation Health Care Industry Advisory Council’s twelve-member subcommittee on Patient Safety and Quality in Medical Imaging. The “Patient Safety and Quality in Medical Imaging: The Radiologic Technologist’s Role” report notes that while radiologic technologists are primarily responsible for advocating for their own training and patient safety concerns, management and vendors must also play a part in promoting a culture of safety in medical imaging. “In the busy, budget-driven environment of health care, training time and attention often are sacrificed, yet training is critical to successfully implementing new and emerging technologies,” write the report’s authors, Liana Watson, DM, R.T.(R)(M)(S)(BS), RDMS, RVT, FASRT, and Teresa G. Odle, BA, ELS. According to Watson and Odle, the rapid pace of technological advancement both in imaging and in health care overall have created some challenges that could lead to patient safety problems like patients needlessly being given more radiation than necessary because the technologist is inadequately trained, has no direct face-to-face communication with the radiologists, is confused by conflicting vendor terminology for similar technology features, and/or lacks sufficient computer literacy and understanding of basic of principles of imaging with digital equipment. The subcommittee included many vendor representatives and the white paper notes that vendors have observed, for example, that new technology installations are often done without adequate support for staff training. This includes ensuring that there is sufficient staff coverage for the training time as some vendors have noted that technologists are often unable to attend the full scheduled trainings and have to leave midway through to attend to their clinical responsibilities. Digital imaging and archiving, along with adoption of electronic health records, have also minimized direct communication between technologists and radiologists. “Technologists no longer enter reading areas to hang radiographs for physicians and potentially discuss technical aspects of the studies in real time,” the authors wrote. “Radiologic technologists often must rely on interpretation of infrequent notes from radiologists, input from their managers or their own initiative for education regarding image quality and exposure improvement.”Specific recommendations for imaging managers in the report included:

1. Develop a culture of safety and learning supported by management through policies and procedures that ensure adequate staffing.
2. Help facilitate better radiologist/radiologic technologist collaboration on care, feedback and quality improvement.
3. Support licensure and certification efforts that help ensure radiologic technologists are educationally prepared, clinically competent and certified in their respective modalities.
4. Work collaboratively with vendors to develop a detailed training agreement that outlines both parties’ expectations before finalizing a medical imaging equipment purchase.
5. Provide effective and efficient applications training for new and upgraded medical imaging equipment.
6. Recognize that multivendor environments introduce new layers of complexity requiring cooperation with vendors to avoid confusion with new and existing technologies.
7. Use vendor provided documentation and analysis tools effectively to introduce accountability for patient safety and image quality.

Download a PDF or the white paper.