Fostering Organizational Excellence through Inclusive Leadership: Practical Guide for Radiology Leaders.

Inclusive leadership styles value team members, invite diverse perspectives, and recognize and support the contributions of employees. The authors provide guidance to radiology leaders interested in developing inclusive leadership skills and competencies to improve workforce recruitment and retention and unlock the potential of a rapidly diversifying health care workforce. As health care organizations look to attract the best and brightest talent, they will be increasingly recruiting millennial and Generation Z employees, who belong to the most diverse generations in American history. Additionally, radiology departments currently face critical workforce shortages in radiologists, radiology technicians, staff, and advanced practice providers. In the context of these shortages, the costs of employee turnover have emphasized the need for radiology leaders to develop leadership behaviors that promote recruitment and retention. Radiology department leaders who perceive and treat valued employees as replaceable commodities will be forced to deal with the extremely high costs associated with recruitment and training, decreased morale, and increased burnout. The authors review inclusive versus exclusive leadership styles, describe key attributes and skills of inclusive leaders, provide radiology leaders with concrete methods to make their organizations more inclusive, and outline key steps in change management. By adopting and implementing inclusive leadership strategies, radiology groups can position themselves to succeed in rapidly diversifying health care environments. ©RSNA, 2024 See the invited commentary by Siewert in this issue.

Coaching in a Radiology department.

Coaching is an effective tool that seeks personal reflection as a way for people to find their own solutions. In this article we show our results when applying it in our Radiology Service. The article includes a bibliographic review on its potential applications in Medicine and in Radiology. We specifically reviewed the fields of improving self-care and preventing burnout as well as the teaching field, both for residents in training and for certified radiologists.

[A Survey of the Current Status and the Needs of Medical Imaging Technicians in China]. / ä¸­å›½åŒ»å­¦å½±åƒæŠ€æœ¯ä»Žä¸šäººå‘˜çŽ°çŠ¶å’Œéœ€æ±‚è°ƒæŸ¥ç ”ç©¶.

Objective: To investigate the status quo and the needs of medical imaging technicians (MITs) in the radiology department of secondary and tertiary hospitals in China, so as to provide references and support for the development of the medical imaging technology industry and the relevant policymaking by health administrative departments. Methods: The questionnaire was developed by the Chinese Society of Imaging Technology. The radiology department of each hospital involved in the survey recommended one MIT to fill out the online questionnaire. The contents included: (a) the basic information of the hospital; (b) a general overview of the MITs in the hospital; (c) daily work; (d) career development and promotion; (e) research status and needs, etc. Differences in the number of MIT staff were compared using the Mann-Whitney U test and the chi-square test was used to compare the differences in the selected numbers of MITs in need between regions or between different levels of hospitals. Results: In this investigation, valid questionnaires were finally obtained from a total of 5403 hospitals in 31 provinces in China. The total number of MITs of the hospitals covered in the sample was 67481. The number of MITs in each hospital was 9 (5, 16). The male-to-female ratio was 1.41:1. MITs who were 20 to 40 years old accounted for 78%. The proportions of MITs who had completed doctorate, master's, undergraduate, junior college, and technical secondary school or lower level education were 0.6%, 3.3%, 60.7%, 30.8%, and 4.55%, respectively. The proportions of chief MITs, deputy chief MITs, supervisor MITs, primary MITs, assistant technician and those below were 1.0%, 4.21%, 22.1%, 51.8%, and 20.9%, respectively. The overall professional satisfaction of MITs was good. "Lack of opportunities for learning and communication" was quoted as the main problem MITs encountered in regard to improving their job-related competency. 59.2% of the respondents had not published any academic papers in the past five years, and only 7.0% of the respondents had published in journals included in the Science Citation Index (SCI) in the past five years. Conclusion: MITs in China are on average relatively young and the number of MITs has greatly increased. At this stage, more attention should be given to the cultivation of talents and continuing education of MITs and the construction of the discipline should be further strengthened, so as to provide strong support for the development of the medical imaging technology industry in China.

Organizational Health Literacy as a supportive tool for the effective implementation of the 2013/59/EURATOM Directive in Italy.

INTRODUCTION: Since 2013, European countries have transposed the 2013/59/EURATOM Directive that lays down basic safety standards for protection against dangers arising from exposure to ionising radiation. In the years between the issuance of the European Directive and its formal transposition, Italian researchers investigated solutions to renew the technological, educational, and organizational culture in radiology departments. SCOPE: This article proposed a reflection on the contribution of Organizational Health Literacy (OHL) to implement Legislative Decree 101/2020 in the practice of Italian radiology departments. RESULTS: By implementing OHL principles, examinations with exposure to ionizing radiation and related informative processes could be personalized based on patients' knowledge, abilities, and competencies, as well as on the services' provision. These principles can be in fact integrated with the organizational, training, and management requirements set by the Directive. CONCLUSIONS: According with the state-of-the-art, decision-makers and health managers could support the application of OHL principles in Italian radiology departments.

