Michael Odgren, BS, RPA, RRA, RT(R)(CT), a registered radiologist assistant for Diversified Radiology of Colorado, P.C., a U.S. radiology practice in Lakewood, began his X-ray training two weeks after his high school graduation. “I’ve been in radiology for a long time, even though I’m pretty young,” says Odgren. “I’ve been an RT for 25 years. That’s more than half my lifetime.”
Odgren, who serves as president of the American Society of Radiologic Technologists’ (ASRT) and is a member of the Society’s eight-member board of directors, has witnessed a lot of change in those 25 years. “I remember back in the day when there was always a radiologist available right there,” says Odgren. “Now, with teleradiology and all of these remote reading models that we have, there’s this sort of barrier to the radiologist being able to get to know the RTs. It’s not as easy as the
radiologist getting out of the reading room and going around the corner to speak to the RTs. They might be at another site or even in another state.”
Coming Together in Crisis
Chrystal Barnes, director of imaging services at Emory University Hospital Midtown, has also been a witness to the RT-radiologist disconnect that Odgren describes. “The improvements in technology have definitely created a sort of barrier — the RT and radiologist don’t always understand exactly what the other is doing or what the other’s challenges are,” says Barnes. “I see that type of disconnect as one that leads to the onset of potential errors and not the optimal quality of care patients are looking for and deserve.”
However, Barnes saw this disconnect vanish almost overnight when COVID-19 struck in March. “The pandemic showcased a lot of different players within radiology having to work more closely together,” says Barnes. “COVID-19 is terrible, but one of the positive things it has shown us is the teamwork — from the front-desk staff to the nurses, from the RTs to the radiologists. Everyone has had to work together, and it’s something that probably ought to have happened a long time ago but started happening very suddenly because of the pandemic.”
Odgren agrees. At his practice in Colorado, the radiologists were very involved with the RTs in the discussions about COVID-19 processes and procedures. “There was so much more communication,” says Odgren. “We talked about how we were going to keep our patients and staff safe. Yes, we need to take care of our patients, because that’s why we’re all here, but if the RTs get sick, then who’s going to take the films? As RTs, we’re very much on the front lines. There’s not a patient who comes in with a COVID-19 symptom who doesn’t get at least one chest X-ray.”
Barnes, who saw similar discussions at her institution, notes that during these types of conversations, her radiology department chair was heavily engaged with the RTs and a great relationship developed from it. “The RTs could go to her with their concerns, and then the chair would bring those directly to the top — and she would take it to hospital administration. If there was one positive during COVID-19, it was, and is, the value of teamwork.”
Making a Group Effort
Dan Loch, CEO of Imaging Healthcare Specialists (IHC) — an outpatient imaging provider with centers throughout San Diego — was already working toward teamwork that Odgren and Barnes saw long before COVID-19 struck. Loch, who joined IHS in 2016, immediately began aligning the RTs, radiologists, and the administrative team that support them through the adoption of Lean management — with the goal of improving value, quality, and the patient experience.
“We started by bringing all areas of expertise within the organization — including doctors, clinical staff, support associates, IT, and HR — in weekly working sessions, supplemented with daily progress reporting. We dove into eliminating non-value-added activities throughout the entire value stream,” says Loch. “It was a way for everyone to see how their work affects the patient, and then work together to continuously improve care delivery.”
William C. Snyder, MD, of IHS, adds that when COVID-19 hit, their company was prepared to meet the challenge. “Because we had removed silos in the workplace and already were working together in areas such as quality and safety, it was much easier to quickly create and empower a rapid response infection control team. In a few days, we had a screening matrix of how to handle COVID-19 at our centers, and how that would be communicated to employees, patients, partners, and the referral community.”
COVID-19 is terrible, but one of the positive things it has shown us is the teamwork — from the front-desk staff to the nurses, from the RTs to the radiologists.
Creating Lasting Change
Odgren, Barnes, Snyder, and Loch are confident this type of teamwork will continue long after the pandemic is over and will be vital in solving new challenges as they arise. They believe organizations like the ACR will take a lead in making sure the conversations and collaborations continue for the betterment of patient care.
“This crisis showed us how critical it is to have every aspect of the radiology business working together,” says Loch. “It has only reinforced our commitment to these principles.”
Barnes recommends radiologists partner with clinicians, other medical professionals, and patients to make the transition from a focus on the volume of scans read to the value of care provided — principles already being put into practice through the College’s Imaging 3.0® initiative (learn more at acr.org/Imaging3). “Radiologists need to get out of their reading rooms and walk around or pick up their phones and ask questions of their team members, such as, ‘Are you running into any problems or challenges today? Is there something we can do differently to make your job easier?’” says Barnes. “I think it’s a form of mentorship. It’s finding out how you can help someone else work better.”
Ultimately, says Odgren, it’s all about delivering better patient care. “Chat with your RTs or invite them into your reading rooms,” he urges. “It’s all about providing high- quality care together. That’s why we’re all here. We just want to take care of people.”