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    Although radiologists’ list of responsibilities is more than full, they also are responsible for managing and maintaining relationships with practice stakeholders, said Jason Itri, MD, PhD, of University of Pennsylvania Hospital in Philadelphia, during a session on Dec. 1 at the 97th Scientific Assembly and Annual Meeting of the Radiological Society of North America (RSNA).

    Itri offered a plan for evaluating practice and stakeholder needs and started by defining stakeholders as hospital administration, referring physicians and patients.

    The basics of understanding stakeholder needs are simple and vary little by group. Open communication is critical, said Itri. He suggested radiology practices can use survey instruments with various groups, and explained that practices can focus on various elements of practice operations such as reports, staffing and appointment availability with referring providers. “Be sure to include a free text comment area as referring physicians may give great ideas that you would have never considered.”

    Itri suggested radiology practices consider using Hospital Care Quality Information from the Consumer Perspective (HCAHPS) surveys for inpatients because the surveys are published nationally and tied to reimbursement.

    Outpatient surveys can be found online or developed internally.

    Another group to study is the competition. Itri advised visiting teleradiology providers’ and local competitors’ websites to understand their missions and products, and noted that it’s important to understand national trends as well as the local imaging market.

    Put the practice under the microscope
    A comprehensive practice evaluation is essential. “An honest self-evaluation can be difficult because you are exposing deficiencies in the practice.” Key areas to explore are governance and quality.

    “What differentiates the average practice from the truly fantastic is an effective governance structure based on a group-developed mission and business plan. All members are involved and everyone is engaged in the process,” he said.

    Itri divided radiologists’ approaches to quality into two camps: those who do what they have to do and those who understand the importance of quality and process improvement. “Radiologists and practices who take the lead on quality are creating an incredible competitive advantage for their practices,” said Itri, and, by doing so, aid reimbursement and marketing.

    Quality initiatives can address multiple avenues: access, exam appropriateness, patient safety and more, with multiple tools, including dashboards, safety events and surveys, available as resources.

    In addition to an internal analysis of operations, finances and marketing, Itri suggested practices review socioeconomic trends such as advances in technology and new standards of care as they develop a strategic plan.

    Finally, as the practice crafts its plan, Itri recommended focusing on a few critical issues that have the most impact, rather than attempting to address every challenge. Another important, often overlooked, part of the process is to develop action plans and monitor progress.

    Itri concluded with a few examples of specific strategic suggestions for radiology practices. These included:
    •Optimize group governance;
    •Maintain financial viability of the hospitals; and
    •Integrate into the hospital board.

    Finally, he said to protect exclusivity with a hospital, a radiology practice should demonstrate its performance in terms of quality and cost-effectiveness and back it up with data.

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