Physician Engagement:
What It Is & Why It’s Important

Physician Engagement Definition | Measuring Physician Engagement | Improving Physician Engagement | Physician Engagement Best Practices

In healthcare, the impact of workforce engagement has similarities with other industries such as productivity, turnover, and financial performance. However, physician engagement also impacts the health, safety, and well-being of patients. The good news is clinical communication and collaboration solutions can address those common denominators and support key stakeholders.

What is Physician Engagement?

Engaged physicians take greater care of their patients, reduce medical costs, and are more efficient than their unengaged counterparts. The Health Care Advisory Board states that creating organizational alignment is one of the most challenging initiatives, but the most crucial to success—impacting cost, quality, and experience initiatives.


PHYSICIAN ENGAGEMENT DEFINITION
A strategy that focuses on streamlining communication, building relationships, and aligning physicians with the values, vision and mission of their organization and with other healthcare stakeholders to continuously improve care and the patient experience.


 

Why is Physician Engagement Important?

Physician engagement is critical for a successful patient care experience. When physicians feel a lack of association, it manifests itself in ways ranging from physician burnout to a poor patient experience.

Engaged physicians are 26% more productive than those less engaged, adding an average of $460,000 in additional patient revenue per year.

Physician employment does not automatically equal engagement. Communication and collaboration skills are a must-have regardless of the number of employed physicians. High levels of physician engagement have been correlated to increased productivity, the generation of more referrals, expanded influence amongst peers and medical staff, and a greater inclination to driving organizational strategy and change.


BENEFITS OF PHYSICIAN ENGAGEMENT
  Reduced referral leakage.
  Increased in-network referrals.
  Higher engagement of patient population.
•  Improved patient care delivery.
  Enriched physician development and performance.
  Decreased burnout and turnover rates.



Effective engagement strategies require a multifaceted approach. One that includes retention, clinical and cultural fit, onboarding, benefits, leadership development, formal recognition, and physician burnout.

 

Measuring Physician Engagement

Surveys

Consistently measure and invite physicians to share their needs and challenges to gauge physician sentiment and identify gaps within care teams and workflows.


Run monthly engagement surveys for insights into how physicians perceive your organization and its services. Using that information, closely examine the factors that contribute positively or negatively to engagement and create a plan to improve physician’s everyday experience.


 

Scorecards

Help physicians understand what is expected of them in a transparent way while measuring productivity and performance metrics.


“We feel transparency is extremely important in order to change behavior. The scorecard gives a comparison of provider to provider within the same specialty. And then it’s a provider to their individual practice. And then it’s that provider to the network.”

 Travis Turner, Mary Washington Healthcare


 

Dashboards & Reporting

Employ platforms that enable your organization to visualize sufficient, real-time data that drives organizational initiatives and empowers physicians to have the autonomy to course-correct quality to improve care delivery.


Develop an in-house practice transformation dashboard to show overall movement of your practice through the phases of your organizational initiatives. Here’s an example of a dashboard used in the special report Practice Transformation Analytics Dashboard for Clinician Engagement, published by Annals of Family Medicine.

physician-engagement-dashboard


 

Accountability Tools

Implementing a solution that provides your organization and physicians to practice accountability enables both personal, peer-to-peer, and clinical autonomy. Solutions that use read receipts, automatic escalations, and self-managed scheduling can foster opportunities for meaningful dialogue and potentially reduce burnout.

There are hundreds of ways to slice your data. Look back to your guiding questions to determine the most important KPIs for your organization’s unique goals and priorities.


Check out this snippet from our webinar with Mid-Atlantic Nephrology Associates to learn how they utilize our Tracking and Reporting capabilities for transparency and accountability across their organization.

Mid-Atlantic Nephrology Associates reduced operational costs by over $9k by modernizing practice communication for a network of more than 52 facilities, 50 providers, and 1,700 patients.

Improving Physician Engagement

Provide Pathways to Influence

Create physician-led channels to the executive suite to share their voice in decision-making to reframe the narrative of physicians being personnel, to being partners, by creating a forum for open dialogue between executives and physicians.


