|Author: Kelly Dolde|
|Building an Efficient Department with Limited Resources
|Spend just a short time talking with Steve Davis, RT (R), and you'll likely pick up on his tenacity, focus and optimism. The director of the Radiology Department at Clarendon Memorial Hospital in Manning, South Carolina, Davis says he lives by the statement, "there are no failures, only outcomes." This outlook has directed his management style since taking over the department in 1999. "I strive to provide an environment for staff that allows us to safely and reliably offer the highest quality imaging services while constantly improving efficiency and controlling expenses." This attitude has led his department well. By taking it from paper and film to digital, for example, Davis has put the small, rural hospital on par with many large, metropolitan hospitals.
Davis is very focused on being the best radiology technologist and department manager he can be, but radiology is not a field he always wanted to pursue. In fact, just three weeks separated the day he first learned what radiology was all about and the beginning of his training. "I was a medic while I was in the Army National Guard, and I was thinking about going to nursing school. An opportunity opened up for an X-Ray technologist and I researched just what an X-Ray tech did and learned that there was an opening at my local community college—so I signed up." During his schooling, he was activated for military duty and had to defer for one year. When he returned, he finished school and began working.
Working as a medic in the military had its perks, according to Davis. "In the military, you have a lot more responsibility than in the private sector; you can do more. There isn't that many differences with regard to what you do on the job. The military entrusts you with more responsibility, like the level of responsibility I have now as a director."
Davis' dedication and his practical nature are characteristics he traces back to his early adolescence when his father was injured in a motorcycle accident and was disabled. "I realized at that point that I wasn't going to inherit a million dollars. I had to start working earlier, first at a printing press at age 13, later in a plant. I decided the military could be part of my plan. I had the sense that whatever I did I would try to do my best. That's how I got to where I am today, striving for excellence in everything I do. Even if it was just when I was a student working as a school bus driver, I would try to have the best driving record."
Prior to directing the radiology department, Davis had been employed part-time by Clarendon. "I was friends with the director at that time, and I'd graduated from X-ray school in 1992 and was working two jobs, full and part-time, and my friend would have me come in for a couple of weekends from time to time. When he left Clarendon, the human resources person offered me my friend's job. I was just in the right place at the right time and was always putting in a lot of hours."
"We had some turnover when I first arrived. We hired good people, lost some, but not many. Most of the people who were here in 2000 are still here. I tried to create an environment that was good for staff and offered competitive salaries. Some people left and have come back. We think we have a good program and we keep enhancing it for patients and staff."
One accomplishment Davis is particularly proud of is that his department doubled its revenue during a four-year period while they increased operating expenses by only 25 percent and completely modernized their equipment. "We're completely digital with the exception of mammography. We've just installed a 16-slice CT scanner. We do currently use mobile MRI, but we're building on to the hospital to house a high-field MRI scanner. We've done this through negotiations with the vendors who helped us set up different lease/purchase payments. We were very realistic and evaluated the results of a lease verses a purchase while also considering service costs. For example, with the CT scanner we had, when it was paid off, we would have saved money by not having payments on it, but the service costs would have been much higher than if we just bought a new scanner. The old scanner took 20 minutes and our new scanner is finished in a matter of seconds. We already had budgeted the service expense so we end up saving money by negotiating a fair price and service for five years. The PACS system, itself, saves its cost by reducing our dependency on film. We also acquired grant money to help offset its cost.
"The greatest challenge I face as a manager is probably financing. We're a not-for-profit hospital and we're rural, so we make very little money. And there have been Medicare cutbacks, and local competition from a private imaging center in town. We know when there are things we need to do, and the chief level officers know what these things are, but there aren't always the funds to do them."
Davis has successfully stabilized his department's staffing without the use of contract workers. "We did this by keeping our staffing levels low so that we were able to work with reduced staff. As our volumes grow, we don't grow our staff numbers, we grow our staff's capabilities." Clarendon's staffing needs are helped by its rural location. It is the only hospital in the county. "We're very lucky to have an excellent, stable staff of radiographers. We haven't been hit with the shortages larger hospitals have faced. We keep our staff to a bare minimum to reduce operating expenses and allow our staff to cross train in other modalities. The staffing shortage is stable, we have a number of techs coming out every year, and the market is stabilizing rapidly." Davis likes to empower his staff. "I believe in setting extremely high goals for others and myself. It is my view that, provided with the proper tools, knowledge, and a sense of ownership and responsibility, people will always exceed expectations. Valuing people and their contribution to the mission is paramount to success in healthcare."
