Productivity metrics reports improve efficiency in radiology departments

A productivity tracking system out of Ottawa Hospital in Canada measures both clinical and academic productivity among radiologists and provides physicians with an incentive to improve workplace efficiency, according to work published in the Canadian Association of Radiologists Journal. The program’s developers say it’s a system applicable to practices across the world.

“Productivity is challenging to measure in a complex radiology organization,” first author Cynthia Walsh, MD, and colleagues in the Ottawa Hospital department of radiology, wrote. “This is particularly true in an academic department where radiologists have a broad portfolio of scholarship and obligations, including clinical service, education, administration and research.”

Walsh and her team didn’t base their Ottawa RADiologist Activity Reporting (RADAR) system on published reactive value unit data, like most similar systems—instead, they said, they created an adaptive model that could bend to accommodate different cultures and priorities in different medical departments.

“Our goal was to credit radiologists based on the estimated time to perform a task, rather than on income generated,” the authors wrote.

RADAR points were allocated for every procedure in the researchers’ radiology department, and physicians could earn points either by reporting imaging studies or engaging in educational activities around the hospital, like resident and student teaching and multidisciplinary rounds. An automatic system collected and tracked points—which could later be adjusted based on individual performance—and outputted weekly individual reports, which were emailed to each radiologist.

Walsh et al. tested RADAR in a group of around 60 radiologists of varying skill levels during a three-month period in 2016. During that time, the authors said, 97.7 percent of all points were earned for clinical duties, and 2.1 percent were allocated to educational activities. Radiologist productivity improved, which the researchers attributed largely to the Hawthorne effect—a theory that suggests individuals are more productive when they know they’re being closely monitored.

“Based on this theory, some groups choose to use monitoring systems for information only, without implications for low productivity,” Walsh and co-authors said. “Our productivity increased after radiologists began receiving weekly RADAR reports, even after accounting for nonclinical work and changes in the system over time.”

Performance was enhanced across the board, they wrote, even among top-tier radiologists whose productivity was already high.

Walsh and her team said the RADAR model is most suitable for an urban, academic radiology department where cases are abundant and complex, educational programs and teaching opportunities exist, radiology residents and fellows are plentiful and academic radiologists are assigned administrative duties. Still, they said, the system could be improved to include other metrics, like quality control, clinical awards, teaching evaluations or research metrics.

“RADAR data provide multiple additional benefits in departmental administration,” Walsh and colleagues wrote. “For example, specific tasks can be queried over time. Trends revealing potential limitations can then be addressed quantitatively to enhance the overall quality within the organization at large.”