• Team Approach Builds Diagnostic Imaging Volume

    Darrell Pile Jul 18, 2013

    Two hospitals revived a declining diagnostic imaging business with a team approach that improved services for patients and encouraged referrals from physicians’ offices.


    At two Houston-area hospitals, we recaptured patient volume in our diagnostic imaging departments that was migrating to corporate- and physician-owned competitors. In addition to reviving the imaging volumes, we exceeded budgets in that department by more than 10 percent throughout multiple financial reporting quarters.

    In my role as an administrator focused on business development at a freestanding community hospital and a for-profit hospital (that was part of a large national chain), I led teams using similar strategies to successfully increase patient volume in the hospitals’ imaging departments.

    First, I worked with the hospitals’ leadership to determine reasons for the decline in our imaging patient volume. We concluded that faster scheduling and more efficient handling of new patients at corporate-owned and physician-owned imaging facilities in the area was drawing patients away from our imaging services.

    Initially, some team leaders recommended buying new software to improve the patient scheduling challenges. However, covering the costs of the software was a concern. We were not certain if the loss in volume resulted from a need for new technology or from permanent changes in healthcare delivery trends that would continue in the future regardless of a software investment. We needed an alternative strategy. We decided to examine our processes and identify areas for improvement that could boost volume at little to no cost. Without taking on additional expenses, projected growth in patient volume would go directly to the hospitals’ bottom lines.

    Collaboration Inspires New Approaches

    In both markets, we formed multidisciplinary diagnostic imaging volume development teams that met every two weeks to assess what was necessary to compete with the corporate- and physician-owned centers. Each team included radiologists, a medical director, an imaging administrator, an MRI/CT manager, MRI/CT/other imaging techs, a business office manager, a scheduling coordinator, a marketing director, physician liaisons, a CFO, and other officers including the CEO.

    Instead of finding fault or casting blame, team meetings fostered a sense of collaboration and emphasized compassion for patients and a concern for the future of the imaging departments. We knew that the traditional hospital delivery model was under fire and changes might be uncomfortable for some hospital staff. However, maintaining our current processes wouldn’t improve patient care or the health of our imaging business.

    Our teams asked a root question: Why are customers choosing the corporate- and physician-owned facilities? The teams concluded that those facilities could get patients in faster for their X-rays and tests, which was a critical differentiator. In each case, the teams believed that their hospitals had a quality edge over the corporate- or physician-owned facilities, so they set out to make organization-wide changes to address this lack of speed and turn the hospitals back into providers-of-choice for customers.

    8 Changes Boost Volume

    We made the following changes at the two Houston-area hospitals that resulted in significant increases in patient imaging volume.

    Filled immediate holes in the schedule. When customers called to book an imaging appointment, schedulers were suggesting dates a few weeks in the future. This was easier for the schedulers than looking at the schedule for the next few days and suggesting specific open times. Unfortunately, such an approach left near-term holes in the imaging schedule. In addition, this approach generally was not in the best interest of patients who usually prefer to receive their MRIs or mammograms as soon as possible. We instructed schedulers to try to fill the immediate holes in the schedule and explained to schedulers why this approach was important to the hospitals’ imaging businesses.

    Prepared the business offices for quicker pre-certification turnaround. Because schedulers were now filling immediate open times in the schedule, the business offices at both hospitals needed to pre-certify patients for insurance coverage more quickly than in the past. Rather than having two weeks to conduct that process, they might only have two hours if an appointment was made on the same day the customer contacted the hospital.

    Added hours of operation. We added Saturday imaging hours to create more scheduling capacity and better accommodate the schedules of today's consumers. The additional hours also improved our competitive advantage because patients are more likely to select providers that offer convenient hours.

    Assigned imaging employees to physicians and offices. We asked imaging techs, who served on the imaging committee, to acquaint themselves with specific physicians and their office managers and office nurses to personalize the scheduling experience.

    For example, after imaging techs developed relationships with a physician’s office, the office managers calling with a question or to schedule an imaging appointment had confidence that their request would be handled competently. That confidence in the hospitals’ imaging staff also increased the number of patient recommendations that physician managers and nurses made to the hospitals’ imaging departments.

    We also found another benefit to building relationships between imaging techs and physicians’ offices: The imaging staff reported greater satisfaction in their work because they were helping people they knew personally.

    Notified physician offices of schedule openings. Physicians’ offices expected that the hospitals would take longer to schedule imaging appointments, so they directed patients wanting faster service to the corporate- and physician-owned centers.

    To ensure that physicians’ offices knew our hospitals could deliver timely services, we started using fax blasts to inform physicians’ offices when same-day appointments were available. When physician office managers or office nurses arrived in the morning, a fax was waiting with imaging appointments available that day.

    We also encouraged imaging techs to call their assigned physician office managers and office nurses early in the morning to inform them of open afternoon appointment times. Those notifications attracted patients who saw their physicians in the morning and wanted to receive their imaging results that same day.

    Scheduled multiple tests in a single visit. If patients required multiple tests, schedulers would try to complete all tests in a single visit as part of the overall efforts to better meet customer needs. For instance, lab work would be scheduled the same day the patient arrived for an imaging study.

    Encouraged fast turnaround from radiology. Whenever possible, the hospitals’ radiologists would send imaging results back to the referring physicians on the same day of patients’ appointments. This improved physician and patient satisfaction. Suddenly, we were doing a better job at satisfying our medical staff, the physicians, and our patients.

    Assessed volume by physician—and shared the results. We identified which physicians were taking advantage of the new approach to scheduling imaging appointments. Those results were shared with the imaging team members as evidence of the success of their efforts,which served as additional motivation to bring about improvements. Soon, these satisfied physicians began sharing with their colleagues how our outpatient imaging services had improved. This favorable feedback led to other physicians, including historically low utilizers, to refer patients to the hospital's outpatient imaging department for prompt, high-quality outpatient services. As in other businesses, satisfied customers can become your greatest sales force.

    Hospitals Service a Broad Range of Customers 

    By meeting the needs of multiple customers—patients, physicians’ offices, and hospital colleagues—the diagnostic imaging departments at the two Houston-area hospitals recaptured lost volume and exceeded budgets. Our all-hands-on-deck approach allowed both hospitals to overcome a declining diagnostic imaging business by improving scheduling, extending service hours, and developing relationships with physician offices.

     Darrell Pile, MHA, is an executive advisor for Outpatient Healthcare Strategies.