Davis had no background in management before assuming his current role in 1999. "Business training has come on the job. My work in the military prepared me for the supervision aspects of my work." Davis also took advantage of available training by attending the South Carolina Hospital Association Management Academy at Clemson University in 2004. "That was a wonderful experience. It was the first time they had offered it; we were their first graduating class. It was developed for managers, like me, who worked their way up without formal management training. We had a lot of HR training; HR is such a huge part of management when you're supervising others. There was training in finance and, with our encouragement, they've since increased that component. We've worked with them since that time to develop the program, and their second class graduated in 2005.
"One of the most interesting things that I got from this experience didn't have anything to do with the training itself. We had people from major universities and the largest and smallest hospitals and we found that we all face the same problems and issues. That was very reassuring. We also got networking contacts within the state and I've drawn on these and intend to maintain these relationships. It's really a great program. There are many leadership programs through some of the associations that are certainly worthwhile and are good experiences. They are great ways to gain new view points and management information."
In 2002, Clarendon became a clinical site for students of Orangeburg-Calhoun Technical College. Davis serves as a clinical instructor. "It certainly enhances your current staff to teach students. It helps your own ongoing education to teach someone else. It keeps the things you've learned in school fresh in your mind. Serving as a clinical site has been a wonderful experience for Clarendon and our students. Many of our students want to come work here and we have hired two of them. As we are expanding, we hope to hire more students in the future."
Davis sees radiology exposure as the greatest concern of RTs. "It's easy to get somewhat lackadaisical about radiological protection. It is a dangerous job. Technology has helped, but in some cases we're producing additional exposure in our effort to do things faster." The greatest challenge RTs face is keeping up with the ever-expanding technology used in the field. "The role of RTs hasn't changed significantly in my 16 years. We still provide direct patient care as we always have. The biggest change is just how fast technology has changed. Diagnostic equipment has changed somewhat but the digital aspect of things has been incredible. Many X-Ray techs from my generation or earlier didn't get a tremendous amount of computer training in school—so that's been a very big change. We generate the image and then have a lot of computer work that must be done. The speed and accuracy of our equipment is tremendously better. Before, it was easy to miss charges, misplace film or reports. Now everything is online 24-hours a day, lessening staff needs. The benefits are tremendous. The speed has dramatically increased. This has changed our role somewhat: we're seeing more patients in a day than we ever did before."
A new challenge RTs at Clarendon face is working in the operating room. "The OR is a completely different world. Most X-Ray techs don't like to go to the OR. It's really a different environment. There are sterility issues. There are issues with moving your machine around in that area. Unless you do it often, it's tough to get acclimated. It's very easy to get stuck in a rut with how you do things. In the OR, every time is different. Each physician is different with what he expects and how he asks for it. Some RTs enjoy it immensely, and others despise it. I've never minded it."
"Set goals and believe that you can make them happen," Davis encourages. "If your goal is to be the best radiographer, then that's a fantastic goal. If your goal is to be in administration, you've got to work hard and take on additional responsibilities. As a director, I love when someone wants to do something more than is required. It takes some work off of my shoulders and gives me more time for patient/staff interaction. Goal setting is tremendous as far as getting ahead and making your workday life more enjoyable. Know what you want and know how to get it. At least, in my experience, you work hard and long and it all pays off. Now my goal is to be in hospital administration. The more small goals you meet, the further along you are to your big goals."
Steve Davis, RT (R), completed an AS in Radiologic Technology at Florence-Darlington Technical College, Florence, South Carolina in 1992 and was in the first graduating class of the South Carolina Hospital Association Management Academy of Clemson University in 2004.
Kelly Dolde is a freelance writer from Baltimore and is on the Editorial Staff of NEWS-Line for Radiology Professionals.