Organization and Operation of the Radiology Department
On completion of this chapter, you should be able to:
• Describe the role of the hospital administrator.
• Describe the role of the radiology administrator.
• Describe the role and function of the policy and procedures manual.
• Construct a radiology organizational chart.
• Describe how requests for radiology services are made and received.
• List essential procedures and policy items included in the procedures manual.
• Describe the rationale for in-service education programs.
• Describe the rationale for a quality assurance program.
• Explain the role of The Joint Commission.
• List the factors that determine the selection of radiology equipment.
The characteristics of a radiology department are determined by the roles and functions of the hospital and the needs of the community it serves. If these facilities are part of a large teaching institution, some departments may have teaching and research in addition to patient care responsibilities. In smaller hospitals, the radiology department may be involved only in patient care.
Although no typical or average radiology department exists, certain characteristics are common to most departments. The organization of a radiology department affects its internal structure and the disposition and management of personnel and fiscal resources. Management goals are to arrange employees into working groups according to their work functions. Administration directs the efforts and skills of employees toward reaching departmental objectives in a cohesive and satisfying fashion.
Specialized areas within a radiology department may include diagnostic radiology, nuclear medicine, and sonography. Large departments may have sections devoted to radiation oncology, radiation biology, and radiation physics.
This chapter is devoted almost exclusively to the diagnostic radiology department because it is the largest and is usually the first clinical affiliation for the student. Currently, the sections of radiology departments that are devoted to diagnostic services only are often called imaging departments, departments of imaging, or diagnostic radiology departments.
Administration and staff responsibilities
The hospital administrator and the medical staff are responsible for the operation of the hospital. The administrator is responsible for planning, developing, and maintaining programs that implement the policies and achieve the goals established by the governing body. This person organizes the administrative functions of the hospital, delegates duties, establishes formal meetings with personnel, and provides the hospital with administrative direction.
The physician director and the radiology manager staff have the following responsibilities:
1. Participation in medical staff activities as required
2. Establishment of an effective working relationship with the medical staff, the administration, and other departments and services
3. Development and approval of all policies and procedures for the radiology department
4. Verification of the qualifications and capabilities of all radiology staff technical personnel
5. Development of comprehensive safety rules in cooperation with the hospital safety committee
6. Review and evaluation of the quality and appropriateness of radiologic services
7. Advisement of the medical staff and administration of equipment needs, modification, and utilization
Chapters 23 and 24 provide the American Society of Radiologic Technologists (ASRT) position description, which is a term that is synonymous with “job description” but that encompasses a broader scope of activities. Notably, however, this terminology is not standardized and may vary from institution to institution. A position description similar to the ones listed here may carry a different title and may occupy a different place on an organizational chart.
Radiology Staff Activities
The ultimate objective of the diagnostic radiology department is to aid physicians in their efforts to diagnose and treat disease by providing them with timely and reliable information obtained from radiographic examinations using the least amount of radiation necessary for conducting the radiographic examination. To ensure the reliability of this diagnostic information, careful attention must be given to the performance of every examination, beginning when the examination is ordered and continuing until the examination results have been returned to the requesting physician. This relentless attention must come from all members of the radiology staff. Diagnostic radiology services should be conveniently available to meet the needs of the patient and should be directed by one or more qualified radiologists and a sufficient number of qualified technical personnel.
Effective Working Relationships
Because patient care is the primary concern of any hospital department and effective patient care depends on cooperation between all of the hospital departments, the radiology department must have an effective working relationship with the medical staff, the administration, and other hospital departments and services.
Being familiar with the procedures of the admissions and medical records departments is also important for members of the radiology department so that the process of patient care runs as smoothly as possible. The radiology staff must interact with the personnel department, which is largely responsible for recruiting personnel and maintaining personnel records. Radiology services are often a substantial part of the patient’s hospital expense; therefore department personnel need to be familiar with business services, which is the department that monitors billing procedures.
Policies and Procedures
Developing and approving all radiology department policies and procedures is the responsibility of the radiology administrator. When this responsibility is executed thoroughly, the radiology department should function in a smooth and organized manner.
Flowcharts and Organizational Charts
Organizational charts and departmental flowcharts establish clear lines of authority, responsibility, and accountability to provide proper spans of control, create appropriate independence of operations, and define administrative record-keeping responsibilities (Figs. 15-1 and 15-2). A plan for internal control should be implemented. This plan establishes the methods and procedures necessary to safeguard assets, monitor the accuracy and reliability of accounting data, promote managerial efficiency, and encourage adherence to managerial policy.
FIGURE 15-1 Radiology department flowchart.
Full access? Get Clinical Tree
