Transcript Notes Radiology Department: Organization and Operation

Chapter 12: Radiology Department: Organization and Operation

Objectives

  • At the end of this chapter, we should be able to:

    • Describe the role of the hospital administrator.

    • Describe the role of the radiology administrator.

    • Describe the role and function of the policy and procedures manual.

    • List essential procedures and policy items included in the procedures manual.

    • Describe the rationale for a quality assurance program.

    • List the factors that determine the selection of radiology equipment.

    • Contrast quality assurance with quality control.

    • Explain equipment evaluation and monitoring.

    • Explain the significance of a quality assurance program from the standpoint of patient care, economics, and staff development.

Medical Imaging Department

  • The medical imaging department is dedicated to:

    • Services and working relationships among:

    • Radiographers

    • Supervisors of the department

    • Radiologists

    • Other hospital departments

    • Hospital administration

  • The connection between radiographers and hospital administration is indirect, relying on supervisors for communication.

  • Characteristics of the radiology department:

    • Determined by hospital roles and community needs.

    • Not all hospitals perform every procedure, but effective communication networks link patients to capabilities outside their institution.

  • Researching medical imaging services:

    • Institutional websites typically have department tabs or "About Us" sections, including:

    • Faculty and staff information

    • Procedures offered

    • Institutional mission, vision, and goals for community engagement.

Development of Medical Imaging Departments

  • Key factors in the development include:

    • Population and community healthcare needs.

    • Popularity of specific exams.

    • Requests for specific software from radiologists.

    • Quality, speed, and functionality of equipment.

  • Entities involved in development and implementation:

    • Human resources:

    • Department management, supervisors, team leaders, and technologists.

    • Fiscal resources:

    • Budget, financial obligations, and contractual agreements.

  • Medical imaging services are specialized, providing:

    • Specific patient assessments, diagnoses, and solutions (e.g., interventional radiology).

    • Highly specialized and expensive equipment.

Organization in Radiology Departments

  • Hierarchy within organizations involves a structured system of authority, responsibility, and accountability.

  • Organizational charts display:

    • The hierarchy and names of personnel in various positions.

  • Responsibilities in an organization:

    • Vary from financial oversight to risk management.

  • Board of Directors:

    • Highest-ranking officials elected to hire the CEO.

    • Approve CEO decisions regarding equipment, services, and facilities.

  • Chief Executive Officer (CEO):

    • Manages the overall organization.

    • Responsible for department operational breakdowns, staffing, budgets, and protocols.

  • Chief Financial Officer (CFO):

    • Manages purchases and budget reporting.

  • Chief Operating Officer (COO):

    • Oversees departmental operations including medical imaging.

  • Department Directors:

    • Report to the COO on departmental activities, staffing, examinations, and budget information.

  • Department Organization:

    • Typically includes managers, supervisors, team leads for modalities, and staff technologists who perform examinations.

Radiology Staff Activities

  • Activities are structured according to organizational charts, indicating top to bottom responsibilities.

  • Staff performance reflects standards and practices set by higher-ups.

  • Connection to departmental performance is vital for:

    • Appraisals

    • Patient satisfaction scores

    • Image quality analysis.

Administrative and Staff Responsibilities

  • Administrative and staff responsibilities, while different, contribute to the same goals, namely:

    • Building effective working relationships within and across departments.

    • Collaboration in policy and procedure development.

    • Responsibilities include giving feedback and implementing changes.

  • Evaluation process includes:

    • Administrative input with staff feedback.

    • Involvement of infection control and risk management teams.

  • Historical context:

    • Many administrators were formerly staff members in radiology.

    • Career paths often lead from technologist roles to supervisors and higher positions.

Policies and Procedures

  • Policies and procedures ensure smooth, safe, and effective operations, especially in healthcare.

  • Administrators are responsible for developing and implementing these policies.

  • Essential considerations in policies:

    • Proper requisition details for examinations and their reviews by staff to ensure accuracy.

    • Infection precautions/documentation of previous examinations to support patient safety and care

  • Example of requisition requirements:

    • Patient details (name, date of birth, exam type, physician details, clinical indications).

  • Procedure protocols aim to promote efficiency and timely care in exam completions.

Procedure Manuals

  • Designed to ensure compliance with organizational, accreditation, and state standards.

  • Must include details related to:

    • Hazard/biohazard information

    • Patient presentation

    • Specific contrast agents used.

  • OSHA compliance requires MSDS for all chemicals in the institution.

    • Required documentation on how to handle potential risks associated with substances used in procedures.

Human Resources Procedures

  • HR roles function at both organizational and departmental levels, tracking:

    • Employee records, benefits, and performance.

    • Credential verification for technologists.

  • Management is responsible for:

    • Providing annual continuing education to ensure compliance with standards.

    • Monitoring attendance and performance reviews.

Economics of Radiology

  • Radiology departments were historically considered profit centers because they generated revenue for the hospital.

  • Today many radiology departments function as cost centers because they require large amounts of resources and funding to operate.

  • Radiology is still one of the largest revenue-producing departments in hospitals along with laboratory and pharmacy services.

  • The two largest expenses in radiology departments are imaging equipment and staff salaries.

  • Imaging equipment can cost tens of thousands to millions of dollars, and additional costs include training, software systems, and maintenance contracts.

Staffing in a Radiology Department

  • Administrative Staff:

    • Director

    • Managers

    • Supervisors

    • PACS administrator

    • Team leaders

  • Technologists:

    • Radiologic technologists (general x-ray)

    • CT technologists

    • MRI technologists

    • Sonographers

    • Nuclear medicine technologists

    • Interventional radiology technologists

  • Clerical Staff:

    • Receptionists

    • Administrative assistants

    • Transcriptionists

  • Support Staff:

    • Clinical aides

    • Environmental services

    • Patient transporters

Radiographer Responsibilities

  • Selecting appropriate exposure factors

  • Proper patient positioning

  • Ensuring patient safety and comfort

  • Adjusting techniques based on patient condition or body habitus

  • Producing high-quality diagnostic images

Radiographers are trained to operate imaging equipment and maintain image quality but are not responsible for repairing equipment if it malfunctions.

Exposure Factors That Affect Image Quality

  • kVp – controls beam energy and penetration

  • mA – controls number of electrons flowing through the x-ray tube

  • Exposure time (seconds) – affects total radiation produced

  • Distance – affects beam intensity

  • AEC (Automatic Exposure Control) – automatically adjusts exposure

Other factors that affect image quality include grid use, focal spot size, and collimation.

Continuing Education Requirements

  • Radiographers must complete 24 continuing education (CE) credits every 2 years.

  • CE credits may come from seminars, lectures, in-service training, or peer-reviewed articles.

  • Continuing education ensures technologists stay updated on new technology, safety standards, and imaging techniques.

Radiology Equipment

  • Radiology departments use highly specialized and expensive equipment.

  • Examples include x-ray machines, CT scanners, MRI scanners, and PACS image storage systems.

  • Equipment costs include the purchase price, software systems, equipment upgrades, and maintenance contracts.

  • Hospitals must regularly update equipment to maintain efficiency and compatibility with modern technology.