Collaborative communication flow can speed radiological change requests

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Eliminating a hierarchical communication structure can allow for faster initiatives within the radiological environment, however some caveats still exist, according to a presentation during the Society of Imaging Informatics in Medicine (SIIM) pre-conference symposium held Wednesday for the preparation for Imaging Informatics Professionals (IIP) symposium.

Ann Scherzinger, PhD, associate professor at the University of Colorado, School of Medicine in Denver, discussed the traditional organizational communications structure as administration on the top, followed by various departmental management heads. She noted that the problem with this model is “if a department has an initiative they want to foster, they have to go clear up the chain of command, and break down through the ranks,” making the decision process slow.

She suggested that the current trend is a more “flattened management structure, where the “organization is based on strategic initiatives and market needs.” With this model, managers in the services have authority and accountability, but decisions are made within the collaborative group and so they can adapt more quickly, according to Scherzinger. The downside of the new method is that it often requires a duplication of services, she noted.

These flattened approaches are the marketing approach of the future for organizational structures, Scherzinger said.
Typically, she said that organizations will adopt a combination of the two structures. However, Scherzinger acknowledged that certain problems still exist for the hybrid method, such as:

  • Duplication of services is expensive in time, personnel and equipment
  • Radiology may exist in some but not all centers and there still is a department;
  • Management can be a problem because the center’s personnel really work for the department;
  • Center and department goals may not always be aligned; and
  • PACS expertise is easily expanded to support the center.

She advised her audience that they should know certain aspects of their organizations. For example, the mission and strategic initiatives of the organization, which drive most of the initiatives and funding opportunities, as well as determine the necessary system statistics. She also noted that these organizations need to be aware of the accrediting bodies, like the Joint Commission (JC) and its information management standards.

Scherzinger noted that change requests occur most often when there is a new software upgrade, either because a vendor dictates the change or it is the result of a long-awaited enhancement; a new organization initiative, which is either a response to a strategic initiative or a response to an enterprise system change; and Q1 analysis dictated a change.

In order to initiate a change request and propose a project plan, the initiator needs to clearly indicate the current problem, along with the need for change. With that proposal, the users affected and overall costs (hardware and software, IT services, personnel, training requirements) need to be clearly defined, according to Scherzinger. She also said that the plan must have a specific time line, accompanied by potential business risks and outcome measures.

If a change request is clearly defined by the preceding factors, Scherzinger said that projects are less likely to go wrong because the scope is defined, the accountability should be clear, the magnitude of the task is properly evaluated and the users feel like participants in the change process.