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Chapter 6
Radiology
Administration
Copyright © 2012, 2007, 2002, 1997, 1991, 1984, 1979 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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Objectives
1. Provide an overview of the administration of a hospital radiology
department and the structure of hospital organization.
2. Describe how the radiology department fits into and complements
the hospital environment.
3. Understand the role of the radiology administrator.
4. Describe the functions of management, including planning,
organizing and facilitating, staffing, directing, controlling,
coordinating, and project management.
5. Discuss the transition from traditional functions of management to
the requirements of managing radiology in the current health care
environment.
6. Describe regulating agencies that affect radiology.
7. Discuss the characteristics of desirable applicants for employment
in radiology.
Copyright © 2012, 2007, 2002, 1997, 1991, 1984, 1979 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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Hospital Environment
• Hospitals are like “communities within
communities.”
• Hospitals serve a community need.
• Hospitals are staffed by various types of
workers.
Copyright © 2012, 2007, 2002, 1997, 1991, 1984, 1979 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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1
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.
Copyright © 2012, 2007, 2002, 1997, 1991, 1984, 1979 by Saunders, an imprint of Elsevier Inc. All rights reserved.
4
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.
Copyright © 2012, 2007, 2002, 1997, 1991, 1984, 1979 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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Typical Organizational Structure
FIG. 6-1 Organizational chart.
Copyright © 2012, 2007, 2002, 1997, 1991, 1984, 1979 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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2
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
Copyright © 2012, 2007, 2002, 1997, 1991, 1984, 1979 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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Healthcare 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
Copyright © 2012, 2007, 2002, 1997, 1991, 1984, 1979 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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Typical Organizational Designs
Top-Heavy
Vertical Design
FIG. 6-2 Vertical organizational structure.
Copyright © 2012, 2007, 2002, 1997, 1991, 1984, 1979 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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3
Typical Organizational Designs
Downsized
Horizontal Design
FIG. 6-3 Horizontal, or flat, structure.
Copyright © 2012, 2007, 2002, 1997, 1991, 1984, 1979 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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FIG. 6-4 Matrix structure.
Copyright © 2012, 2007, 2002, 1997, 1991, 1984, 1979 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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Radiology Organization
•
•
•
•
Varies depending on size and scope
Often consists of subdepartments
Requires support services
Led by Administrative Director
Copyright © 2012, 2007, 2002, 1997, 1991, 1984, 1979 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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4
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
Copyright © 2012, 2007, 2002, 1997, 1991, 1984, 1979 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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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
Copyright © 2012, 2007, 2002, 1997, 1991, 1984, 1979 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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Changing Healthcare Trends Have Created
Nontraditional Healthcare 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
• Physician’s Offices
• Research Centers
• Veterinary Medicine
• Teleradiology Services
Copyright © 2012, 2007, 2002, 1997, 1991, 1984, 1979 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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5
Management Functions
• Primary functions
• Communication skills are very important
• A Key Management Trait includes
leadership skills and “coaching” staff
Copyright © 2012, 2007, 2002, 1997, 1991, 1984, 1979 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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Process Improvement
• Current trends emphasize the
improvement of services as an ongoing
process.
– Referred to by different names
• Continuous Quality Improvement (CQI)
• Total Quality Management (TQM)
• Customer service is the focus!
Doing the right things right the first time, and meeting and exceeding the
customer’s expectations
Copyright © 2012, 2007, 2002, 1997, 1991, 1984, 1979 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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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
Copyright © 2012, 2007, 2002, 1997, 1991, 1984, 1979 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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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
Copyright © 2012, 2007, 2002, 1997, 1991, 1984, 1979 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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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
Copyright © 2012, 2007, 2002, 1997, 1991, 1984, 1979 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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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
Copyright © 2012, 2007, 2002, 1997, 1991, 1984, 1979 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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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.
Copyright © 2012, 2007, 2002, 1997, 1991, 1984, 1979 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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