Administration of a Radiological Facility

Function of Radiology Department

• Radiology - is a specialty on the field of

medicine that uses medical imaging to
diagnose and treat diseases seen within the
body.
- example of imaging modalities:
X-Ray, CT scan, MRI, UTZ, DEXA scan,
mammogram, nuclear medicine, fluoroscopy,
DSA, interventional radiology, and radiation
therapy.
 X-RAY Machine

• a machine that uses “x-

ray” mainly for the purpose
of visualizing internal
structures.
• can be used to rule out
foreign body, pathologies,
fractures, and/or
dislocations.
 Computed Tomography

• AKA CAT
• invented by Godfrey
Hounsfield
• can reveal anatomic
details of internal
organs that cannot
be seen in
conventional X-rays
 Magnetic Resonance Imaging

is a technique that
uses a magnetic
field and radio
waves to create
detailed images of
the organs and
tissues within your
body
 Ultrasound

is a modality that
uses high
frequency sound
waves that
allows view of
internal soft
structures
 Mammogram

• An X-ray of the breast

that is taken with a
device that compresses
and flattens the breast.
• helps in the
determination whether
a lump in the breast is a
harmless cyst or a
tumor
 DEXA scan

• aka bone densitometry

or bone density scan
• Dual energy X-ray
absorptiometry imaging
system use to assess
bone mineral density
 Fluoroscopy

• An x-ray procedure that

makes it possible to see
internal organs in motion.
• fluoroscopy uses x-ray to
produce real-time video
images.
 Radiation Therapy

• The use of high-

energy rays to
damage cancer
cells, stopping
them from growing
and dividing.
 Digital Subtraction Angiography

• is a way of taking images

of arteries, veins and
organs of the body using
complex computerised x-
ray equipment.
• usually requires an
injection of a special ‘dye’
to highlight the blood
supply to the legs, heart or
other organ.
 Interventional Radiology

• employ image guidance

methods to gain access to
the deep interstices of
most organs and organ
systems.
• includes the use of
balloons, catheters,
microcatheters, stents,
therapeutic embolization
 Location of Radiology Department

• should be located at the lower ground

floor
• adjacent to the emergency room and
as much as possible it is near to the
operation room and opd clinics
 Members of the Radiology Department
• Chief Radiologist
• Radiologists
• Radiation Safety Officer
• Medical Physicist
• Department Engineer/Technician
• Chief Technologist (for CT scan, MRI, UTZ, X-Ray, etc..)
• Radiologic Technologists/Radiographer
• Radiology Nurse
• Receptionist/Secretary
• Filling Clerks
• House keeper or Aides
 Qualification of Personnel

1. must possesses the formal educational

background, formal training, and experiences
2. must be fairly intelligent personnel, mature,
honest, cooperative, courteous attitude, sincere
for improvement, sense of humor, and a lot of
common sense
3. good moral conducts, loyal to his/her
superiors and coworkers
 Duties and Responsibilities of each members
1. Chief Radiologist 2. Radiologist
• supervise and drives activities • interpretation of acquired
of rad department in
radiological data
accordance with accepted
standards and administrative • sometimes performs
policies radiological services
• establishes department • assist chief radiologist
procedures and method of
operation
• assigns and supervises
activities of its personnel
• schedule duties on dept.
personnel
 Duties and Responsibilities of each members

3. Medical Physicist 4. Chief Technologist

• dosage to be use • prepare the technologist
• calibration and schedule of duties then
maintenance of machine for approval to chief
• treatment planning radiologist
• in charge of department
supplies
• QC officer
• guide, train, and
supervise technologists
 Duties and Responsibilities of each members
5. Radtech
• performing radiologic
procedures
• treating of patient
• assisting
physicians/radiologist
• maintains patient records
6. Clerical Work
• receive patients for
examination
• scheduling of patients
• instruction regarding on
preparation for the
procedure
• charging patient
• releasing of result
7. RSO 8. Engineer
• conduct of radiation safety • responsible for the repair
program and maintenance of xray
• they can be medical machines with training in
physicist, qualified radiation protection
physician, or radtech
 Scheduling for the procedure

Priorities in scheduling/accepting
patient in chronological order
1.stat procedure
2.executive check up
3.in patient
4.out patient
 Requirements for the construction of X-ray Facilites