Invite physicians to join in leadership by developing a roundtable discussion. This fosters an environment where physicians know their voice is heard, helps identify leadership opportunities, and shows commitment to invest in formal and informal opportunities to develop physician leaders.


 

Launch a ‘North-Star’ Initiative

Workflows and systemic factors are universal and aren’t limited to one group of care providers. By demonstrating the intent of how multiple initiatives interconnect, it streamlines the number of things physicians are asked to do on top of their patient care routines. As an example, Figure 1 shows how the factors and behaviors that build a safer culture, drive positive outcomes.


physician-engagement-strategy-northstar

Note: Figure adapted from Bisbey et al. (2019)


 

Create a Data Strategy

Data should be used and not simply collected. An effective way to drive physician engagement is to build a comprehensive data strategy that improves transparency and helps physicians understand the objectives their organization is driving.


North Memorial Healthcare adopted an enterprise data warehouse (EDW) with visualization capabilities to enable physicians to get near real-time answers to their clinical quality improvement questions. The physicians could then see how their decisions affected length of stay (LOS) and how specific changes in clinical processes would improve LOS. By accessing the data, it was easier to convince physicians to make the needed changes.


 

Form Leadership Development Programs

Physician relationships with staff, background, outlook, and training are different from hospital leaders. This can create challenges in how rapidly physicians are able to respond to marketplace and regulatory change. Adopt intentional leadership development programs for physicians who are not only formal leaders but also informal leaders.


 

•  Hold annual leadership summits with executives and c-suite.
•  Establish physician champions to present peer-selected awards.
•  Kick off meetings with peer-recognized moments of excellence.


 

How Does Technology Improve Physician Engagement?

Physicians are trained to be patient care providers, not data-entry administrators.

Physician engagement in technology is critical for the future of care delivery, and physicians are eager for solutions that streamline clinical practice, allow more face-to-face time with patients and improve outcomes. The secret is to improving physician engagement in technology adoption is to illustrate why the technology is needed, involve physicians in the selection and implementation process, and provide data to show the benefit.

While there is apprehension about the impact of technology on payment, liability and quality of care, achieving more balance in providers day-to-day is possible with the right solution. When looking for a clinical communication and collaboration platform, look for solutions that have considered end-users in the build of their user interface and capabilities, interoperability across technology, and the capabilities to streamline workflows to increase operational efficiency.

In an environment that is inherently high stress, recognizing physician needs can empower them to implement new technologies. As a result, this can improve satisfaction levels, assist in making better care decisions, and support patient engagement and satisfaction levels.

Find out how the right solution can support your physician engagement strategy.

Operating Room Management: Scheduling and OR Efficiency

Operating Room Management: How Digital Scheduling Can Improve OR Efficiency

Operating rooms (ORs) account for roughly 60% of a hospital’s revenue,1 but they also represent the largest hospital cost category.2 As a result, effective operating room management can make or break the financial stability of your hospital. Yet, many operating room managers and staff lack the technology needed to optimize OR utilization, including physician scheduling software and exam room scheduling tools.

How to Improve Operating Room Management

Many hospitals target “on-time first case starts,” meaning the first operation begins on time with no delays, as a baseline for using operating room time most efficiently.3 Delays in first case starts can delay OR operations for the remainder of the day, frustrating patients and surgical teams. For diligent leaders, the essential first step to streamlining processes that get patients, surgeons, and equipment to the operating table on time is to evaluate how clinical teams and cases are scheduled.

Implementing the right provider scheduling and operating room management system can help hospitals and health systems holistically address OR efficiency. An advanced solution will also arm clinical and operational leaders with the data they need to track progress and set benchmarks for success. Investing in comprehensive scheduling technology can maximize the operational efficiency of your OR, increase patient access, improve patient throughput, and increase revenue.

