The evolving radiology landscape: the importance of effective leadership

Think Like an MBA: Development, Implementation, and Evaluation of an Academic Radiology Business Series (ARBS) for Radiology Trainees

RATIONALE AND OBJECTIVES

To address existing educational gaps in the business of radiology and medicine, we developed, implemented, and evaluated an Academic Radiology Business Series (ARBS) as part of a longitudinal noninterpretive skills curriculum in our radiology residency program.

MATERIALS AND METHODS

Mixed lecture- and discussion-based sessions were prepared and taught by content experts and radiologist-leaders at our institution in the style of a typical MBA curriculum, drawing on five core pillars: strategy, management, operations, finance, and health policy and economics. The series concluded with an interactive discussion of a Harvard Business School case study. To study the effectiveness of the curriculum, Wilcoxon rank-sum test was used to compare survey results before and after the curriculum.

RESULTS

Nearly 80% of the pre-curriculum survey respondents were not satisfied with the current training offered in the business of medicine. Although 94% of trainees were interested in pursuing leadership positions in healthcare, they have self-reported knowledge gaps in the fundamentals of the business of medicine. There were significant improvements in satisfaction with their training in the business of medicine and perceived improvements in knowledge of important concepts in the business of medicine after participating in the curriculum (p < 0.001).

CONCLUSION

Radiology trainees have strong interest in the business of radiology and appreciate its importance yet feel inadequately prepared during training. Intentional training incorporated into residency education in the form of an innovative educational initiative that brings radiology trainees together and utilizes an institution's own leaders to teach is feasible and effective.

Tips for leaders, part III: leadership during a time of change

Good leaders anticipate the need for change and manage change well. However, the members of an organization generally oppose major change. There are many risks for the people and the group during a period of significant change. It is important that the leader communicates the reasons for the changes, involves as many people as possible in the process, develops a clear plan for implementation, and communicates well with the followers.

Radiologist report turnaround time: impact of pay-for-performance measures

OBJECTIVE

Expedited finalized radiologist report turnaround times (RTAT) are considered an important quality care metric in medicine. This study was performed to evaluate the impact of a radiologist pay-for-performance (PFP) program on reducing RTAT.

MATERIALS AND METHODS

A radiologist PFP program was used to assess its impact on RTAT for all departmental reports from 11 subspecialty divisions. Study periods were 3 months before (baseline period) and immediately after (immediate period) the introduction of the program and 2 years later after the program had terminated (post period). Three RTAT components were evaluated for individual radiologists and for each radiology division: examination completion (C) to final signature (F), C to preliminary signature (P), and P to F.

RESULTS

Eighty-one radiologists met the inclusion criterion for the study and performed a final signature on 99,959 reports during the baseline period, 104,673 reports during the immediate period, and 91,379 reports during the post period. Mean C-F, C-P, and P-F for all reports decreased significantly from baseline to immediate to post period (p < 0.0001), with the largest effect on the P-F component. Similarly, divisional C-F, C-P, and P-F also significantly decreased (p < 0.0001) for all divisions except the C-F for nuclear and neurovascular radiology from baseline to immediate period and the C-P component from baseline to post period for cardiac radiology.

CONCLUSION

A radiologist PFP program appears to have a marked effect on expediting final report turnaround times, which continues after its termination.