"I have yet to see any problem, however complicated, which, when looked at in the right way, did not become still more complicated." - Poul AndersonAn example of a simple system is a thermostat-furnace keeping a building at a given temperature. An example of an extremely complicated system is the national economy. A radiology practice is a system somewhere in between. Although a thermostat-furnace, the national economy, and a radiology practice are all very different, there is a common thread. All systems have a function or purpose, elements, and interconnections. When you utilize habits, tools and concepts to develop an understanding of the interdependent structures of each system, you are employing Systems Thinking. The goal is to identify the systems’ leverage points so you can drive desired outcomes.
When applying systems thinking to your radiology practice, it is important to understand your practice is more than the sum of its parts. As a matter of fact, conventional systems approach would theorize that a practice's purpose and interconnections are more important in modeling the system than any individual radiologist.
At Clario, we frequently employ systems thinking when designing and configuring our software solutions. This approach includes intuition and holism, as much as science, logic and reductionism. The typical radiology practice is a complex system, but by applying the basic ideas of system thinking, and monitoring every element/interconnection of the system, you can "tune" your practice to achieve better results. You need to listen to your intuition, but measure and check everything.
The fun part of systems thinking is exploring creative ideas. Examples include:
- - Instead of employing simple carrot and stick incentives to encourage radiologists to do their peer reviews, you can detect times when the exam volume is slower than usual, and suggest doing peer reviews now
- - Instead of creating a rigid RVU quota, inform radiologists that they are "on track" or "behind" based upon expected shift output and overall practice busyness
- - Instead of completely breaking down silos, create “release valve” worklists that activate into more readers’ queues when the worklist counts get too high
One power of systems thinking is that it often uncovers possible unintended consequences before they manifest themselves. Here are some examples:
- - Will showing fast radiologists how many RVUs they are reading slow them down?
- - Will reducing turnaround times increase the number of exams ordered?
- - What will be the effects of routing exams to the fastest reader? Will TATs go down overall? Will report quality go down for exams radiologists read infrequently?
- - Will increasing subspecialty reading percentages decrease collaboration?
- - Will hiring radiology assistants increase overall radiologist output? Will retention rates for radiologists go up or down? Will customer satisfaction go up or down?
Systems thinking is something we have made a central part of our culture. Our experience with this approach has been positive, and we encourage all of our customers to employ these ideas as well.