4 Ways Physician Scheduling Software Improves Operating Room Efficiency

1. Digitizing Provider Schedules for Real-Time Visibility

Without proper scheduling technology, clinical teams can have trouble accessing the latest schedule and keeping it up to date. As schedules are updated, different versions of the schedule can linger and create confusion for both clinicians and administrators. A digital scheduling platform increases schedule access by making real-time schedules available on any device 24/7.

Hospitals and health systems that deploy a single digital scheduling solution across the enterprise can further streamline operating room management and efficiency by giving OR managers, directors, and others one place to see schedules for all clinical staff moving in and out of the OR.

2. Automating the Scheduling Process

Based on client data, we estimate that each specialty department in a hospital spends roughly 291 hours building and managing shift schedules. Much of that work is delegated to physicians and clinical leaders who know the ins and outs of their departments’ schedules. Automating the schedule-building process with a rules-based scheduling solution frees up physician’s time so they can get back to revenue-generating patient care.

3. Leveraging Data to More Efficiently Manage Resources

A schedule becomes a tool for resource optimization when organizations can analyze and compare historical staffing patterns and create future schedules that align staffing with patient demand. The result? Efficient use of capital resources and more productive, satisfied staff. Prescriptive analytics can give organizations insight into patterns of provider supply and patient demand on a daily, weekly, monthly, or seasonal basis. Supply and demand patterns help leadership optimally allocate resources as needed for certain surgical services, allowing organizations to cut waste, increase patient access, and avoid patient leakage.

4. Improving OR and Exam Room Scheduling

The right scheduling tool can provide the proper utilization metrics to set benchmarks for improving operating room management and efficiency. With real-time visibility into OR availability, turnover times, and openings, users can best schedule providers and surgical teams directly into specific operating rooms.

OR Outcomes: Optimal Utilization and Increased Revenue

1. Reduction of Errors and Improved Operational Efficiency

Automating the scheduling process saves time and reduces the risk of human errors leading to empty rooms, double bookings, and other inefficiencies that cost time and money. With real-time schedule availability, your staff can waste less time on back-and-forth communication about open rooms and scheduling.

2. Improved Patient Access and Patient Experience

By reducing errors and optimizing the scheduling of clinical staff and operating rooms, great scheduling software helps ensure your patients receive timely care, fewer delays, and less frustration. An ideal solution will also allow your team to identify gaps and opportunities in your OR utilization—improving patient access and generating additional revenue for your hospital.

3. Increased Provider Satisfaction and Retention

A scheduling solution can eliminate many of the frustrations providers experience when it comes to their schedule, including inconvenient errors and the struggle to find the latest version of the schedule. When operating room resources are optimally utilized, physicians can see more patients, leading to more billable services per provider.

The result of better OR scheduling? An overall increase in revenue and profitability for your hospital. With the proper technology, your organization can increase patient throughput, reduce overhead costs of underutilized operating rooms, and improve OR efficiency.

Discover how one major health system leveraged our physician scheduling software to uncover hidden resource availability and maximize its utilization of exam rooms and operating rooms.

Sources

  1. Analysis of the US and EU5 Hospital Operating Room (OR) Products and Solutions Market, Forecast to 2022, Frost & Sullivan, May 2019: images.discover.frost.com/Web/FrostSullivan/%7B633567b3-e18e-4fd3-82d8-bd6fd5bfc13f%7D_MDD8_Preview.pdf
  2. Where Are the Costs in Perioperative Care?: Analysis of Hospital Costs and Charges for Inpatient Surgical Care, Alex Macario, MD, MBA, Terry S. Vitez, MD, Brian Dunn, BA, Tom McDonald, MD, Anesthesiology—Vol 83, Pages 1138-1144, 1995: pubs.asahq.org/anesthesiology/article/83/6/1138/49/Where-Are-the-Costs-in-Perioperative-Care-Analysis
  3. 7 of the Most Important Metrics for Measuring OR Efficiency, Becker’s Hospital Review, Jan. 19 2012: beckershospitalreview.com/or-efficiencies/7-of-the-most-important-metrics-for-measuring-or-efficiency.html

 

Nurses of Note Awards 2021: Week Four

 

PerfectServe’s Nurses of Note awards program focuses on the many nurses who deserve recognition for the dedication, sacrifice, and resilience they bring to work every day. For the inaugural Nurses of Note Awards, we have the privilege of highlighting a new level of commitment, strength, and integrity in nurses from around the country who have battled on the front lines of the still-raging coronavirus pandemic.

