Learning From Children

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IsabelBreenBy Isabel T. Breen, PhD, MPA, RT(N)

Recently, I had the good fortune to participate in AHRA Education Foundation’s Partners in Learning program. I chose Anne & Robert H. Lurie Children’s Hospital as my host site. As we all know, diagnostic imaging is an integral part of a patient’s diagnosis and outcome. Changes in healthcare, technology, and technologists’ training requirements and scope of practice demand that imaging technologists maintain a mindset of life-long learning. Remaining current in industry trends and practice standards is an essential element in patient outcome optimization. The learning opportunity from AHRA coincided with my own university’s transition to a new Bachelor of Science in Imaging Sciences degree designed to meet the knowledge needs of the 21st century imaging technologist.

The first question my host, Laura Gruber, director of medical imaging at Lurie Children’s asked was, “Why did you want to visit a pediatric hospital?” My reasoning was simple: when a patient is a child there seems to be a large supply of positive affective feelings that intermingle with the cognitive knowledge in healthcare delivery. The HCAHPS provision of the ACA introduced a value based incentive payment calculation for hospitals, giving credence to the affective skill of just being nice. This trait was evidenced in Lurie Children’s staff from the first interaction at the hospital information desk to my final handshake goodbye with Ms. Gruber.

The main objectives for my visit went a bit deeper than just finding nice people. Prior to my arrival, I had sent Ms. Gruber a list of three objectives and eight questions. These objectives were:

  1. Reconcile the changing regulatory environment with employee motivation;
  2. Understand quality drivers in an uncertain reimbursement environment; and
  3. Remain current in the latest imaging strategies (cost effective and value driven operations).

To my absolute delight, Ms. Gruber was not only nice, but extremely efficient, well-organized, and forthcoming. In addressing accreditation standards and the impact on quality, Ms. Gruber stated that “sometimes blunders happen.” Sometimes patients forget that healthcare providers are human and make mistakes. However, the commitment to quality patient care was evidenced in the obvious management focus on employee engagement.

It was easy to see why Lurie Children’s has earned many recognitions and awards. The hospital is the academic partner to Northwestern University’s Feinberg School of Medicine as well as several local colleges’ site for imaging technologists’ clinical training. Merima Karastanovic, clinical education coordinator for the imaging services department, reinforced the attention to affective skills with her general training philosophy that technologists must remember they were all students at one time and to use teaching as an opportunity to grow. As an educator, I know that this attitude makes all the difference in a student’s perception of the program quality.

The ideals of initiative and motivation were mentioned during my time with Ms. Karastanovic and echoed by the clinical manager of CT, MRI, and 3D Imaging, James Hickey. Mr. Hickey’s primary concern was helping his staff learn how to motivate themselves. Since internal locus of control and employee efficacy are primary topics in my own research, this was an especially enlightening conversation. Management supported staff through videos designed to shape employee expectation in patient engagement.

The teamwork philosophy is modeled after Seattle’s Pike Place FISH Philosophy with an emphasis on having a culture of play and being present at your work. Ms. Gruber mentioned that employees were often “goofy” but always devoted to the health of the pediatric patients in their care. Patient satisfaction data is not just collected; it is collated into a very user friendly report and used to identify any areas of concern. This practice seemed to manifest in a problem solving culture rather than a focus on disciplinary actions and fault finding.

All in all, the visit reaffirmed my focus on not simply teaching didactic skills, but developing the whole person in both cognitive and affective professional skills. Just as a fish market in Seattle became a model for organizational culture, perhaps the attitudes in pediatric care can be used as a model for adult care as well. Thank you to all those I encountered during this learning experience for opening your doors to me and being so nice.


Isabel T. Breen, PhD, MPA, RT(N) is the program director, nuclear medicine technology at  Keiser University in Fort Lauderdale, Florida. She can be reached at ibreen@keiseruniversity.edu.

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