Medical students within the Radiology Departments: Drawback or opportunity?

University Radiology training has been carried out for years out of the Radiology Departments, where radiologists play their professional role. However, the educational needs and the leadership of the Scientific Societies make the Radiology Departments to be involved more and more in that training, though it has to be done in overloaded professional environments where medical students can be seen as a drawback. Nevertheless, radiologists must play an important role in the Radiology training of the future doctors for optimising the use of diagnostic imaging techniques and enhance the future of the specialty by bringing to our Departments those medical students who had demonstrated the most adequate personal profiles. The Radiology Department is that place to succeed by increasing the healthcare outcomes, the research results and the visibility of Radiology through a fruitful interaction between radiologists and medical students.

Artificial intelligence solution to accelerate the acquisition of MRI images: Impact on the therapeutic care in oncology in radiology and radiotherapy departments.

PURPOSE: MRI is essential in the management of brain tumours. However, long waiting times reduce patient accessibility. Reducing acquisition time could improve access but at the cost of spatial resolution and diagnostic quality. A commercially available artificial intelligence (AI) solution, SubtleMR™, can increase the resolution of acquired images. The objective of this prospective study was to evaluate the impact of this algorithm that halves the acquisition time on the detectability of brain lesions in radiology and radiotherapy. MATERIAL AND METHODS: The T1/T2 MRI of 33 patients with brain metastases or meningiomas were analysed. Images acquired quickly have a matrix divided by two which halves the acquisition time. The visual quality and lesion detectability of the AI images were evaluated by radiologists and radiation oncologist as well as pixel intensity and lesions size. RESULTS: The subjective quality of the image is lower for the AI images compared to the reference images. However, the analysis of lesion detectability shows a specificity of 1 and a sensitivity of 0.92 and 0.77 for radiology and radiotherapy respectively. Undetected lesions on the IA image are lesions with a diameter less than 4mm and statistically low average gadolinium-enhancement contrast. CONCLUSION: It is possible to reduce MRI acquisition times by half using the commercial algorithm to restore the characteristics of the image and obtain good specificity and sensitivity for lesions with a diameter greater than 4mm.

Footprints in the scan: reducing the carbon footprint of diagnostic tools in urology.

PURPOSE OF REVIEW: There is an ever-growing focus on climate change and its impact on our society. With healthcare contributing a sizeable proportion of carbon emissions, the sector has a duty to address its environmental impact. We highlight the recent progress, current challenges, and future prospects for reducing the carbon footprint in diagnostic urology, specifically for imaging, without compromising patient care. RECENT FINDINGS: The review is separated into four key areas of recent research: the design of a green radiology department, considering both infrastructural as well as behavioural changes that promote sustainability; individual scanners, where we provide an update on recent technological advancements and changes in behaviour that may enhance sustainable use; responsible resource allocation, where it is important to derive the maximal benefit for patients through the smallest use of resources; the recent research regarding single versus reusable urologic endoscopes as a case example. SUMMARY: We offer an overview of the present sustainability landscape in diagnostic urology with the aim of encouraging additional research in areas where existing practices may be challenged. To protect the environment, attention is drawn to both more simple steps that can be taken as well as some more complex and expensive ones.

Positive Leadership within Breast Imaging: Impact on Burnout, Intent to Leave, and Engagement.