The actions of this diverse group of nurses highlight the extraordinary among us. Their stories give us a glimpse into the unique ways our nurses have fought this pandemic and made a difference in the lives of their patients and the communities they serve. Out of hundreds of nominations, we selected three nurses and one team of providers to spotlight as recipients of this award.

Honoree 4: Chief Operating Officer Erica Johnson and the COVID-19 Vaccination Nursing Team, Hampton Roads Community Health Center (Portsmouth, VA)

Erica Johnson and her team at the Hampton Roads Community Health Center (HRCHC) are not just nurses—they are educators, community liaisons, and friends to the people of Portsmouth, VA. This team of five nurses, dubbed the COVID-19 Vaccination Nursing Team, worked with unwavering resolve to serve the underserved throughout the COVID-19 pandemic. Their names are Nicol Franklin, LPN; Daira Person, MA; Lawona Smith, RN, BSN; and Shaye Spellman, LPN. As Chief Operating Officer, Erica (who has been with HRCHC for 14 years) is the spokesperson for the team and shared how the facility had to adapt to continue providing the quality care they always strive for.

HRCHC is a federally funded, non-profit care center. Erica and her team serve an underserved population and pride themselves on being a “one-stop-shop” for “cradle to grave” care for those who would not normally have routine, accessible healthcare resources. As early as March 2020, the HRCHC was one of the first testing sites in the area for COVID-19. Dr. Vladimir Markovic, HRCHC’s Chief Medical Officer, implemented the COVID-19 Vaccination Nursing Team, and Erica led the team through 11- to 12-hour shifts, sometimes five to six days a week. The team updated their COVID-19 policies every weekend, adjusting to keep pace with the rapid flow of information and new understanding about the virus.

As a community health center, HRCHC couldn’t afford to stop primary and general care—the needs of the community didn’t cease to exist simply because COVID-19 was around. Erica and her team were able to continue seeing regular patients thanks to their rigorous attention to detail with infection control best practices. They were able to screen people and see regular patients as well as provide triage care over the phone. Amazingly, they had no in-house COVID infections thanks to their diligence.

As soon as the vaccine became available, HRCHC was one of the first vaccination locations in the area. But, as you might expect, they didn’t stop at just vaccinating those who came to their center—they also provided transportation to the clinic. They carried out community outreach and education about vaccination for those who were scared or nervous. Erica and her team acted as community liaisons, taking federal updates and translating them to make them more digestible for the people they serve. Erica’s team prioritized their outreach to the most vulnerable, striving to educate and encourage conversations about vaccination to alleviate hesitancy among their patients.

The Hampton Roads Community Health Center’s nominator wrote this about Erica and her team: “The due diligence and resiliency of HRCHC’s COVID-19 nursing team are undeniable, as they continue to be a living embodiment of our mission: serving as frontline, healthcare safety net professionals, delivering much-needed, accessible, quality healthcare to tens of thousands throughout the Hampton Roads region.”

What is one positive thing you and your team learned from COVID-19?

The team learned the value of talking and listening to people; in a pandemic, every vulnerability, every concern—everything was heightened. Heightened apprehension, depression, and anxiety. It made every word that everyone said potentially critical. We also learned that creating a learning environment is important. We realized that nobody knows anything when we’re supposed to know everything!

What was your team’s outreach strategy to encourage vaccination?

The most significant thing we’re doing is asking, “Why?” Everyone has their own reason for being skeptical. We approached the vaccines from an unbiased point of view and encouraged conversations around it. Once we talked to people about the vaccine and why it works in general terms, then we’d ask, “So do you want the vaccine?”

If you had to think of a word to describe the work your team has done during the pandemic, what would your work be?

