We spoke with the imaging director of a health system in a major metropolitan area with an anticipated peak still at least a few weeks away. (We have given this health system the pseudonym Oak Hill). Based on this conversation and other Advisory Board research, here are steps imaging leaders can take to prepare.
4 steps to prepare for a Covid-19 surge
- Leverage mobile units for imaging Covid-19 patients whenever possible. Imaging of Covid-19 patients is challenging, due to the need for extensive use of personal protective equipment (PPE), cleaning, and ventilating of rooms required across transportation and scanning. As volumes grow, these challenges could severely reduce the availability of scanners, staff, and resources. Many imaging departments are turning to utilizing mobile imaging units. Oak Hill plans to limit patient transport by using portable x-ray machines whenever possible.
- Cross-train and prepare technologist staff. The imaging leader at Oak Hill wants to ensure the organization can flex staff when the surge hits. The leader is taking the following steps to maximize flexibility:
- Cross-training technologists on multiple modalities;
- Preparing technologists from outpatient care sites to work in the ED; and
- Training technologists on Covid-19 infection prevention protocols, including use of PPE.
- Communicate with staff about non-traditional work. Covid-19 is an unprecedented pandemic that demands a lot from health care workers. Imaging leaders should:
- Prepare technologists for 24/7 hospital work. Technologists from outpatient care sites are used to working certain, set hours. During the surge, however, imaging leaders might ask them to work in different care sites and for different hours. For instance, imaging leaders at Oak Hill are preparing technologists for working evening, overnight, and weekend shifts in the hospital. Start these conversations with staff sooner rather than later. Be aware that some of your staff will not be able to make these changes, if they are taking care of family members or rely on public transportation. Be sensitive to these challenges. Consider what help your organization might be able to provide to these staff members—including transportation, childcare, laundry, resting space, premium pay, or even housing.
- Donate hospital-based imaging staff time to cover immediate system needs before imaging is strained. In this pre-surge time period, many imaging departments have seen a drastic reduction in volumes. At Oak Hill, the imaging director is using some of this newfound downtime for training. But he also offered to flex staff across the hospital. Currently, imaging staff are helping with PPE distribution and patient intake.
- Collaborate with radiologists to increase reading capacity. To maintain adequate turnaround time (TAT) during the coming surge, radiologists should be prepared to flex into reading ED exams from remote locations. At Oak Hill, the imaging department is working with their radiologists to refurbish and update old workstations for use at home or other remote locations. This preparation will allow for an estimated 5-7% increase in reading capacity during a potential surge. In addition, Oak Hill is temporarily altering its worklist to allow all radiologists to read ED cases.
4 steps to prepare for an eventual flood of rescheduled exams
- Develop plan to increase capacity via extended hours. Most, if not all, markets around the country will have significant pent-up demand for imaging after the Covid-19 outbreak wanes and governors lift social isolation guidelines. Imaging teams should expand their hours to "catch up" on scans. Currently, Oak Hill is planning to open outpatient facilities for an additional two hours on weekdays. They will also open on one weekend day from 9 a.m. to 5 p.m.
- Recapture referrals by advertising new hours. Oak Hill, like other health care systems, cannot take post-Covid-19 referrals for granted. If traditional partners have long wait times, referring providers might shop around to different imaging centers for the sake of timely care. Additionally, patients will not be aware of extended hours. The imaging director at Oak Hill is developing a plan to advertise this additional capacity to patients and referring providers.
- Leverage newly cross-trained technologists to limit staff burnout. Imaging departments with cross-trained technologists will be better prepared to cover additional hours necessary to "catch up on" rescheduled exams. Oak Hill's imaging director expects increased variation in volumes across modalities in the first weeks and months when exams resume. Cross-training will allow Oak Hill to cover these variations without placing an outsized burden on any one set of technologists.
- Maintain radiologists' remote work stations to leverage for continued increase in volumes. Oak Hill is planning to maintain the 5-7% increase in radiologist capacity through the post-surge period. Imaging leaders are not yet sure how long they will need to have this increased capacity in place.
Do you have questions or tips to share with colleagues? Email me at aderholM@advisory.com
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