Rethinking a Staffing Benchmark

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By Brian Johnson

Earlier this year, I was selected to participate as a guest in the 2015 AHRA Education Foundation Partners in Learning Program. I was very excited to have the opportunity to connect with another imaging administrator and get a new perspective on staffing benchmarks, quality metrics, succession planning, and radiation dose monitoring with new standards.

I was paired with Ernesto Cerdena. Ernie was in the middle of transitioning from a hospital in Maine to the hospital where I would eventually visit him in Connecticut. I arrived at Waterbury Hospital in Waterbury, CT at 8am and reported to Ernie in the radiology department. In meeting with Ernie I immediately felt lucky to have him as my partner – his office walls were covered with multiple degrees, awards, a CRA certificate, and he is also the current AHRA President. Ernie was quick to make me feel like part of the Waterbury Hospital team by taking me to the security department and having a photo ID made for me.

I spent two and a half days with Ernie, and each day started off the same way: quick departmental rounds through all his areas and then off to an administrative huddle. At my hospital we do departmental huddles but not administrative ones. The administrative huddle was a quick 15 minute meeting driven by senior leadership to look at current census, ED volume, and discharges before then asking each area to report any issues that could hinder daily operations. I was amazed how quickly theses daily meetings would start and finish with so much information quickly and effectively shared. If a problem was identified, all key stake holders and administration were there to quickly identify the issues and possible resolutions. Their expectation was that anything identified in the daily huddle would be reported on at the next huddle as well so it would hopefully be resolved. This morning huddle was driven with purpose and dedication from all of the area leaders, physicians, and hospital executive leadership.

In my current position, I struggle with our staffing benchmark report. In this report we are compared to other like facilities, and my hospital focuses on the worked hours per unit of service for our standard for job hiring/replacement. My goal is to be at the 50% mark or below. In one area, MRI, I was over the mark and of course did not completely agree that all facilities are looking at staffing and counting exams the same way. I had become fixated more on the data not being correct. Ernie was able to get me to look past the debatable accuracy of the data and to focus on what it would take to get to the 50% mark with exams. We dug into the data and determined that for my MRI department to get to the 50% mark, the department would only need to do one more exam every day! Ernie then recommended sharing this with my staff in order to engage them. Ernie reminded me that this goal was not only my responsibility to own but that staff needed to know that it is only going to take one more exam per day to get to our goal. Presented this way the goal is manageable and obtainable with everyone on board and focused to make it happen. Wow, this re-direction of my attention was the biggest take away that I had from my visit with Ernie, and I was very thankful to him for focusing me on what I can control.

In addition to seeing how Ernie’s normal day went, I was also able to sit in on two vendor presentations for new software and equipment, attended a hospital committee discussing ICD-10, participated in their Stroke Committee, met with the Hospital QA Department, and was able to listen in on one of Ernie’s routine conference calls with the AHRA.

As imaging leaders in the current state of ever changing health care we are lucky to have a program like Partners in Learning so we can network together to handle issues and regulatory changes to strengthen not only our own facilities but also the profession as a whole.

Ernie and his colleagues at Waterbury Hospital went out of their way to make me feel at home, and the observation time provided me with valuable insights to help me become a better and more effective leader. Hopefully I was able to share a few items with them as well!

Brian Johnson is the medical imaging manager at Swedish American Medical Center in Belvidere, IL. He can be reached at

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