Background High rates of provider burnout and turnover, as well as staffing shortages, are creating crises within radiology departments. Identifying ways to support health care workers, such as the Positively Energizing Leadership program, is important during these ongoing crises. Purpose To identify the relationship between leadership behaviors and workplace climate and health care worker outcomes (ie, burnout, intent to leave, and engagement) and to determine whether the positive leadership program could improve workplace climate and health care worker outcomes. Materials and Methods This prospective study involved two parts. First, a web-based survey was administered to faculty and staff in a breast imaging unit of a large academic medical center in February 2021 to identify relationships between leadership behaviors and workplace climate and health care worker outcomes. Second, a web-based survey was administered in February 2023, following the implementation of a positive leadership program, to determine improvement in engagement and reduction of burnout and intent to leave since 2021. Multiple regression, the Sobel test, Pearson correlation, and the t test were used, with a conservative significance level of P < .001. Results The sample consisted of 88 respondents (response rate, 95%) in 2021 and 85 respondents (response rate, 92%) in 2023. Leadership communication was associated with a positive workplace climate (ß = 0.76, P < .001) and a positive workplace climate was associated with improved engagement (ß = 0.53, P < .001), reduction in burnout (ß = -0.42, P < .001), and reduction in intent to leave (ß = -0.49, P < .001). Following a 2-year positive leadership program, improved perceptions were observed for leadership communication (pretest mean, 4.59 ± 1.51 [SD]; posttest mean, 5.80 ± 1.01; t = 5.97, P < .001), workplace climate (pretest mean, 5.09 ± 1.43; posttest mean, 5.77 ± 1.11; t = 3.35, P < .001), and engagement (pretest mean, 5.27 ± 1.20, posttest mean, 5.68 ± 0.96; t = 2.50, P < .01), with a reduction in burnout (pretest mean, 2.69 ± 0.94; posttest mean, 2.18 ± 0.74; t = 3.50, P < .001) and intent to leave (pretest mean, 3.12 ± 2.23; posttest mean, 2.56 ± 1.84; t = 1.78, P < .05). Conclusion After implementation of a positive leadership program in a radiology department breast imaging unit, burnout and intention to leave decreased among health care workers, while engagement increased. © RSNA, 2024 See also the editorial by Thrall in this issue.

'You make the call': Improving radiology staff scheduling with AI-generated self-rostering in a medical imaging department.

INTRODUCTION: New Zealand's shortage of medical imaging technicians has intensified due to factors like illness, the pandemic, and an ageing workforce. Addressing staff retention issues requires attention to intrinsic factors like workplace satisfaction and work-life balance. Self-rostering has proven effective in healthcare by enhancing work-life balance, job satisfaction, and retention, but it has not been implemented widely in radiology. This study aimed to explore the perceptions, benefits, and challenges of implementing AI-generated self-rostering in a radiology department through simulated trials. METHODS: This study simulated an AI-generated roster in a regional New Zealand radiology department, engaging 23 staff members. A mixed-methods approach included surveys and discussion groups. Community-based participatory action methodology guided discussion groups and informed modifications. RESULTS: The AI-generated self-rostering method demonstrated success by meeting a high percentage of shift preferences while fulfilling service demands. Participants perceived potential benefits in work-life balance and autonomy, though uncertainties persisted regarding implementation and fairness. Despite staff reservations, we found that an AI-generated self-rostering system may be fairer than manual self-rostering, while saving radiology staff time and cost. CONCLUSION: AI-generated self-rostering offers an innovative solution to an old problem. This self-rostering system provides a fair way for staff to have a say in the shifts they do, which increases feelings of work-life balance and autonomy. In this simulation, AI-generated self-rostering was well received, and most staff were receptive to moving to pilot the programme. IMPLICATIONS FOR PRACTICE: Self-rostering could be a potential solution to staff retention issues in radiology; we recommend a pilot study is implemented. When switching to self-rostering, departments should consider implementing one-on-one support systems to assist staff with entering preferences. Education is essential to encourage staff understanding and cooperation.

Reporting radiographers in Norway - A qualitative study on implementation, organisation, and outcomes.

INTRODUCTION: Worldwide, there is an increasing use of imaging services and a shortage of radiologists. One potential solution to this challenge involves introducing task shifting, where radiographers actively contribute to reporting diagnostic images alongside radiologists. This study explored the purpose and value of reporting radiographers in Norway's imaging departments. METHODS: This study used a qualitative design with a descriptive approach. Semi-structured interviews were conducted with eleven participants, comprising managers, radiologists, and reporting radiographers, from four hospital trusts in south Norway. The collected data were analysed using inductive content analysis. RESULTS: The analysis generated three main categories: "Organisation," "Barriers and facilitators," and "Experienced outcome." The study showed that successfully implementing reporting radiographers required careful planning and preparation due to radiologists' resistance. The radiologists and managers experienced that reporting radiographers contributed to increased service quality and better training of radiographers and resident physicians. Reporting radiographers found the combination of reporting and diagnostic radiography tasks rewarding and challenging simultaneously. CONCLUSION: The implementation of reporting radiographers in imaging departments in Norway was described as successful, positively impacting service quality, reporting capacity, and quality development. However, preparation and planning are needed to overcome barriers to task-shifting. IMPLICATIONS FOR PRACTICE: This study shows that with management involvement and careful planning, reporting radiographers contribute to a high-quality imaging service.

Design of overnight radiology shifts - primum non nocere.

