Operational Efficiencies in Imaging Centers: People Problems

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For my first concurrent session I decided to drop in on “Opportunities for Operational Efficiencies in Imaging Centers,” presented by Debra Platt, RT, of Great Basin Imaging in Carson City, Nevada. “I don’t know about you,” she said, “but for us the last five years in imaging reimbursement have been downright depressing, and every year it continues to get worse. We don’t know what’s on the horizon, and the need to be efficient and to save money is greater now than it ever was. It’s a matter of survival.”

Platt divided the ways her center has saved money into three categories: people, equipment and processes. Beginning with the people side, she quoted Jim Collins: “The purpose of bureaucracy is to compensate for incompetence and lack of discipline—a problem that largely goes away if you have the right people in the first place.” People can be an imaging center’s greatest commodity, or they can be its downfall. Platt suggested evaluating employees by a simple criterion: if they came to you saying they were leaving, would you secretly be relieved? If that’s the case, that employee is probably not right for your organization. “Why don’t we do anything about these employees?” Platt asked. “Maybe we’re tired. Maybe they’re doing just well enough for us to get by. But the bottom line is, it’s not working, and everyone else knows it and expects you to do something about it.”

Platt also pointed out that radiologists are the most expensive employees of an imaging center, and when dealing with radiologists, data is a manager’s number-one asset. When Great Basin’s radiologists said they wanted to be more efficient, management met with each of them and learned what factors they thought contributed to inefficiency:

--Dealing with personal issues at work
--Consults between each other
--Mix of slow and fast readers
--Pawning work off on each other
--Interruptions by staff, including technical and administrative staff
--Being late for their shifts or procedures

Great Basin’s management team responded by gathering together RVU productivity data, logging all radiologist phone calls, evaluating the radiologists’ reading styles, tracking procedure time and wait time, and analyzing how regularly radiologists were late for work. They now present this data to the radiologists on a quarterly basis. Platt said that after some initial disputes over the data’s validity—an aside that drew laughter from the audience—the least productive radiologists began to change their ways. “They understand that we’re not doing this to be punitive,” Platt noted. “It’s better patient care, and it’s a better use of their time.”

In closing, Platt offered an HR mantra for imaging centers: “Hire slow, fire fast.” She added that your employees will let you know if there’s a problem with a fellow staffer—as long as you’re willing to listen. “If I hear something once, I ignore it,” she said. “If I hear it twice, I pay attention. If I hear it three times, I know it’s time to do something.”