Relentless … resilient. There have been so many challenges and barriers where we could have stopped. But for so many people, we are the only healthcare outlet they have. We couldn’t stop. We had to persevere.

What is your advice for new nurses coming into the field?

Do not expect anything particular; appreciate everything that happens, even the challenges. There’s no facet of healthcare that can’t utilize nursing in some capacity. Be open to different experiences. All of your patients are important, everyone is valuable, and everyone has something that makes them unique. Even COVID has made us stronger providers and practitioners of caring and healing. Always focus on the healing component of nursing.

Thank you, Erica, and the COVID-19 Vaccination Nursing Team at Hampton Roads Community Health Center!

Erica, your team’s service to the Portsmouth community has been impressive, honorable, and inspiring. Thank you for your dedication to underserved communities and for leading a relentless and resilient team!

Read the Full Winners List

Nurses of Note Awards 2021: Week Three

 

PerfectServe’s Nurses of Note awards program focuses on the many nurses who deserve recognition for the dedication, sacrifice, and resilience they bring to work every day. For the inaugural Nurses of Note Awards, we have the privilege of highlighting a new level of commitment, strength, and integrity in nurses from around the country who have battled on the front lines of the still-raging coronavirus pandemic.

The actions of this diverse group of nurses highlight the extraordinary among us. Their stories give us a glimpse into the unique ways our nurses have fought this pandemic and made a difference in the lives of their patients and the communities they serve. Out of hundreds of nominations, we selected three nurses and one team of providers to spotlight as recipients of this award.

Honoree 3: Missam “Sam” Merchant, MBA, BSN, RN, CCRN, PCCN, RN-BC, NE-BC; Hospital Supervisor for University Health System (San Antonio, TX)

Missam Merchant—who goes by Sam—wanted to be a doctor at a young age. His family could not afford that educational path, but Sam still found his way to a career in healthcare; nurses were needed in the United States, so his family agreed that nursing school would be his best bet. In school, he realized he could change the world by helping one person at a time, and he hasn’t looked back since.

Sam’s nominator described him as someone who shows humanity to every patient regardless of identity or background. He started to appreciate the impact he could have on the lives of others after providing care for a homeless man facing diabetic complications during nursing school. Since that moment, Sam has been utterly dedicated to helping his community and those who are underserved. In the past two years, he spearheaded many campaigns and fundraisers that provided donations for the homeless. He has conducted fundraising to the tune of more than $16,000 for blankets, hygiene kits, and more to support the homeless population and many shelters in San Antonio.

Even though it’s not what drives him, Sam is no stranger to recognition for the services he provides to his patients and coworkers—he has received many awards for his work. To name a few: The Weezie’s Angel Healthcare Hero Award, Best 25 Nurses of South Central Texas, and the 20 for 2020 Nurse Award (given by the Texas Nursing Association). As a leader, speaker, coach, and mentor, Sam is also a major proponent of higher learning and continued education.

Even with the challenges presented by the COVID pandemic, Sam was still able to help launch the San Antonio Indian Nurses Association (SAINA), a not-for-profit organization with over 300 nurse members intended to serve as “a professional body and resource for all licensed professional nurses of Indian descent/origin and heritage” in the United States. In fact, in the past year alone, he has given speeches, served as a mentor, submitted journals for publication, and founded not one, but two organizations. He also works to give free certifications to nurses in leadership and professional development (he’s taught 17 classes this year), equipping them with the training needed to move the needle on healthcare and education policy at the county and state levels.

A true advocate for diversity in nursing, education, and leadership, Sam is active in many diversity-centered associations and boards. He serves as president for SAINA, director for the Asian American Alliance of San Antonio (AAASA), is a member of the governing board for the National Association of Indian Nurses of America (NAINA), and is involved with many others. Sam provides safe and educational forums for nurses to collaborate on practices and how to best serve their communities.

What inspired you to become a nurse?

