By K. Richard Douglas
With nine and a half million people, the Chicagoland area is the third largest metropolitan area in the United States.
Two local acute care hospitals that provide health care services to this population are AMITA Health Mercy Medical Center in Aurora, a 292-bed full-service facility with a Level II Trauma Center, and AMITA Health Saint Joseph Hospital Elgin, which is a full-service 184-bed hospital with a Level II Trauma Center. The hospital recently added a four-story bed tower, containing all private rooms, to better serve patients.
Saint Joseph Hospital also includes the Meadows Regional Cancer Care Center; a 25,000-square-foot, state-of-the-art facility. The cancer center offers 64-slice CT scanning, image-guided radiation therapy (IGRT) and intensity modulated radiation therapy (IMRT).
The technicians and specialists who operate the many imaging systems at these facilities are part of AMITA Health Saint Joseph Hospital Medical Imaging.
“I am the current imaging director for two hospitals who are part of a large health care system – AMITA Health within the Chicago area – which is part of the Ascension Health System. AMITA has over 19 hospitals within the Chicagoland area,” says Laurie Schachtner, Ph.D., MBA, FACHE, CRA, RT(R)(M).
“There are a total of approximately 90 associates that I am directly/indirectly responsible for between the two hospitals at this time,” Schachtner says. “This is comprised mostly of the modality technologists, front desk associates/tech aids and two FTEs of imaging nurses.”
“At both of the hospitals we have: CT, MRI, nuclear medicine, radiology and ultrasound. I am also over the Cancer Center, which includes a linear accelerator and a 4D CT unit for simulation,” Schachtner adds.
Imaging equipment includes five CT, two MR, one LINAC, 10 rad rooms, eight C-arms, five portables and seven ultrasound units.
The staff stays up to date on the operation of equipment and clinical knowledge via training.
“We train our staff via the OEM vendors when we purchase new clinical equipment (or have software upgrades). The clinical staff are also required to maintain their clinical licenses by completing their continual education hours (per their respective licensed accreditation professions). Nuclear medicine is different than radiography – so each modality has specific criteria,” Schachtner says.
The department’s leadership also plays a role in the capital purchase process.
“At the time of capital approval and purchasing; the biomed leader signs-off on the capital request. They are in the loop so they can negotiate for additional training from the vendor and/or decide which kind of service level agreement they will decide to participate in with the OEM,” she says.
She adds that she is directly involved when it comes to negotiating for the equipment itself; although for the service portion, the system’s biomed leader negotiates that portion of the transaction. This way each department’s needs are vetted by the respective leader prior to issuing a purchase order.
Through collaborative work, those in the imaging group work to provide continuous improvements and learning opportunities to their colleagues and staff.
“We have a radiology council – which is led by a system vice president – where all imaging leaders meet (via Skype) monthly to discuss imaging improvements or issues that we are working on together as a system,” Schachtner says.
“There are four various imaging leaders who lead, report and present on four key areas on behalf of radiology for the system: stewardship, patient experience, growth, and quality and safety. This team also includes the medical director radiologist from each hospital as well,” she says.
Schachtner says that they invite various subject matter experts ad hoc in order to provide current information if and when a topic of interest is needed. Some examples she shared are insurance verification, central scheduling and IT.
“This forum fosters important information and processes so we can communicate and improve together as a clinical department within a larger system,” Schachtner explains.
The department has also been proactive in problem solving and helping colleagues throughout the system. Schachtner says that the radiology council has helped identify system opportunities that may have otherwise been considered to be a local issue. One example was a technologist staffing shortage issue. This enabled the group to work at the system level, with corporate human resources, in order to perform a market analysis to investigate the pay range relative to the market.
She shared the best practice ‘Imaging Order Exam Change’ across the system that can be utilized when a patient’s procedure is changed at the time of clinical service. This can happen when tech and patient history inquiry discloses the appropriate procedure needs to be changed – after conferring with the radiologist for approval. An example for a change would be a CT without contrast [pre-approved]; being changed to CT with and without contrast. Once the change has been learned, the CT tech will fill out a form and fax it to Insurance Verification for a “stat approval” — so it will not be denied.
The radiology council also serves as the forum where they standardize contrast products and supplies in order to best leverage standardization and manage costs without compromising on quality.
Away from the workplace, department members continue expanding their knowledge.
“Our imaging department (along with many Chicago imaging departments) are attending the College of Imaging Administrators – which has a local two-day continuing educational event that grants continuing educational credits for the two days of attendance. There are varied imaging topics that are presented. The topics are proposed to the board and approved for presentation. Many imaging leaders meet monthly to plan for this annual event. We work with vendors and imaging leaders for presentations,” Schachtner says.
Patients in the Chicago area who require diagnostic imaging are in experienced hands when they utilize the imaging services at AMITA Health Mercy Medical Center in Aurora or AMITA Health Saint Joseph Hospital Elgin.