1. Baptist Outpatient Center, Miami, 2. Battlefield Imaging at Hutcheson Medical Center, 3. Elizabeth Jekot M.D., Breast Imaging Center, Richardson, TX, 4. Elizabeth Wende Breast Clinic, Rochester, NY, 5. Sierra Nevada Memorial Hospital, Grass Valley, CA
In the war against breast cancer, the patient’s initial – and arguably most important – offensive weapon is imaging equipment. That includes access to it and making effective use of it, whether the equipment is the most advanced available or the basic bread-and-butter variety on the verge of obsolescence.
Women’s healthcare centers that specialize in breast imaging, surgery and treatment carry a heavy responsibility. Not only do they battle one of the leading causes of death in women on a daily basis, but they also have to serve as a serene refuge for patients amid the volatility of variable reimbursement and conflicting research studies.
That’s why Outpatient Care Technology and its sister magazine Imaging Technology News teamed up to showcase women’s healthcare centers that make a difference. We asked readers to submit nominations of worthy facilities to recognize based on their achievements in innovation, operational efficiency, customer service and teamwork. From there we chose five to recognize as influential facilities to watch in 2008.
We acknowledge that thousands of women’s healthcare facilities qualify for a list like this. OPCT and ITN hope to identify and promote each one going forward because we feel their contributions to high-quality patient care must be shared. For this “hall of fame” feature, however, we felt that the following five – listed in alphabetical order by facility name – were uniquely qualified for induction this year. And if you know of any facility that you believe should make this annual listing, be sure to let us know who and why via email at [email protected].
Athens (GA) Regional Breast Health Center (www.armc.org/arf/breastcenter.shtml)
Innovation: Opened the all-digital facility Oct. 28, 2004. With the help of the community the facility raised $3.5 million to build and equip the state-of-the-art center, which includes digital mammography, breast ultrasound and image-guided biopsies. Athens Regional also integrated a new information system to facilitate improved reports and follow up to physicians and patients.
Efficiency: With digital mammography, the center shortened appointment times and changed its schedule to allow better flow of screening and diagnostic patients who have really appreciated the shortened wait times and the ability to get screening and diagnostic appointments within a shorter time-frame. The center recently installed a digital unit 18 miles north in a facility that also has an urgent care center and a family practice physician, which allows some of its patients to get their screening mammograms closer to where they live and work. Patient response has been very positive and patient volume has increased.
Service: Athens Regional has a very spa-like feel so that women can get their mammogram without feeling like they are going to a hospital. It offers patients terrycloth robes to wear while they wait to have their exam and a locker to put their belongings in. It has a separate waiting area for the screening and diagnostic patients. All of the diagnostic patients have their exams read by the radiologist and receive results before they leave. The center has two registered nurses available to navigate biopsy patients through the steps of biopsy to breast cancer diagnosis.
Teamwork: Prior to the center’s opening the administrative team started a Physicians Advisory Board to help in the planning and development. Members included area physicians from multiple specialties, hospital staff members and members of the administrative team. This group worked in conjunction with the Mammography Process Team to improve every process in the facility prior to the opening in 2004. This team also facilitated its Multidisciplinary Breast Cancer Conference, which started in May 2002. This conference occurs every two weeks, enabling physicians to discuss treatment options for newly diagnosed breast cancer patients.
Capital Imaging, Albany, NY (www.capimaging.com)
Innovation: In addition to providing general X-ray, fluoroscopy, mammography, ultrasound, DXA scanning (used in evaluating osteoporosis) and computerized axial tomography (CT), Capital Imaging recently introduced magnetic resonance imaging (MRI) to the local community. Capital Imaging has been instrumental in setting the standard for quality diagnostic imaging and continues to bring the latest technological advances to the community. It has continued to monitor and upgrade its imaging technology, ensuring that patients have the benefit of the most advanced and patient-friendly imaging equipment available. In addition, Capital Imaging offers a conventional, or closed, MRI imaging scanner, as well as an open MRI unit for those patients who find that they are claustrophobic or who feel more comfortable in the open environment, eliminating the need for re-scheduling.
