MEDICAL IMAGING AND PACS 6. Staff satisfaction
Staff satisfaction is a key enabler of high clinical quality, good patient experience, high retention rates, and also of ability to deliver financial performance improvements.
modalities is well used, in each of: • Absolute number of exams per machine per year
• Complexity-weighted number of exams per machine per year (where departments have an internal recharge model, income can be an appropriate way of weighting for complexity)
The target for machine utilisation should differ by modality and by machine type.
Enablers for good performance: Extending machine working hours (e.g., 8am-8pm rather than 9am-5pm); clear expectations on number of patients per hour/ slot length for different exam type; minimisation of cancellations and ‘did not attend’ (DNA) activity.
Enablers for good performance: Well-designed departmental layout; active positive feedback on staff performance; effective staff appraisal process, with managers well trained in how to complete appraisals effectively; encouragement and support for personal development plans; clearly stated departmental objectives; clear communications of the rationale for changes.
How to measure: Via the national NHS staff survey, and where appropriate via
frequent local staff surveys. 7. Machine utilisation
High-value equipment such as CT and MRI scanners as well as Nuclear Medicine and Interventional Radiology equipment are often underutilised, to the extent that a recent NAO report showed that opening hours of CT scanners ranged from 40 to over 100 hours per week.7
If a department is to be financially efficient, then it is essential that equipment in these
more
How to measure: Record the total number of exams per machine per annum, and total income per machine per annum. Benchmark this data both internally across machines, and most importantly, externally with peer organisations.
8. Staff productivity
As around 70% of imaging department costs are pay-related, it is essential that staff are used productively if the department is to be efficient.8
Measures of staff productivity will vary by staff group. For instance, for consultant radiologists, a number of imaging departments are using consultant productivity scorecards which show, for each consultant over a time period t.
might be credited 4 minutes for reporting a plain film X-ray.
The concept of the productivity scorecard can be applied at an individual level for consultant radiologists, but for radiographers can more usefully be applied at team level (e.g., for the team of radiographers who deliver MRI scans on site X).
Enablers for good performance: Measuring, reporting on, and managing output of reports per radiologist or reporting radiographer; measuring, reporting on and managing output of scans per team of radiographers.
Conclusion
There are further metrics which radiology departments are obliged to record (such as Ionising Radiation (Medical Exposure) Regulations and Eliminating Mixed Sex Accommodation) and this would need to continue. In radiology departments in teaching hospitals, academic research outputs will also be important. But stripped down to its core, we believe that the above are the key metrics which give an accurate picture of an excellent imaging department.
The outputs of these consultant productivity scorecards can be as shown in Fig 1. The value (in time) of activities conducted is based on a number of minutes allocated to each procedure type: for instance, a consultant radiologist
Below: Fig 1 Consultant scorecards can drive increases in productivity
Above: The 8 measures to assess your imaging department
References
1 ‘Facing the future: the effects of the impending financial drought on NHS finances and how UK radiology services can contribute to expected efficiency savings’, Grant, Appleby, Griffin, Adam and Gishen, British Journal of Radiology, (publication forthcoming), Table 1.
2 Royal College of Radiologists. Clinical radiology annual census 2008.
3 Department of Health statistics, ‘Imaging and Radio Diagnostics’, 2010-11.
4 For instance ‘Cardiac imaging: a report from the National Imaging Board’; ‘Delivering quality imaging services for children’, Department of Health website. 5 Reference cost data provides some financial benchmarking on some imaging modalities. 6 2010-11 figures for NHS, Department of Health website. 7 ‘Managing high-value capital equipment in the NHS’, National Audit Office, 2011. 8 Staff also need to focus on providing a high quality service as well as a productive service. The quality of service provided can be measured through, for example, patient experience and reporting quality.
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54 | national health executive Jul/Aug 12
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