Reaching Beyond the Possible

By Michael Cecil

My career in radiology began in the Air Force in 1987. It has been an exciting and challenging journey that has included every aspect of our field, from a deployment during Desert Storm, to years in applications, to my current role as director of advanced imaging at Virginia Mason Medical Center in Seattle. I currently oversee the MRI, CT, NM, and PET sections of radiology and develop current and future leaders.

When I applied for AHRA’s Partners in Learning program, I had hoped to learn how others have led change for future survival, including cross coverage in multiple modalities; challenging staff to keep open minds and look for ways to change and improve; and creating tools to guide staffing decisions. My ultimate goal every day is to help my teams become more efficient by focusing on having the right work done by the right person at the right time and eliminating waste in the workplace. Change is difficult, and overcoming the muscle memory caused by always doing the same thing can be nearly impossible. Speaking with leaders who are on the same journey gives me tools and ideas to move forward.

Over the years I have spent a lot of time developing dashboards and other analysis tools in my current role, but they always fell a bit short of my expectations. As I read over the potential Partners in Learning host sites, selecting one was easy. The description of Robert Wood Johnson’s site discussed their journey to a paperless workplace and their utilization of current technology to improve workflow.

During my visit I met with team members from all of their modalities and from different leadership levels, from leads to the chief administrative officer. We had great discussions on every aspect of their department’s journey and had opportunities to compare notes on different topics. The best part of the experience was the realization that we are not alone in our struggles or on our journey. Even though our organizations are on opposite coasts, we have very similar problems.

In my brief visit to Robert Wood Johnson I was able to glean a lot of information. My hope was to come away with tangible steps to improve MRI safety, dashboard data, and patient flow. While I did obtain knowledge in those areas, what I really learned most was just how much I still needed to learn! Since my return from my Partners in Learning visit, I have been challenging myself daily with these questions:

• I need to reevaluate what the metrics mean. If I am pulling data, why am I pulling it and what story is it telling me and my teams? At RWJ they are tracking order to complete and complete to final, and in MRI they track from arrival to complete and compare it to national trends. How would my teams respond to that?
• Could my MRI department be more efficient if I only offered sedation with my out of OR anesthesia team?
• Am I training my successor?
• Where am I spending my energy, and am I getting any returns on those investments?
• Do I have the right people doing the right work at the right time? Do I really need to continue to staff a file room if I am a digital department?
• What support do my radiologists need on a daily basis, and do I have someone already on staff that can help by collocating them in the read rooms?
• How am I tracking quality defects, and how is it visual to my teams?
• What does the paper form (order, screening, consent, etc) mean to the radiology staff? What will it take to make it electronic and paperless?
• How am I preparing today for any future Joint Commission visits?
• Am I communicating in a way that my team understands, and are they receiving the data they need to succeed?
• It is easy for me to say that the patient is our top priority, but am I backing that up with actions? How far do my teams have to travel to get a warm blanket for their patient? What other simple actions am I unintentionally blocking?
• At one of the RWJ facilities their C-Suite staff holds an informal meeting with the team three times a day (once for each shift). Would my teams be willing to volunteer their time to attend an informal meeting with a VP? If I provided lunch, would the staff sit and listen to a radiologist discuss images?

While this was a whirlwind tour, I could have sat and listened to the RWJ teams for days on end and still have more to learn. They display great teamwork with their teams focusing on the whole of the department, not just their sections. Every day they are challenged to think beyond their self-imposed limitations, pushing beyond what they thought was possible. Their leadership and teams are aligned around a common goal, and together they approach the future. I left feeling inspired, focused, and filled with a desire to lift my organization beyond what they feel is possible. As I learned, thanks to the Partners in Learning program, the best way to reach beyond the possible is to reach out together. The momentum of 200 radiology staff headed in the same direction will be impossible to stop! Thank you AHRA and Robert Wood Johnson Hospital.

Michael Cecil is the manager, diagnostic imaging at Virginia Mason Medical Center in Seattle, WA. He can be reached at michael.cecil@vmmc.org.