COVID’s Lasting Impact on Radiology Administration

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Strategies and insights from radiology administrators for navigating the new normal.

Editor’s Note: as we approach #AHRA2021, Everything Rad interviewed radiology administrators to understand their challenges for the remainder of 2021, and their strategies for addressing them.

Although the number of COVID-19 cases in some countries is waning, its implications continue for radiology administrators in 2021 and beyond. Its lingering influences are affecting imaging volumes, staffing, and budgeting. Read on to learn more about COVID’s lasting impact on radiology administration and strategies from these three insightful radiology administrators:

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Radiology administrators say COVID-19 is having a lingering impact on imaging volumes, staffing, and budgeting.

“COVID is still here”

“We are at a point where we are able to resume normal operations, but COVID is still here,” emphasized Dr. Weatherly at UAB Medicine. “We are still masking. We are still adhering to social distancing. And we are making sure that we still hold staff, patients, and visitors accountable to those guidelines. It’s all about navigating normal in the midst of COVID.”

The need to reassure patients that imaging facilities are safe also remains, said Dr. Weatherly. “If I’m trying to increase units of service while caring for COVID patients, I need to create an atmosphere that is safe for all patients and we need to communicate that to people. We need to continue to be transparent and let people know, ‘this is what we are doing to ensure your safety.’”

Continuing to maintain safety measures and communicating that fact is especially important for organizations where imaging exams for inpatient and ambulatory patients are done on shared equipment, said Dr. Weatherly.

COVID’s lasting impact on budgets and patient volumes

Outpatient volumes have started to rebound at Baptist Pensacola Health System; however the fact that fewer people have healthcare insurance is limiting growth, said Mrs. Menier of Baptist Pensacola Health System. “A lot of people are still collecting unemployment which often correlates with dropped insurance and delaying care,” she explained.

Kernesha S. Weatherly, University of Alabama at Birmingham Hospital.

However, she is hopeful that volumes will increase now that doctors’ offices are re-opening.  “Patients feel more ‘pushed’ (to follow through on an exam) when they meet in person with a doctor, rather than getting a recommendation over the phone.”

At UAB, volumes in preventative scans are still in flux in part due to concerns around COVID. “Because of the overall uncertainty, some patients are waiting to come in until they have a known issue like a headache or stomachache.  But they’re less likely to come in for a screening exam unless they are having a problem,” said Dr. Weatherly.

The decrease in volume – and revenue – compounds the punishment that COVID-related expenses already dealt on budgets for radiology departments.

“We had to increase spending in the Respiratory Department for more ventilators and respiratory equipment,” said Mr. Scott of Witham Health Services. “We might not be able to purchase a new X-ray room or MRI equipment because of it. The extra complication is that we don’t know where COVID is going. Volumes have been up, down, and  all around. COVID is changing all the time, so it is unpredictable what the future holds for us.”

Given the continued uncertainty, UAB is taking what Dr. Weatherly calls “an intentional pause”. “Understandably so, a lot of things were put on hold during COVID, but equipment is still aging therefore we needed to evaluate immediate buying needs and how it will affect the department long term if we don’t buy it,” she explained.  

COVID’s lingering shadow on radiology department staffing

Jason Scott, Witham Health Services.

The extended period of anxiety, change, and uncertainty from caring for COVID-infected patients took a very heavy toll on everyone in the radiology department.

“Staff remained stressed out,” said Mr. Scott. “It hasn’t been easy wearing a mask and social distancing during an entire shift. We even had to limit the number of people in the lunchroom. Staff are not as positive as they were pre-COVID. In my approximately 15 years of being a director, this has been by far the most stressful time.”

Dr. Weatherly is encouraging her team to take a break. “They have literally been running on all cylinders and they don’t realize how it affected them, their team, and their personal life. I’m telling them all to take some time off; to take a moment and just breathe. I tell them to give themselves grace and celebrate that they made it through the past year.” Dr. Weatherly plans to lead by example, taking time off herself.

The disparity in pay during COVID remains a bitter pill for some to swallow, said Mrs. Menier. “When you give bonuses to inpatient nursing for dealing with COVID, and don’t give bonuses to imaging staff because they are not with patients as much, that’s an issue.”

Additionally, there has been a decline in volume from patients who are funded by the Hospital Care Assurance Program – and this impacts staff salary. “Fortunately things are starting to level out so I hope we can stop having these inequities,” Mrs. Menier added.

Amy Menier, Baptist Health Care.

COVID also is contributing to staffing shortages. Some radiology professionals left to join traveling healthcare companies during the peak of COVID where they could earn literally triple the pay, said Mrs. Menier. COVID drove others to retire sooner than they had planned, or to take jobs outside of healthcare. To help close the gap, Baptist Health Care in Pensacola is working closely with radiology education programs to help them increase their student population and to recruit those students. Some healthcare facilities are offering bonuses to new hires for the first time.

Even the vaccine is having an impact. “Before, we had techs outbecause of COVID, and now people are out because of their reactions to the vaccine,” explained Dr. Weatherly. “Now we may have a different person out every day and my staff has to schedule around that in a way that does not impede patient flow.”

Additionally, due to the ongoing presence of COVID, the department continues to follow a “clean and dirty tech” approach when available. “Having two people in place was not an issue when service levels were down,” said Dr. Weatherly. “But now imaging volumes are back up and we still try our best to have a clean and dirty tech. That adds up to another FTE.”

COVID’s lasting impact on radiology administration

It appears that several of the effects of the COVID pandemic will be lasting.

It left a very physical reminder at Baptist Health Care. The organization is in the process of building a new structure. However, the need to work remotely during the peak of COVID demonstrated that a significant amount of administrative work can be completed effectively without coming into the facility.

“We learned that many different areas of healthcare can work remotely, eliminating the need for a brick and mortar office for departments that are now 100% remote such as billing and some IT services. This saves our organization money in the long term,” said Mrs. Menier.

Another lasting change is more emphasis on handwashing. Baptist Health Care is exploring the use of RFID technology embedded on staff badges to track the length of time that hands are washed. “It will save managers the time of monitoring it, and it will assure us that proper hand washing is being performed,” explained Mrs. Menier.

Witham Health will continue some of its more stringent cleaning measures, said Mr. Scott. “We will continue to pay special attention to making sure things are cleaner, like wiping off cassettes after every patient. And we are more conscientious about wearing the right PPE and washing hands. We are definitely more vigilant about infection control as result of COVID, and that will probably stick around for a while.”

The pandemic also shone a light on the need for improved communications. “Before COVID, we thought we had good communications, but the pandemic made us realize there is room for improvement. Are people doing daily huddles? Are websites updated? I think our communications definitely changed and for the better,” said Mrs. Menier.

There are personal changes as well. “I think administrators tend to be see things as black and white; but COVID brought out the need to be more flexible. It helped many people in healthcare become comfortable with being uncomfortable. I’ve enjoyed seeing people adjust and evolve,” said Dr. Weatherly.

Mrs. Menier ponders an even bigger question about the lasting influence of COVID. “People’s homes became their whole world doing COVID. People can work from home, get groceries delivered and receive telehealth. And because they can work remotely, they can work from anywhere in the world. We need to consider this new paradigm for the future. How can imaging meet our customers where it is convenient for them? How can we deliver imaging differently? We need to be thinking about this.”

What are the lasting effects of COVID on your radiology department? Comment below.

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