1. the room must be well light lighted and ventilated

2. must be accessible to most of the department
3. must be provided with an outside entrance and one with
the hospital.
4. size and activity of the hospital must determine the size
of department
a. 50 - 100 beds = 400 sq meter floor areas
b. 100 - 150 beds = 700 sq meter floor areas
c. 150 more beds = 1200 sq meter floor areas
 Radiology Department
Inside the Radiology Dept. Inside the X-Ray Room:
• conference room • dressing room
• offices for radiologists • waiting room
• staff lounge • dark room
• Xray room
• exposure room
• UTZ room
• CT scan room • control room
• Radiotherapy room • viewing room
• Fluoroscopy room • filling room
• MRI room • immobilization devices
• Mammogram room • CM materials
• Nuc med room etc...
• first aid kit
 Formulas for Estimating the Departmental Size based on
the Departmentalized Activity

1. number of examinations / yr. = required number of X-ray room

5,000

2. number of hospital beds = required number of X-ray room

200

3. number of X-ray room x 1,500 sq. ft = total space necessary

 Standard Measurement of Rooms

1. 16 ft x 18 ft = max. size for any general fluroscopic

room
2. 20ft x 25 ft = special exam room
3. 1,500 sq ft = total area designed to the xray dept.
for each room
4. 24” by 36” = viewing window
5. 8ft x 8ft = average area of darkroom
 Radiology Policies and Procedures

• Policy is defined as • Procedure is a step-by-

course of action, or rule,
adopted by an
organization. It answers
the questions 'who,' 'what'
and 'why.' It sets direction.
Compliance is mandatory.
step set of instructions on
how to perform a specific
task or solve a problem. It
answers the question
'how.' It is a description of
activities involved in
implementing a policy.
 REQUIREMENTS OF A GOOD DARKROOM

1. SIZE - should be big enough to house all the necessary

equipments in the darkroom and still gives a room for the
technologist to move around.
2. LOCATION -should be located adjacent to exposure area.
3. PROTECTION-Darkroom should be lead-lined. The
background radiation should not exceed 7 μR/hr.
4. CLEANLINESS-Darkroom should be kept spotlessly clean,
since sensitive materials are handled in this room (film and
IS)
5. ILLUMINATION-Darkroom should be equipped with both white light
and safelight.
 Safelight is used during loading and unloading of film into and from
the cassette, and during processing of films.
• Must be located at least 3 to 4’ above the loading bench or 6’
above the floor.
• Safelight wattage should be between 7 to 15 watts.
• The filter must have 2 color separation from the sensitivity of the
film.
-Wratten 6B filter - for monochromatic film
-GBX2 - for orthochromatic film
 White light is used for all activities that does not require the
6. VENTILATION
–Darkroom should be properly ventilated
since the chemicals gives off bad odor and
the dryer or processor gives off heat.
•Should be air-conditioned
•Should have an exhaust fan
7. ENTRANCE -should provide complete
protection from outside white light.
 TYPES OF ENTRANCES

1. Single door
2. Double door or light lock
3. Labyrinth
4. Revolving door
Single Door Entrance
Double Door Entrance
END OF PART 1
Labyrinth or Maze
Revolving Door Entrance
Leadership and Supervision
 Leadership

• process of influencing other to

achieve designated organizational
goals
• main function of leadership is to
persuade, direct, inspire, and
guide participants
 Decision Making
Decision - a conscious choice made after evaluating the
available alternatives for the purpose of achieving a specific
result
STEPS IN MAKING GOOD DECISION:
1. recognize that there is a problem
2. analysis of the cause and extend of problem
3. identification of alternative solution
4. evaluating each options
5. select the best solution
6. implementing the best solution
 Factors that Influence Leadership Success

1. Corporate Culture
> the way things are done in an organization,
the habits, traditions, and customs

2. Management Styles
> relationship among the members of
organization might affect the success of
leadership
 Principal Dimension of Leadership Behavior

1. Initiating Structure
> emphasis on actively directing the staff toward getting the
work done
> specifying and clarifying what is expected from the
subordinates to accomplished