Efficiency: The addition of an open MRI has eliminated the need for patients to reschedule procedures. While it has been reported that nationally 10 percent of the population cannot complete MRI scanning due to claustrophobia, Capital Imaging’s rate is less than one percent.
Service: Capital Imaging’s focus has always been on people and it’s proud of its reputation for providing the most technologically advanced diagnostic imaging in a setting that promotes people as individuals with specific needs and concerns. Capital Imaging’s staff is always in attendance to answer any questions or concerns that may arise.
Teamwork: Everyone at the facility is involved in helping the patients, as well as each other. The operations manager helps out with the technologist when needed, and attends and gives input to the radiologist board.
Charlotte (NC) Radiology Center (www.charlotteradiology.com)
Innovation: Charlotte Radiology offers a variety of procedures, including breast MRI, diagnostic mammography, screening mammography, uterine fibroid embolization, ultrasound, CT, X-ray and more. All radiologists are certified by the American Board of Radiology, are members of the American College of Radiology, and most have received subspecialty fellowship training following their residencies in diagnostic radiology. They are backed by highly talented and certified technologists who also have specialized training in their specific areas. Subspecialized areas include: Body imaging, diagnostic radiology, emergency radiology, neuroradiology, musculoskeletal and pediatric radiology.
Efficiency: Private, secluded changing rooms (that look like high-end dressing rooms) maximize patient comfort and efficiency. The patient can go from modality to modality without being exposed to the public or having to change. All images are instantly available on PACS so if a patient needs a diagnostic mammogram in addition to her screening mammogram the facility can do it right away, as well as any additional diagnostic studies (ultrasound or MRI).
Service: The facility employs a spa-like atmosphere (complete with a waterfall), including private consultation rooms, refreshment stations with gourmet snacks, lemonade and flavored water available to everyone, private dressing rooms, robes (instead of hospital gowns), minimized wait times and fast turnaround time for any results. The center is active in the community and breast cancer support groups – all while providing top-of-the-line image quality and patient care.
Teamwork: Technologists and physicians work very closely together to achieve optimal patient throughput. Patients are escorted through the facility from exam to exam by tech aides. Administration is on site everyday and involved in day-to-day activities. There is a physician on site everyday that sits in the middle of the facility and can be easily contacted for any questionable findings.
Windsong Radiology Group, P.C., Williamsville, NY (www.windsongradiology.com)
Innovation: Windsong Radiology Group, P.C., was the first to offer stereotactic core biopsy; computer-aided detection; color, helical and 64-slice CT, PET/CT, virtual colonoscopy, dedicated breast MRI and biopsy. Windsong’s newest upgrade to the PET/CT has increased efficiency through innovation. With the extended field of view of the new scanner, Windsong has decreased scanning time to about 12 minutes from 20 minutes for a full body scan, which is very significant for cancer patients who suffer pain. Plus, Windsong can accommodate almost twice the amount of patients on a given day. Bilateral breast MRI enables Windsong to scan both breasts simultaneously in the same amount of time as when it was done unilaterally, which helps to identify unsuspected multifocal and multicentric disease. Windsong also uses a CAD system for breast MRI that performs a digital second reading. MRI-guided breast biopsy has been key to identifying breast lesions, allowing for smaller lesion detection and earlier detection. Windsong recently installed new digital mammography machines and phased out the analog machine, installed a new PET/CT, and upgraded its ultrasound units.
Efficiency: Digital imaging, online access to images and reports to referring physicians and PACS all serve the patient and referring physician by streamlining processing and turnaround time, which speeds diagnosis and access to care. Plus it saves time internally by not having to pull and re-file charts.
Service: Windsong provides patients face-to-face results, focusing on the patient and giving them personalized attention. This relieves anxiety for patients. Windsong never says “no” to add-on patients or patients needing immediate exams, striving to coordinate imaging services whenever possible. The facility produced educational videos for patients to understand examinations before they undergo a procedure. Windsong pre-registers patients, especially for busy times of the day. All patients that undergo diagnostic breast MR receive a personalized call at their home from the reading radiologist with an interpretation. Convenient hours of operation are offered, including Saturday and evening appointments. From the greeters and secretaries, to the technologists, to the radiologists, to the staff in the billing department, Windsong concentrates on adding the best people with the best people skills to its team. Additionally, every new team member completes a thorough orientation process that takes them through the history and values of the patient-centric organization, tracing how the group grew from seeing 35 patients a day with four team members 21 years ago to seeing almost 700 patients a day with 200 team members today.
