By Mark Lerner
In the May/June 2012 issue of Radiology
Management I wrote about the influence
Joseph E. Robert, Jr. had on both public education and pediatric healthcare in
Washington, DC. I’d like to expand on
one part of the piece because I think it
has implications for all of us who work in
radiology. Mr. Robert had arranged for a
grant from the government of the United
Arab Emirates, specifically Abu Dhabi,
of $150 million for Children’s National
Medical Center to transform surgery on
children, but I did not explain the background of the gift.
Already ill with the brain cancer that
would take his life, one Sunday morning Mr. Robert called leading physicians
from Children’s to his house and asked
them one question. Mr. Robert inquired
as to what it would look like to drastically improve the way pediatric surgery is
performed. At first, none of the responses
from this group of experts satisfied him.
Then, finally, after time and time again
of pushing them for an adequate response, one member of the group came
up with an idea. He suggested that
they set as their goal removal of all pain
associated with invasive procedures.
Mr. Robert readily accepted this suggestion and his enthusiasm led him to
securing the monetary award through
which he hoped to make this dream
a reality. (For more information on
this subject, please go to: http://www.
I think it is past time to have the
same kind of revolutionary change in
the field of radiology. As I think about
my hospital department, it is similar, if
not exactly the same, as many other sites
that practice the same specialty. We all
work with radiologists, technologists,
and support staff. Commonly utilized
technology has now generally been adopted by most of us. We have PACS and
radiology information systems. Our
physicians dictate their examinations
utilizing voice recognition technology.
Most of our work is accomplished on
a computer instead of on paper. We
take care of inpatients, outpatients, and
emergency department patients.
We also share the same challenges.
We sometimes have patients waiting due
to delays caused by other imaging exams.
Sometimes procedures are simply scheduled incorrectly. Our report turnaround
times may not be as quick as we and our
customers would like. Perhaps our staff
could be providing a higher level of customer service. So we work hard everyday
as managers to make process improvements. But guess what? All of the changes
we are about to discover and implement
have already been figured out by someone else. In essence, we are reinventing
the wheel which, in the world of Lean
Six Sigma, is considered waste.
There are certainly best practices out
there. The problem is many of us are
not aware of what they are. Some of us
attend continuing education meetings to
learn how to do things better. Published
articles also help us perform our jobs at
a higher level. The problem is, in an era
of rapid change and consistent uncer-
tainty, it is taking much too long for good
ideas to travel pervasively throughout
Mark Lerner is the director of diagnostic imaging at
the George Washington University Hospital. He can
be reached at Mark. Lerner@gwu-hospital.com.