2. Considerations
> typified by manager`s effort to explain their action, treat
workers as equals, listen to subordinate concerns, and be
generally approachable and friendly
 MANAGERIAL GRID: SEVEN BASIC LEADERSHIP STYLE
(ROBERT BLAKE)
LEADERSHIP
CONCERN: PEOPLE CONCERN: PRODUCTION DEFINITION
STYLE
AVOID CONFLICT;DO JUST
IMPOVERISHED LITTLE LITTLE
ENOUGH TO GET BY
FOCUS ON BEING WELL-
COUNTRY CLUB GREAT LITTLE
LIKED
AUTHORITY-OBEDIENCE LITTLE GREAT JOB MUST BE DONE

AKA “MIDDLE OF THE ROAD

ORGANIZATION MAN MEDIUM MEDIUM LEADERSHIP”
- BALANCE
FATHER`S KNOWS BEST
- REWARD FOR
PATERNALISTIC MEDIUM GREAT COMPLIANCE AND
PUNISHMENT FOR NON-
COMPLIANCE
WHAT`S IN IT FOR ME
OPPORTUNISTIC LESS LESS -SELF BENEFIT

IDEAL TYPE
 Concept of Supervision

supervision is process of helping,

guiding, advising and simulating growth
in the subordinate in order to improve
of the quality of his work (Nwaogu,
1980)
 Functions of a Supervisor

• provides technical knowledge

• give orders, instructions and implements the rules
• converts the goals and resources into action then
results
• arranges work assignments by determining the
procedures
• motivates workers
• becomes an example
 Responsibility of Supervisor

•towards the subordinates

•towards the management
•towards his own function
•towards his colleagues
 Impediments to an effective supervision

• lack of experience on the part of the

supervisor
• favoritism
• lack of personal, leadership, and, professional
quality
• lack of benefits
• lack of motivation
Types of Supervision according to behavior of supervisors

Autocratic

Laissez-Faire Democratic Bureaucratic

 Autocratic or Authoritarian

• supervisor wields absolute power and wants complete

obedience from his subordinates
• everything must be done strictly according to his
instructions and never likes any intervention from his
subordinates
• this type of supervision is resorted to tackle indiscipline
subordinates
 Typical Characteristics of an Autocratic Supervisor

• tells and enforces

• little to no feedback is needed from the team
• decions, tasks, and goals are all created by the
supervisor
• a sense of lack of trust to his team members
• strongly points at a method of just getting the job
done
 Positive on Autocratic Supervision

• the job can be done more quickly

• advisable if a team member`s skills for the
task is very low or novice (giving clear
direction and making the right decisions
allows that person to focus on learning)
 Negative of Authoritarian Supervision

• appear to be bossy, cold, and dictator

• chances are that supervisor won`t be
voted as the next best leader sometime
soon
• subordinates might felt the feeling of
being unvalued and distrusted
 Laissez-faire or Free-rein

• aka independent supervision or delegative style

• come from the French phrase which means “let
them do”
• maximum freedom is allowed to the subordinates
• in this type of supervision, subordinates are
encouraged to solve their problems themselves
 Characteristic of Laissez-faire supervision

• very little guidance from the supervisor

• complete freedom for followers to make decisions
• supervisors provide all the tools and resources needed
• subordinates are expected to solve problems by
themselves
• power is handed over to followers, yet supervisor will still
be reliable for the outcome
 Positive of Laissez-Faire Supervision

• need a little guidance if the group members

are highly skilled, motivated, and capable of
working on their own
• can be useful if the team members are more
effective than the group`s leader
• good morale among members
 Negative of Laissez-Faire

• not ideal if group members are weak and

inexperienced
• if the group members are not good at setting
their own deadlines, managing the projects
and also solving the problems
• can result in dissatisfaction
 Democratic

• aka participative or consultative supervision

• supervisor acts according to mutual consent and
discussion with his subordinates
• subordintes are encouraged to give suggestions, take
initiative, and exercise free judgement
• this type of supervision results in job satisfaction and
improved morale of employees
 Characteristic of Democratic Style

•very open and collegial

•ideals move freely amongst
the group and are discussed
openly
 Positive of Democratic

good in facilitating the

conversation, encouraging people
to share their ideas, and then
synthesizing all the available
information into the best possible
decision
 Bureaucratic

