Under Pressure

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By Bill Algee, CRA, FAHRA

As the summer fades away and fall begins, most of us move into that six letter season that none of us want to see: BUDGET season! None of us are exempt from the changing expectations of this crazy season either. One thing that is certain is that no matter where you work, you can’t get away from the pressure.

This year, our facility is moving to a “forecasting budget,” which means we will be reviewing budgets on a quarterly basis to make real time adjustments based on the trends in our facility. These trends include fluctuating volumes, staffing levels, etc. to reach our preset target for Expense per Procedure. Maybe some of you have experienced this before, but this is new to us. Like many of you, we are expected to be targeted at a specific percentile using our comparative data. We utilize Action O/I for comparison. So it would be really helpful if a few of you could do really badly so I can look a lot better – joking of course!

Budget season also brings hunting season. While some of my friends are out hunting deer and turkeys, I am busy hunting for cost reductions. For example, some of the reductions I’m looking at include switching MRI contrasts to reduce costs, reducing the use of Visipaque, trimming back staff hours to reduce OT and staffing to demand, and assessing the viability of some programs. Many of you may be feeling the pressure to find cost reductions in your education budget. Keep in mind that AHRA works hard to offer low-cost educational opportunities throughout the year, including the upcoming Virtual Fall Conference, running October 26- November 8. With special discounts for group registrations and scholarship opportunities, this conference is a great way to provide valuable education to your whole team in a cost effective manner.

Trust me, fellow imaging leaders, you are not alone. AHRA offers a great way to get some help as you’re working through your budgets or other daily issues. The member forum on AHRA Connect is a great way to get ideas and even to share your own nuggets of wisdom. Why reinvent the wheel when there is a plethora of expertise right at your fingertips? Let’s get those ideas flowing… I need some help!

Pressure pushing down on me
Pressing down on you no man ask for
“Under Pressure” – Queen


Bill Algee, CRA, FAHRA is the 2018-2019 president of the AHRA Board of Directors. He is the director of imaging services at Columbus Regional Hospital in Columbus, IN and can be reached at balgee@crh.org.

One comment

  1. Bill –

    Great commentary! Here at St Luke’s in Idaho, we have moved away from Action OI and into a HealthTrust productivity product called PLUS. It uses an algorithm to calculate a 12-month “run rate” of exam volumes versus hours worked to produce those volumes and gives an exact “Unit of Service” or UoS per modality. With this UoS, you can anticipate your staffing needs in the future based on a mixture of known scheduled exams and your anticipated same day “add-on” exams.

    It is no magic bullet to what I consider the Golden Chalice of Imaging: how to staff perfectly. But it is a great start.

    If I may add, the lecture I will be sharing during the Fall Virtual Conference ties in perfectly with the budget motif. In this presentation, which I shared in a 90 minute session during the AHRA Annual Conference in Orlando, will be topics I have used at my facility to improve efficiency…which ties to reduced costs.

    I welcome everyone interested in departmental efficiency to join me for a discussion titled: “Leadership Standard Work – Adaptability is the New Efficiency.” I was asked for the powerpoint over 30 times via email so it was uploaded to the AHRA website here:

    https://www.ahra.org/AM/Downloads/AnnualMeeting/2018/Leadership-Standard-Work-for-Imaging-Leaders—Ada.pdf

    I will “virtually” see YOU at the Fall Conference Oct 26 – Nov 8th, 2018.

    Ron Jones
    Director of Imaging
    St Luke’s Magic Valley
    St. Luke’s Jerome
    JonesRon@SLHS.org

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