By Sharon Mohammed, RT(R), CT, ARRT
Radiology is an important medical specialty, driven by limitless technological advances. Various imaging modalities are now central to diagnosing and treating various diseases for patients all across the globe. Despite the recent changes in the radiology landscape caused by the COVID-19 pandemic, the demand for imaging services will continue to increase. Moving forward, radiology leaders must develop new approaches and strategies to define the pathway forward.
Economic impact
During the height of the pandemic, many outpatient centers cancelled elective and non-emergent imaging examinations. At one specific tertiary health care institution, there was an 87% reduction in outpatient imaging and specifically a 93% reduction in mammography because of COVID-19. With significant reductions in imaging volume, radiology departments experienced decreasing revenues, causing full salaries for hospital personnel to be at risk. Radiology practice leaders were proactive with practice modifications and financial maneuvers. This put them in a position to emerge from this pandemic in the most viable economic position. Recovery efforts included federal assistance. The Coronavirus Aid, Relief, and Economic Security, or CARES, Act was signed into law on March 27, 2020. Hospitals were targeted to receive $100 billion. Aside from the many federal provisions and stimulus funding, practice leaders worked to minimize the disruption to staffing. However, through a combination of reduced working hours, temporary salary cuts, bonus suspensions, furloughs and explicit freezes on new staff, practice leaders were forced to evaluate overhead expenses and devise these strategies on a semi-permanent basis.
Location and hours of work
In response to social distancing concerns from the pandemic, there was an increase in the installation of home PACS workstations for radiologists to work remotely. Technological advances of PACS, computing power and the Internet further distanced diagnostic radiologists and placed them at the forefront of telemedicine.
As a result, tension and discord grew within in the department. Radiology staff members in higher socioeconomic groups such as staff radiologists were able to stay at home, while lower socioeconomic, patient-facing groups like technologists were not able to do so. This disparity in working environment led to emotional and psychological fears of possibly contracting the virus for hospital personnel who were in direct physical contact with patients.
In response to this, virtual platforms were created to enhance communication between members of the radiology team. Connectivity can be a key element for patient-facing staff to continue to thrive. It can be an antidote for maintaining a department’s culture during this pandemic, no matter what new challenges arise. Remote work technologies such as Zoom and WebEx can be used as pathways to communication, where departmental unity is a driver. Department leaders made sure to actively touch base in regular small group settings. Conscious interaction and engagement through small gatherings was maintained by all members of the imaging team, promoting equitable interactions among all levels of department stakeholders. For patient facing staff to be able to continue to excel at their jobs and perform to their full potential during an extended and stressful period, methods of open communication must be developed. This is critical because when staff members feel as though they know what is happening, they will have more confidence in their leadership and in themselves.
Communicating clearly with all stakeholders and patient facing staff through robust platforms, imaging leaders outlined guidelines to prevent virus spread through human-to-human contact and through imaging equipment and emphasized that every necessary precaution be taken to keep patients and staff safe and protected. Those guidelines included steps to maintain access to critical supplies and PPE. Strategies to clean and decontaminate patient care areas according to CDC guidelines were created. Creating policies for the safe ambulatory imaging of patients with COVID-19 became a priority. Social distancing protocols were implemented in waiting rooms, hallways and work areas. Universal masking of patient facing staff was also implemented. The efficiency of every patient encounter was optimized where imaging protocols were shortened when possible, to minimize the amount of time a patient spent in the radiology department. Patient flow through the imaging suite was streamlined to minimize unneeded contact. A visitor restriction was also put into place. Technologists and all patient facing staff were further educated on safe PPE use and proper hand hygiene.
Inter-professional collaboration and effective communication has allowed radiology leaders to succeed. They have ensured the safety of patients and staff. They have preserved staff morale and well-being and have continued to provide patients with the highest level of care during the height of the pandemic. •
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