• one of the oldest forms of leadership

• concept of “hierarchies”
• there are rules and regulations that are laid down by the
supervisor and all the subordinates are required to follow
there very strictly
• serious note of the violation of these rules and regulations
is taken by the supervisor
• this type of supervision promotes stability
 Characteristic of Bureacratic Supervision

• rely on rules and regulations

• clearly defined positions within
organization
• employees in bureaucracies are promoted
based on their ability to comply to the
rules
 Models of Clinical Supervision

There are several models of CS:

1. Interactive/Functional model based on:

a. Normative tasks that help people to develop
standards.
b. Formative tasks that help people to develop
skills.
c. Restorative tasks help to validate each other and
develop a climate of safety
2. Integrative or Process model
- the focus in this model is on the process of the
tripartite relationship during the supervisory
session; (supervisor supervisee & the patient in
addition to work context), tasks and functions
are made explicit. This model most useful when
the primary work of the nurse is the use of self
reflection on the nurse/client relationship
3. Relationship or Growth and support model
- the focus on the nature of supervisory
relationship and how the development of the
supervisee affect this relation.
- Also it provides guidance to the supervisee
and the supervisor roles (Generosity, humanity,
rewarding; openness, willing to learn,
thoughtful etc…)
END OF PART 2
 Supervisor`s span of control

• span control refers to the numbers of

subordinates that can be managed effectively
and efficiently by supervisors or managers
• an ideal span of control in an organization is
approximately 15 to 20 subordinates per
supervisor (modern) and 5 to 6 subordinates
(traditional)
• Can be Narrow (Hierarchical) or Wide (Flatter)
 Span of Control: Narrow

Advantage:
• supervisors can spend time with employees and
supervise them more closely
• creates more development, growth, and advance
opportunities
Disadvantage:
• more expensive
• tends to result in communication difficulties
 Span of Control: Wide

Advantage:
• fewer levels of reporting resulting in more flexible
• encourages empowerment of employees by giving
more power to them

Disadvantage:
• highly competitive
• may lead to overloaded of works
 Factors for Optimum Span of Control

• Organization Size
• Nature of an Organization
• Nature of Job
• Skills and Competencies of Manager
• Employees skills and abilities
ETHICS
 Introduction

ASRT requires education in

ethics that focuses on future
radiologic technologist to be
taught the foundation of ethics
which includes professional
conduct, ethical issues in health
care, legal issues, legal
doctrines, and patient consent
 Morality and Ethics

Morality
- inner conscience of an individual
- Concerned with the goodness or
badness of character or
disposition, or the distinction
between right and wrong (Samuel
Burns)
- It may differ from each individual
due to other external factor such
as religion, cultures, belief etc..
 Morality and Ethics

Ethics
- From the Greek work
“ethikos” meaning
behavior and “ethos”
meaning custom
- Discipline of dealing with
what is good and bad,
moral duty and obligation
(Samuel Burns)
2 branches of Ethical Theories (Prof. Curtis Brown)

1.Ethics of Conduct – the

actions we should take
2.Ethics of Character – what
type of person we should
be
 Ethics of Conduct: Utilitarianism

• Aka consequentialism
• Doing greatest good for the greatest number
of people
• Uses consequences of an action to determine
whether the action was good or evil
• If the action produces more good
consequences then that action can be
considered as morally right
 Ethics of Conduct: Deontology

• From the Greek word “deon” meaning

duty or obligation, and “logos” meaning
study of
• Ethical decisions are made based on a
set of rules or principles regardless of
what the consequences are
• What is right is more important than what
may the outcome will be
 Ethical Principles

Principle as defined by Samuel Burns

- General law as a guide to action
- Personal code of right conduct

The four (4) Basic Principles are the basis of moral thought
in healthcare
1. Autonomy
2. Nonmaleficence
3. Beneficence
4. Justice
 Autonomy

• Voluntas aegroti suprema lex

• From the Greek word “autonomia” meaning self-rule
• Concept of respect
• To respect an individual`s dignity is to allow the person to
make his own choices without pressure and influences
from others
• Autonomy in health care: YOU SHALL NOT TREAT A
PATIENT WITHOUT THE INFORMED CONSENT OF
THE PATIENT EXCEPT IN NARROWLY DEFINE
EMERGENCIES
 Nonmaleficence