Overnight radiology (ONR) is necessary for providing timely patient care but poses unique professional and personal challenges to the radiologists. Maintaining a sustainable, long-term overnight radiology program hinges on the retention of radiologists who grasp the institutional workflow and can adeptly navigate inherent disruptions while consistently delivering high-quality patient care. Design of radiology shifts can significantly impact the performance and well-being of radiologists, with downstream implications for patient care and risk management. We provide a narrative review of literature to make recommendations for optimally designing ONR shifts, with a focus on professional and personal challenges pertinent to overnight radiologists and system-based risk mitigation strategies.

[Nationwide Questionnaire Survey on Disaster Power Outage Countermeasures in the Radiology Departments of Hospitals].

PURPOSE: To identify the countermeasures and current status of disaster power outages in the radiology departments of hospitals. METHODS: A web-based questionnaire survey of 600 hospitals nationwide was conducted. The questionnaire survey covered 34 items, including availability of power in the radiology department in the event of a disaster and the impact of power outages on medical equipment in the radiology department. RESULTS: In all, 242 facilities (40.3%) responded to our survey. During power outages, 55.8%-68.2% of facilities were able to use CT, digital radiography, and angiography systems with their private generators. In 28.1%-40.7% of facilities, medical information systems were not available in all laboratories. In addition, power outages caused equipment malfunctions in 81.4% of facilities' radiology departments. CONCLUSION: We have identified the power supplied by private generators to the radiology department's medical equipment and medical information systems. Many medical equipment have malfunctioned due to power outages. Therefore, drills should be conducted to simulate various situations caused by power outages.

Planetary Health and Radiology: Why We Should Care and What We Can Do.

Climate change adversely affects the well-being of humans and the entire planet. A planetary health framework recognizes that sustaining a healthy planet is essential to achieving individual, community, and global health. Radiology contributes to the climate crisis by generating greenhouse gas (GHG) emissions during the production and use of medical imaging equipment and supplies. To promote planetary health, strategies that mitigate and adapt to climate change in radiology are needed. Mitigation strategies to reduce GHG emissions include switching to renewable energy sources, refurbishing rather than replacing imaging scanners, and powering down unused scanners. Radiology departments must also build resiliency to the now unavoidable impacts of the climate crisis. Adaptation strategies include education, upgrading building infrastructure, and developing departmental sustainability dashboards to track progress in achieving sustainability goals. Shifting practices to catalyze these necessary changes in radiology requires a coordinated approach. This includes partnering with key stakeholders, providing effective communication, and prioritizing high-impact interventions. This article reviews the intersection of planetary health and radiology. Its goals are to emphasize why we should care about sustainability, showcase actions we can take to mitigate our impact, and prepare us to adapt to the effects of climate change. © RSNA, 2024 Supplemental material is available for this article. See also the article by Ibrahim et al in this issue. See also the article by Lenkinski and Rofsky in this issue.

Integrating human factors engineering into your pediatric radiology practice.

Human factors engineering involves the study and development of methods aimed at enhancing performance, improving safety, and optimizing user satisfaction. The focus of human factors engineering encompasses the design of work environments and an understanding of human mental processes to prevent errors. In this review, we summarize the history, applications, and impacts of human factors engineering on the healthcare field. To illustrate these applications and impacts, we provide several examples of how successful integration of a human factors engineer in our pediatric radiology department has positively impacted various projects. The successful integration of human factors engineering expertise has contributed to projects including improving response times for portable radiography requests, deploying COVID-19 response resources, informing the redesign of scheduling workflows, and implementation of a virtual ergonomics program for remote workers. In sum, the integration of human factors engineering insight into our department has resulted in tangible benefits and has also positioned us as proactive contributors to broader hospital-wide improvements.

Academic radiology department subspeciality organization & fellowship offerings: A hodgepodge.

INTRODUCTION: As opportunities for radiologists to subspecialize have increased, many avenues to organize Radiology department subspecialties exist. This study seeks to determine how academic U.S. Radiology departments structure themselves with respect to subspecialty divisions/sections, as there are no current standards for how Radiology departments are subdivided. Additionally, the extent of Radiology fellowships offered are assessed. The websites of academic U.S. Radiology departments, a highly influential source of information, were analyzed to perform this study. MATERIALS & METHODS: Radiology department websites of all allopathic U.S. medical schools (n = 148) were assessed for the following: presence/absence of Radiology department subdivisions, division/section labels, number of divisions/sections, division/section titles, presence/absence of Radiology fellowships, number of fellowships, and fellowships titles. RESULTS: 114/148 (77 %) medical schools had Radiology department websites. According to their respective websites, 66/114 (58 %) academic Radiology departments had subspecialty divisions/sections, whereas 48/114 (42 %) had no divisions/sections listed. Of the departments that had divisions/sections, the median number of divisions/sections per department was nine, and ranged from two to 14. Fellowships were offered at 82/114 (72 %) academic Radiology departments that had websites, and the median number was six, ranging from one to 13. CONCLUSION: There is marked heterogeneity of departmental organization across Radiology departments nationwide, likely due to the lack of current standards for how Radiology departments are subdivided into divisions/sections. Of the 77 % of medical schools that have Radiology department websites, only 58 % of departments listed divisions/sections, and 72 % posted fellowship offerings.