Nursing fell into my lap in India in 2003. I had a light bulb moment when I took care of a homeless patient who suffered from severe diabetes and had not received foot care for a year. I treated this patient, and at the end of the procedure, he gave me 10 rupees—the equivalent of about 14 cents. I realized how much impact I had on this one patient, who felt cared for and loved and was willing to give me his most valuable possession in return. 15 years later, I am proud and humbled to be a nurse who can continue to make a difference in patients’ lives.

What’s one piece of advice for nursing students entering the field?

Right from the beginning of your career, find a mentor who you can trust. The mentor will help you see things that you cannot see for yourself and will help to motivate you through feelings of burnout. Nursing is not easy; it requires ongoing learning, hard work, commitment, and selfless service.

What would you like to see change for nursing in the future?

The future of nursing is bright. Nurses are fighting for safe staffing, better access to care, and a healthy environment—both for themselves and for their patients. I want to see two things in the future of nursing: greater diversity and leadership. Diversity, equity, and leadership in nursing is the key to sustainability. The ability to compassionately care for our communities is the wave of the future.

How do you combat burnout in your professional life?

Burnout is real, but it’s seldom addressed by leadership and often ignored by nurses themselves. It then manifests itself in poor care, poor relationships, and broken homes. There are three levels to curbing personal and group burnout: Organization, microsystem, and personal. The organization level is a commitment from senior management to acknowledge burnout and put prevention measures in place. The microsystem level focuses on your team and team leader understanding workflow as a whole—how that workflow can lead to burnout when not managed well or when things are not adjusted when needed. This level can be managed by staffing correctly, promoting teamwork, creating acuity plans, and other leadership and organizational work. The personal level is an inward look at being mindful of when we are feeling burnout. Know the signs your body gives, know how to take mental health breaks, and know how to separate work and home life.

What’s your passion outside of nursing?

Working for non-profit organizations and impacting lives. I have been involved with various non-nursing organizations that are involved in early childhood education, alliance for minorities, and others. These organizations have made a big impact on my community.

If you had to pick one song that describes you as a nurse, what would it be?

“Firework” by Katy Perry. I am a nurse that believes in empowerment; inspiring the next generation of nurses to not give up and to push through to make a difference. Everyone is unique, and everyone needs to be able to shine in nursing and life.

Thank you, Sam!

Sam, through your commitment and dedication, you certainly light up other peoples’ lives—just like a firework. Thank you for your continued service to your patients, your fellow nurses, and your community, and congratulations for being named a 2021 Nurse of Note.

Read the Full Winners List

Nurses of Note Awards 2021: Week Two

 

PerfectServe’s Nurses of Note awards program focuses on the many nurses who deserve recognition for the dedication, sacrifice, and resilience they bring to work every day. For the inaugural Nurses of Note Awards, we have the privilege of highlighting a new level of commitment, strength, and integrity in nurses from around the country who have battled on the front lines of the still-raging coronavirus pandemic.

The actions of this diverse group of nurses highlight the extraordinary among us. Their stories give us a glimpse into the unique ways our nurses have fought this pandemic and made a difference in the lives of their patients and the communities they serve. Out of hundreds of nominations, we selected three nurses and one team of providers to spotlight as recipients of this award.

Honoree 2: Vera Hall, SVP/Chief Nursing Executive for St. Elizabeth Healthcare (Cincinnati, OH Area)

In the fourth grade, Vera Hall wrote that nursing was her dream profession. Her older sister told wonderful stories about her time in nursing school, and it made Vera want to help people in their time of need. As it turns out, that dream never faded. Vera now serves as the SVP and Chief Nursing Executive at St. Elizabeth Healthcare in the Cincinnati area, and she has amassed more than 26 years of experience in the field.

Vera’s service throughout the pandemic can best be described as proactive, innovative, and transparent. Before the severity of the COVID-19 pandemic was fully realized, Vera took immediate and strategic action to designate one of the five St. Elizabeth Healthcare facilities as a COVID-19 facility. She then worked vigilantly with supply and management teams to purchase 30 HEPA filter fans and to convert over 160 patient rooms to negative pressure rooms.