• Aka primum non nocere which means

“first, do no harm”
• Must also include prevention of harm
and removing harmful conditions
• Constant duty to never cause harm to
another individual
 Beneficence

• Salus aegroti suprema lex

• Benefits
• It requires that an action is taken
either to prevent harm or to cause
benefit
• Limited duty shown under specific
patient circumstances
 Justice

• Acting fairly and even-handedly

• Each individual should be treated
the same
• No favoritism
• No priorities
• No VIP
 Other ethical principles

• Confidentiality – concept of privacy

• Double effect – the facts of some actions may produce both
a good and bad effect. There are four criteria must be
fulfilled before this type of action will be permissible:
a. the act is good or morally neutral
b. the intent is good, not evil, although a bad result may
be foreseen
c. the good effect is not achieved by means of evil deed
d. the good effect must be more important than the evil
effect
 Other ethical principles

• Fidelity – duty to fulfill one`s commitment and keeping

promises
• Paternalism – attitudes that sometimes prompts
healthcare worker to make decision regarding a person`s
care without consulting the person affected
• Sanctity of life – life is the highest good
• Veracity - honesty
• Respect for Property - keeping patient`s belongings safe
 Professional ethics

• Coined by Thomas Percival

• is a term that encompasses the organizational and
personal standards of behavior a professional individual
is expected to possess

Two different perspectives of PE

a. code of ethics by ASRT (set of expectation) – “thou
shalt”
b. rules of ethics by ARRT (concern for ethical behavior)
“thou shalt not”
 The standard of ethics

• Are set of ethics guidelines which helps in

maintaining ethical behavior through the
evaluation of radiologic technologists
'character and behavior toward the safety
and welfare of the patient.
• It comprises CODE OF ETHICS and
RULES OF ETHICS
 Code of Ethics

• Written by ASRT and endorsed by the ARRT

• Identifies what colleagues should expect of each
other within a profession and what public should
expect from the professional
• Sets aspirational goals for radiologic technologist
in how to conduct themselves as professional
• Consist of 10 principles that specify what is
expected of each radiologic technologist should
possess
 Ten Principles of Code of Ethics

1. Radiologic Technologist conduct himself in a

professional manner by responding to patient
needs, support colleagues, and provide quality
patient care
2. Radiologic technologist acts to provide services to
humanity with full respect for dignity of mankind
3. Radiologic technologist delivers patient care and
service unrestricted by the concerns of patient
attributes and conditions
 Ten Principles of Code of Ethics

4. Radiologic technologist practices theoretical

knowledge and concepts.
5. Radiologic technologist assumes responsibility for
professional decisions and acts in the best interest
of the patient
6. Radiologic technologists acts as an agent through
observation and communication to obtain pertinent
information for the physician to aid in the diagnosis
and treatment of the patient
 Ten Principles of Code of Ethics

7. Radiologic technologist performs services in

accordance with an accepted standard of practice
8. Radiologic technologist practices ethical conduct
9. Radiologic technologist respect the patient`s right
to privacy
10. Radiologic technologist continually strives to
improve knowledge and skills
 Rules of Ethics

• Developed to identify the minimally

accepted professional conduct
expected of radiologic technologist
• Applied only to ARRT certificate holder
• There are twenty two Rules of Ethics
as of 2010
 Philippines Code of Professional Ethics for Radiologic
Technologists and X-ray Technologist

Article I. RELATION WITH THE STATE AND

SOCIETY
Article II. RELATION WITH
PATIENTS/CLIENTS
Article III. RELATION WITH OTHER ALLIED
PROFESSION
Article IV. RELATION TO AGENCY
Article V. RELATIONSHIP TO ONESELF
 Health Care Ethics

•Aka medical ethics or

bioethics
•A set of moral principles,
beliefs and values that guide
us in making choices about
medical care
 Six Commonly Values Applied in Medical Ethics

• Beneficence
• Non-maleficence
• Autonomy
• Justice
• Dignity
• Truthfulness and Honesty
 Other Values for Medical Ethics

• Informed Consent
• Confidentiality
• Double Effect
• Truth-telling
• Conflicts of Interest
• Futility (expressed wishes)