The mobile X-ray service and hip fractures: The impact of the mobile X-ray service on the hip fast track.

INTRODUCTION: Hip fracture is a serious affliction that requires fast care and an X-ray examination, which are provided by an ambulance and a visit to the radiology department, respectively. If a well-functioning mobile X-ray service could be developed, by examining the patient in their own home, both the work strain of hospital workers and patient suffering could be reduced. The purpose of this study was to determine if the mobile X-ray service could be a supplement to the fast-track process that is utilised by the ambulance service. The study also examines other department's opinion of this implementation. METHODS: A mixed method was used where data from a Swedish hospital's local RIS/PACS was collected from 706 patients for quantitative analysis, and six personnel working at the hospital were interviewed to obtain qualitative data. RESULTS: The quantitative data demonstrates that the actual mobile X-ray service cannot act in such an acute manner as an ambulance service due to the staffing problems that the hospital is faced with, but with optimal staffing, radiographs with mobile X-ray service could be performed within an acute timeframe. The qualitative data shows that there is a strong wish for the mobile X-ray service to expand and be more active, but this requires a better staffing situation in the radiology department and better communication possibilities between other departments. CONCLUSION: The mobile X-ray service is desirable in the investigated region, and it could benefit both the emergency ward and the ambulance service, and it could function as infection control for geriatric patients, but more radiographers on staff is required if the service should be functional as a complement to the hip-"fast track". More studies on the subject are required. IMPLICATION FOR PRACTICE: A wide generalisation of the results is not applicable in this study, as mobile X-ray and the "hip fast track" is not a widespread service throughout Sweden. This means that this study only suggests trends, which needs to be studied further.

State of Academic Radiology: Current Challenges, Future Adaptations.

There are approximately 200 academic radiology departments in the United States. While academic medical centers vary widely depending on their size, complexity, medical school affiliation, research portfolio, and geographic location, they are united by their 3 core missions: patient care, education and training, and scholarship. Despite inherent differences, the current challenges faced by all academic radiology departments have common threads; potential solutions and future adaptations will need to be tailored and individualized-one size will not fit all. In this article, we provide an overview based on our experiences at 4 academic centers across the United States, from relatively small to very large size, and discuss creative and innovative ways to adapt, including community expansion, hybrid models of faculty in-person vs teleradiology (traditional vs non-traditional schedule), work-life integration, recruitment and retention, mentorship, among others.

Radiographers' perceptions of the experiences of patients with dementia attending the radiology department.

BACKGROUND: Patients with dementia frequently present to the Radiology Department. However, stigmas have been recorded amongst radiographers surrounding imaging persons with dementia (PwD). This study aimed to investigate the impact of PwD attending the Radiology Department for imaging and the resultant effects to all patients, radiographers, and the Department from the perspectives of the examining radiographer. METHODS: A paper-based questionnaire of radiographers' perceptions and experiences of individual examinations 'termed an interaction form' was created and made available in a public hospital in Ireland for a period of eight weeks. Radiographers completed the interaction form collecting data regarding individual imaging examinations of PwD. The form comprised sixteen closed and one open-ended question on the radiographers' individual perspectives of PwDs' abilities and distress levels, carers and comforters and their role in the examination, what the radiographer found helpful in the interaction, and any adverse events. Data were analysed using a combination of descriptive analysis and thematic content analysis. RESULTS: Thirty-three interaction forms were completed by the participating radiographers. The modality most commonly represented in the survey was general X-ray (58%). Radiographers reported 84% of examinations for PwD required extra time, with 27% of examinations required repeat imaging and 69% of patients appeared distressed. A carer helped facilitate the completion of 77% of examinations. Qualitative data indicated that distractive and communicative techniques were used by radiographers to make the patient feel more comfortable and help with examination success. CONCLUSION: PwD often require more time for radiological examinations, they often need repeat imaging and re-scheduling of an examination at a more appropriate time. These factors need to be considered when scheduling and performing radiological examinations. Patient distress was frequently encountered, this area may benefit from further research and dedicated practitioner training which could help drive improvements in patient experience.