Teamwork: Windsong established an organizational development position to help with internal education, improve communication and establish improved accountability. The facility also extends educational programs to referring physicians to help improve imaging utilization for medically necessary studies. Windsong encourages and rewards employees for any ideas that result in better service to patients. The management team meets biweekly to discuss departmental issues or ideas. The radiologists meet every morning to update on activities and schedules, and hold more formal meetings quarterly. Windsong’s open communications effort, which relies on face time, phone line and online methods streamlines patient care across all modalities when multiple modality studies are ordered on one patient.
Women’s Imaging Center, Pennsylvania Hospital, Philadelphia (www.pennhealth.com/pahosp/ibc/imaging.html)
Innovation: As the nation’s first hospital, Pennsylvania Hospital has consistently provided a full array of diagnostic and therapeutic medical options and remains an important teaching institution. The Women’s Imaging Center features state-of-the-art technology to offer high-quality breast imaging services and osteoporosis screening in a comfortable, private environment. Breast imaging technology includes digital screening and diagnostic mammography with CAD, breast ultrasound and multiple minimally invasive breast biopsy devices, including stereotactic core biopsy, vacuum-assisted ultrasound-guided core biopsy, ultrasound-guided removal of benign masses and cryoablation, as well as advanced imaging and biopsy of abnormalities within the axilla. In addition, breast MRI, MRI-guided core biopsies and PET/CT are a part of the daily evaluation of patients with breast cancer and other diseases of the breast. DXA scanning, as well as RIS and PACS, also are included. Increasing involvement in clinical research and teaching of residents in diagnostic radiology further allows the center, a part of the Integrated Breast Center, to remain among the finest.
Efficiency: By becoming a fully digital center, the Women’s Imaging Center offers faster exam times, and its technologists and radiologists are able to spend more quality time with each patient. Productivity and patient throughout have improved substantially. In addition, a close relationship with central scheduling, outpatient registration and the clinical departments has promoted efficient and optimal flow of patient care. As one of the busiest women’s imaging centers in the Philadelphia region, the facility performs more than 100 diagnostic and screening exams daily, as well as multiple biopsies and MRIs each day. Using the RIS and PACS continues to reduce medical errors and paper work as the facility strives for a paperless environment. The introduction of an automated registration kiosk also has improved patient throughput.
Service: Pennsylvania Hospital prides itself for being one of the only centers in the region to provide immediate results for all screening and diagnostic mammograms in a private “boutique” setting to reduce patient stress and anxiety and to improve emotional well-being. All patients receive one-on-one interactions with the radiologist to provide these immediate results with the most personal care. Additional views, ultrasound and most biopsies are performed the same day so that there are fewer callbacks, and patients become aware of all findings and recommendations more quickly. Attention to every detail by the team leader (chief radiologist) and lead physician, who are available should concerns arise at any time, optimize customer satisfaction. In addition, the RIS minimizes redundant paperwork and streamlines workflow. Mammography is quicker and more comfortable because of the digital technology with flexible compression paddles, optimal compression and rapid image acquisition. Patient brochures, information packets and videos/DVDs are available.
Teamwork: Through the hard work and cooperation of talented, caring people, the administration of both Pennsylvania Hospital and the University of Pennsylvania Health System have worked closely with the department of radiology and the Integrated Breast Center to create a world-class Women’s Imaging Center. There is careful oversight by administration and the clinical departments, with sufficient autonomy to allow the center to grow and to prove itself to be one of the finest. The center itself remains in the “heart” of the hospital, both figuratively and literally, while expansion of the hospital has moved the rest of the radiology department to the second floor. Space continues to be allocated for the expansion of the center, funds are provided for the purchase of new equipment and the replacement of old equipment, and programs and opportunities are continually promoted. Daily and weekly interactions between administration and the clinicians facilitate a close working environment so that the best solutions are achieved to remain best in class.