Marianne Matthews, Editor in Chief of Imaging Economics, interviews Carestream’s own Todd Minnigh, Vice President, Word Wide Sales & Marketing Development, about radiation dose monitoring and the different technologies being used in the U.S. and around the world to address this important issue.
In a session at last week’s AHRA annual meeting titled, “An Executive Guide to Implementing a Successful Enterprise Dose Solution,” Chris Tomlinson, MBA, director of radiology at the Children’s Hospital of Philadelphia, urged administrators to not be myopic. By extending beyond the radiology department to a truly enterprise program that brings together other service lines like cardiology, oral surgery and oncology, dose becomes aggregate across the care continuum.
To successfully lead an enterprise dose program, Tomlinson shared best practices for radiology administrators:
- Ensure radiation safety committee is diverse: Include representation from IT, legal, the C-suite, and a medical physicist. Tomlinson noted a C-Suite stakeholder can help inform the larger health system of changing regulations and program status. The medical physicist, he shared, has an opportunity to demonstrate their expertise and can often be the unsung hero of the committee.
- Understand all clinical workflows involved: An enterprise program must optimize all provider workflows. This cannot be done by radiology dictating protocols, procedures and policies to others. All workflows must be understood and documented in detail for an enterprise program to succeed.
- Foster more physician to physician communication: In alignment with ACR’s Imaging 3.0 initiative, radiologists can be leaders in a dose program by outreaching to referring physicians to discuss the necessity of tests, the technology available to lower dose and regulatory guidelines.
Dose was clearly a hot topic at AHRA with Tomlinson’s session being one of several. You can find more dose management guidance, specifically a slide share from Shawn McKenzie of Ascendian Healthcare Consulting’s “Radiation Dose Safety: Defining and Implementing an Enterprise Dose Management Program” presentation on DiagnosticImaging.com.
Radiology’s “top guns” are being tested and success in the changing healthcare environment is dependent on your commitment to yourself, the mission and your team. This was the message from AHRA 2014 keynote speaker Lieutenant Colonel Rob “Waldo” Waldman, a decorated fighter pilot and the author of the New York Times and Wall Street Journal bestseller, Never Fly Solo.
Think the experience of radiology administrators and fighter pilots are worlds apart? Not so, says Waldman. The fear he felt on his 65 combat missions – sometimes dodging missiles – is the same stress radiology directors feel as they are tasked to deliver excellence in patient care while facing obstacles like declining reimbursement, dose regulations, the ICD-10 roll out, patient satisfaction improvements and staffing challenges.The training fighter pilots receive to be mission-ready can be applied by radiology department leadership to adapt to change and push performance to the next level.
Waldman urged AHRA attendees to:
- Convert fear into focus – Commit. Commit. Commit. Place trust in yourself and your team. Identify your target and never fly solo. You can’t overcome obstacles without your wingman – be confident in their skills and training, establish clear objectives, roles and responsibilities, ensure you have the technology you need to succeed and develop contingency plans to ensure you don’t lose focus.
- Lift Others – Your department team needs to know they can depend on you. You must think outside your cockpit. Foster trust through communication and connection that makes it clear you will not let them fail and will get them to the target. Always “Check 6” or look behind to ensure your wingmen are still with you. Look for opportunities to recognize the unsung heroes in your service line – like those who ensure your mission critical equipment is maintained.
- Recalibrate your attitude – Your wingmen are watching and see if you are pulling back. Be confident that your mission is achievable. Be willing to take risks and set a team culture for success.
Waldman’s motto “Push it Up” – a reminder to overcome your fear and fight the urge to pull back on the throttle in tough times – gave AHRA attendees an inspired rallying cry for their hospital and departmental missions.
Radiology administrators, how do you plan to “Push It Up” in your department?
Erica Carnevale is the social and content marketing manager for Carestream. She is currently attending AHRA 2014 and reporting back to us from the Carestream booth, #212, in Washington D.C., August 10-13.
Todd Minnigh is a familiar face in the AHRA community. As a frequent conference attendee and speaker, he has presented on a variety of topics because he has seen and experienced a great deal throughout his career. In a new role within Carestream, Minnigh’s responsibilities have allowed him to travel the world to get a closer look at how other countries are practicing medical imaging and addressing important trends such as dose reduction and process efficiency.
He took the time to answer a few questions related to the presentation he will be giving at AHRA 2014, “Patient Care, Over There: What We Can Learn from Radiology Practices Around the Globe.” The presentation will be taking place on Monday, Aug. 11, from 4:00-5:00 p.m. and Wednesday, Aug. 13, from 10:00-11:00 a.m.
When it comes to patient care, is there a difference in defining patient satisfaction among countries? Are they looking at different factors?
Minnigh: The biggest difference is probably not what satisfies the patient, but how it is measured. In the U.S., under the ACA, we use the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. It looks at things like responsiveness of the staff and the quietness of the hospital. In many industries, Net Promoter Score (NPS) is considered a best practice. It measures the likelihood that customers will recommend you or refer others to you. In the end, folks will move their efforts toward improving whatever they measure.
What are the biggest challenges facing productivity and workflow issues today?
Minnigh: The most common challenge is having sufficient budget for expertise and technology. This is true everywhere, more in some locations than others. The technology and processes exist today to make almost any place more productive. The trick is to know exactly what you need, how to implement it and how to pay for it.
What are some of the differences in technology adoption you have seen from around the world?
Minnigh: There are many. The most interesting for folks from the new world may be that many countries overseas have PACS, but still print all their images to film. In some cases this is for archive, referring physicians and/or because the patient expects a copy.
What are some approaches to radiation dose management that you have seen around the world but are not as prominent in the U.S.?
Minnigh: In Germany, radiation dose is very carefully managed. This is one reason portables are limited in the emergency department. Scatter reaches other patients even though they may be ‘far away’ by our way of thinking. Also every machine has a DAP, or Dose Area Product Meter, right on the collimator to determine the amount of radiation the machine produced. Carefully tracking this is a common practice in Europe and is becoming much more common here now too.
What’s the most important lesson AHRA members can take away from the practices you’ve seen around the world?
Minnigh: The most important lesson is to think outside the box. There are other ways to do things, other priorities to consider. We get very focused on what we do and doing it better, we often don’t consider if it could be done in an entirely different way or if it really needs to be done at all.
Todd Minnigh is the vice president of worldwide sales and marketing development at Carestream. His talk at AHRA 2014, “Patient Care, Over There: What We Can Learn from Radiology Practices Around the Globe.” will be taking place on Monday, Aug. 11, from 4:00-5:00 p.m. and Wednesday, Aug. 13, from 10:00-11:00 a.m.