Many organizations have been giving valuable advice for how radiology leaders should respond to the CT contrast shortage—how they can prioritize cases, use less contrast, or use alternate modalities. But as the industry manages and eventually moves past this shortage, I want to outline three things leaders shouldn't do.
1. Don't stop regular communications with supply chain teams
I'm sure many radiology leaders spoke with their supply chain teams more regularly over the past couple months. But don't let those be temporary relationships. The global supply chain is still reeling from Covid-19 and the war in Ukraine, so this won't be the last shortage of imaging supplies in coming years. I think Dr. Geoffrey Rubin, Chair of Radiology at the University of Arizona, Tucson said it best in a recent RSNA webinar:
"Just because this is happening with contrast this time, [a shortage] might be completely different next time… We would be remiss if we're not asking the question of what's at most risk moving forward, and how we can protect [our resources] in the future."
The current shortage is unique in that it has an estimated end-date of July. But the length and scope of the next shortage, be that semiconductors or cleaning materials, may not. It's therefore important that radiology leaders continue to meet with their supply chain teams to discuss:
- Potential contingency plans and ways to diversify purchasing for all critical supplies.
- What clinicians or supply chain staff are seeing on the ground and hearing from peers, so both parties can prepare for shortages in advance.
- Ways to improve non-critical item purchasing or management to reduce costs.
The same goes for provider-supplier communication. Radiology leaders should use this time to better understand their suppliers' supply chains. Ask questions about their manufacturing contingency plans or their ability to deliver products and manage shortages.
2. Don't underestimate the toll this shortage may take on imaging staff
Staff shortages have reached a critical point—81% of hospitals report rad tech shortages and many report shortages of nurses and support staff too. As a result, burnout among the remaining workforce is rampant as increasing imaging volumes fall to a limited supply of staff.
The CT contrast shortage will only exacerbate this burnout. Ironically though, techs that specialize in other modalities will feel the greatest impact. That's because techs specializing in MRI, ultrasound, or PET must not only manage their own increasing workload, but also scans that their organizations temporarily redistribute from CT. To ensure that this shortage isn't the "straw that breaks the camel's back", radiology leader should take two steps in the short term.
- Involve rad techs in decisions about redistributing work. This will help ensure that all techs feel represented in decision-making and will also give tenured staff professional growth opportunities.
- Formally recognize rad techs' increased workload. Strengthen morale by communicating how important they are to ensuring patient access to care.
3. Don't miss this opportunity to strengthen relationships with referring physicians by helping them understand appropriate imaging.
Health care's push for more appropriate imaging has been years in the making. One of the most visible of these initiatives has been CMS' clinical decision support, which aims to reduce unnecessary imaging. But the definition of "appropriate" imaging use isn't static.
It's ever changing as science advances, health system priorities shift, staffing challenges emerge, and yes, as shortages force leaders to conserve resources. This constant change can be frustrating for referring clinicians who must constantly adapt ordering practices to new guidance and protocols.
As radiology leaders look to build trust with referring clinicians, supporting them in understanding these changes is a great way to show value. Today, this can take the shape of helping them place the right orders given the CT contrast shortage.
Moving forward, this continued support will be critical for any shift in protocol. To improve communication with clinicians, see our research on Advancing Appropriate Use in Imaging. In this report we include tactics to help leaders:
- Communicate changes in routine orders to referring clinicians
- Systematically check imaging orders to ensure they align with appropriate use criteria
- Hardwire appropriate imaging into standard care pathways