Radiology Administration Notes

Chapter 6: Radiology Administration

Objectives

  • Provide an overview of the administration of a hospital radiology department and the structure of hospital organization.
  • Describe how the radiology department fits into and complements the hospital environment.
  • Understand the role of the radiology administrator.
  • Describe the functions of management, including planning, organizing and facilitating, staffing, directing, controlling, coordinating, and project management.
  • Discuss the transition from traditional functions of management to the requirements of managing radiology in the current health care environment.
  • Describe regulating agencies that affect radiology.
  • Discuss the characteristics of desirable applicants for employment in radiology.

Hospital Environment

  • Hospitals are like "communities within communities."
  • Hospitals serve a community need.
  • Hospitals are staffed by various types of workers.

Hospital Mission

  • The hospital Mission Statement defines the purpose of the hospital’s existence and provides guidance in its community service.
  • All hospital staff are committed to accomplishment of the Mission.
  • Hospital directives and projects support the Mission.

Organizational Structure

  • Governance of a hospital begins with the board of directors or governing board.
  • The President or Chief Executive Officer (CEO) is accountable to the hospital board.
  • The hospital divisions and departments are accountable to the CEO.

Medical Imaging

  • Plays a critically important role in hospital operations and success
  • Works closely with other departments to provide patient care and revenue for the hospital

Health Care Trends and Hospitals

  • Hospitals are more horizontal in organizational structure.
  • Reimbursement shifts from inpatients to outpatients.
  • Strong emphasis on use of services
  • Declining reimbursements from government programs
  • Focus for reimbursement will shift to patient experience quality measures.

Typical Organizational Designs

  • Top-Heavy Vertical Design
  • Downsized Horizontal Design
  • Matrix Structure: Board of Directors, President/CEO, Lab, Radiology, Nursing, Personnel, Surgery, Outpatient Testing, Women's Services, Outpatient Surgery, Pediatrics, Clinics

Radiology Organization

  • Varies depending on size and scope
  • Often consists of subdepartments
  • Requires support services
  • Led by Administrative Director

Administrative Director of Radiology

  • Typically reports directly to upper hospital administration
  • Requires strong business management skills
  • Not necessarily a radiologic technologist
  • Works closely with Medical Director of Radiology

Medical Director

  • Typically a physician
  • Principle responsibility is for overseeing the quality of patient care
  • Works closely with Administrative Director
  • May also serve as Department Chair

Changing Health Care Trends

  • Nontraditional Health Care Settings:
    • Clinics
    • Outpatient Imaging Centers Freestanding Imaging Centers
    • Mobile Imaging Services
    • Outpatient Surgery Centers
    • Urgent Care Centers
    • Commercial Medical Facilities
    • Walk-in Clinics
    • Specialty Clinics Physicians’ Offices
    • Research Centers
    • Veterinary Medicine
    • Teleradiology Services

Management Functions

  • Primary functions
  • Communication skills are important.
  • Key management traits include leadership skills and “coaching” staff.

Process Improvement

  • Current trends emphasize the improvement of services as an ongoing process.
    • Continuous Quality Improvement (CQI)
    • Total Quality Management (TQM)
    • Performance Improvement (PI)
  • Customer service is the focus!
  • Doing the right things right the first time, and meeting and exceeding the customer’s expectations

Regulatory Activities

  • May be internal or external to the hospital organization
  • Often are performed by committees or governmental agencies
  • May be voluntary but closely tied to reimbursement for services, so involvement is an implied mandate

External Regulatory Agencies

  • The Joint Commission (TJC)
  • Nuclear Regulatory Commission (NRC)
  • Occupational Safety and Health Administration (OSHA)
  • Food and Drug Administration (FDA)
  • American College of Radiology (ACR)
  • State Health Departments

Internal Regulatory Groups

  • Vary from hospital to hospital
  • Typically committee based
    • Infection Control Committee
    • Radiation Safety Committee
    • Safety Committee
    • Risk Management/Corporate Compliance
    • Pharmacy and Therapeutics Committee
    • PACS Committee

Desirable Employee Characteristics

  • Strong technical skills
  • Excellent teamwork skills
  • Customer-service oriented
  • Good communication skills with patients, colleagues, and physicians
  • Professional attitude
  • Good work ethic

Conclusion

  • Radiology administration is complex and demanding at many levels.
  • Hospitals and providers are very customer focused.
  • Professionals may work with external and internal regulatory agencies and committees.
  • Medical imaging employees need to be strong technically and have good teamwork skills.