Overall Management Of 15 Beded General Hospital's Radiology Department

Overall Management of Radiology Department Thakur Lamsal© ………………………………………………………………………………………………………………………………………………………………………………………………………………………… ……………………………... •

Bone Densitometry

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CT/CAT Scan

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Mammogram

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MRI

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Nuclear Medicine

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PET Scans

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Ultrasound

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Vascular/Interventional

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X-Ray

Introduction Radiology is the branch of science dealing with use of x-rays, radioactive substances, and other forms of radiant energy in diagnosis and treatment of disease. Among the all major five Department of Hospital, Radiology is the most expensive department of the hospital. Radiography and fluoroscopy constitute almost 90 percent of the work load in the average hospital. The main aim is to provide prompt and accurate examination and treating in pleasant surroundings. The major function of this department is assisting the physicians in the diagnosis and treatment of patient’s diseases through the use of radiotherapy, fluoroscopy, radioisotopes and high voltage acceleration etc. Thus primarily this department should aware about providing adequate quality radiological services to the patients. Secondarily Radiology departments should engage in essential research for medical advancement and participate in educational program for hospital residents. Organization and Staffing The Radiology department varies according to sizes of Hospital. Basically the organizational hierarchy and work flow of this department is as follows. . The Human Resource management defined is planning, organizing, leading and controlling of the 4Mresources (Man, Money, Machine, Materials) of an organizations. Management is an art as well as science so human resources require both skills in radiology department. The basic human resources management in radiology department involves in depth human resources planning, organization and management, staff leadership and motivation, compensation management, performance management. Typically one radiologist is necessary for every 25 patients per day, 3-4 technicians required for a load of 30-35 patients per a day, and at least 2 clerks/Secretaries required per 30 patients to interviews patients, make appointments, type and maintain accurate reports. Information System

A radiology information system (RIS) is a computerized database used by radiology departments to store, manipulate and distribute patient radiological data and imagery. The system generally consists of patient tracking and scheduling, result reporting and image tracking capabilities. RIS complements HIS (Hospital Information Systems) and are critical to efficient workflow to radiology practices. The radiology information system somewhere may be paper based which is time consuming, Policies Radiology services are to be available for patients an hourly and daily basis. The radiologist will have definite hours of attendance in the department, ample to permit examination, interpretation, treatment and medical consultation. All reports are to be signed by the radiologist. Films are the property of hospital as well as patients which should be accurately recorded including a registry and diagnostic index. Protection Radiological protection is the science of protecting people and the environment from the harmful effects of ionizing radiation, which includes both particle radiation and high energy electromagnetic radiation. Radiation exposure can be managed by a combination of these factors: Time: Reducing the time of an exposure reduces the effective dose proportionally. Distance: Increasing distance reduces dose due to the inverse square law. Shielding: Adding shielding can also reduce radiation doses. Amount: Reduce the quantity of radioactive material for a practice. ALARP is an acronym for an important principle in exposure to radiation and other occupational health risks and stands for "As Low As Reasonably Practical". So occupational Health Safety should maintain through education, training and management within the organization with benefits of staffs, patients and population. Similarly, the Radiology departments should be in ground floor. The staffs should regularly test such as blood counts, HB, TC.DC etc. Use of dosimeter as handed for the personnel monitoring. Use of leads aprons e.g. 100 mA machine requires 1mm of equivalent thickness lead aprons according to the basic standard of protection rules. If possible there should be provision of measuring the tolerance dose. The normal tolerance dose is 0-3 rads/week. Basically the thickness of room should be 9” concrete walls, or 14” brick masonry walls. The chest stand should be positioned in front of the walls. X-ray rooms should be lead coated and radiation leakage proof. Similarly in the electrical protection should be considered as low moisture, shock proof room should be selected for operational activities. Total quality management Quality improvement is developed locally in response to the needs of the organization or department. Quality improvement or continuous quality improvement (CQI) is a process that focuses on the processes of delivery of care and continuous improvement of performance indicators in radiology. These programs are part of total quality management (TQM), which is an approach that seeks to continuously improve every Service that is provided and is an umbrella that covers all kinds of quality activities. It involves the concept of improving quality, rather than assuring it. There are five main factors that determine customer satisfaction with radiology services: Reliability, Responsiveness, Assurance, Empathy, Tangibles. Similarly

economical analysis of the radiology services is done because the radiology departments should be considered as ‘High Reliability Organizations’ since they are characterized ‘high tech’ and must be able to maintain reliability, while they implement continuously new technologies. The economic analysis tools for evaluating current radiological services are Cost-Benefit Analysis (CBA), CostEffectiveness Analysis (CEA) and Cost-Utilization Analysis (CUA). Equipment Repair and Maintenance X-ray equipment is complex and expensive. Although minor maintenance can be done by hospital staff, routine servicing and repairs after breakdown can be require trained personnel, nevertheless, a regular routine of cleaning and checking will help to maintain efficiency and often provide early warning of developing faults. Thus daily, Weekly, monthly, six-month, Annual Maintenance Check-Up (AMC) schedule are done according to hospital repair and maintenance manual. References: i.Bachchu Kailash Kaini, Principles of Hospital Management. http://www.auntminnie.com http://en.wikipedia.org www.rtstudent.com .................................................................................. .................................................................................. .................................................................................. . ©Mr.Thakur Lamsal is 6th semester student of Healthcare Management at National Open College. He is radiographer too and engaged in at www.MediBizNepal.Com.Correspondence to him: [email protected] ,http://managinghospital.wordpress.com