Vera’s perceptive planning didn’t stop there. She deployed the Infectious Disease Response Team (IDRT) to provide comprehensive care for patients with COVID-19, protecting both patients and healthcare workers. She then expanded the IDRT team from 50 to 400 associates—an 800% increase—when the pandemic continued to intensify.

To protect the jobs of many coworkers, Vera also implemented a Surge Staffing office, placing associates and healthcare workers where additional staff were needed instead of furloughing them or eliminating their jobs. Workers were able to call Vera’s Surge Staffing office to receive shifts and help alleviate some of the pressure caused by high case numbers. Due to Vera’s novel and proactive approach, no St. Elizabeth associate was furloughed or laid off.

Vera collaborated with many local health departments, colleges, educators, healthcare facilities, and others during the height of the pandemic and as vaccines became available. Innovative solutions during times of peak case numbers included manual proning beds for improved oxygenation of patients, iPads for patient communication with families, cameras in rooms for remote patient monitoring, and expanded telemetry monitoring capacity as need arose. Vera also worked to onboard 33 retired nurses to assist with vaccinating the public.

Vera has been intensely dedicated to her facility and team during the pandemic. She visited nursing units day and night to provide much-needed support for nurses and other staff. Vera made sure to provide timely COVID-19 communication to keep all St. Elizabeth associates safe and informed over the past 14 months, and she continues to do so today.

What inspired you to become a nurse?

In the fourth grade, I had a class assignment to write an autobiography that included my dream profession; I knew without a doubt that I wanted to be a nurse. My sister was in nursing school, and I had always looked up to her; hearing her stories and experiences really inspired me. I wanted to help people in their time of need and make their patient experience as personal as possible. I followed this career pursuit and have never looked back. This career has been an absolute blessing to both me and my family.

What’s one piece of advice for nursing students entering the field?

First and foremost, embrace every moment and experience. Some days will feel longer than others. No matter what type of day or challenge you have, there will always be something new to learn. Nurses are trusted, valued members of the healthcare team, and this has never been more evident than it is today. Your success will continue to grow as you remain open to new experiences and new ways of doing things. Support your peers who are entering the profession, prioritize your health and wellness, and above all, always remember why you decided to become a nurse!

What would you like to see change for nursing in the future?

Even prior to the pandemic, demands in the nursing profession had intensified due to a high volume of nurses retiring in the last decade and a patient population that is more and more composed of aging individuals. In addition, we’re experiencing physician shortage nationwide. We are seeing nurse practitioners practicing independently in a greater capacity. That said, we need to continue to offer more nursing education options—whether that be online or for specialized areas of nursing—so that these growing healthcare demands can be satisfied.

How do you combat burnout in your professional life?

As a young nurse leader, I was not the best example of managing a work-life balance. I eventually learned to leave work at work so I could fully embrace my life outside of it. I value time with my husband and family, though at times work crosses over into my personal life (especially over this past year). I have been doing a better job of disconnecting; whether it be through travel or simply reading a book, I can allow my mind to rest, which is the best way I can manage burnout.

What’s your passion outside of nursing?

I absolutely love the beach—it’s always on the top of my travel list. The laid-back atmosphere, smells of the water and air, and beautiful natural sights and scenery; the overall environment is so relaxing.

If you had to pick one song that describes you as a nurse, what would it be?

The song “I’ll Be There” by The Jackson Five!

Thank you, Vera!

Vera’s nominator described her as someone who “lives for others.” It’s an apt testament, because her unwavering efforts and focus on readiness over the past 14 months have likely saved lives in her community. From the entire team at PerfectServe, thanks for the work you do every day, and congratulations for being named a 2021 Nurse of Note.

Read the Full Winners List

Nurses of Note Awards 2021: Week One

 

Nurses of Note Yoji Patil

PerfectServe’s Nurses of Note awards program focuses on the many nurses who deserve recognition for the dedication, sacrifice, and resilience they bring to work every day. For the inaugural Nurses of Note Awards, we have the privilege of highlighting a new level of commitment, strength, and integrity in nurses from around the country who have battled on the front lines of the still-raging coronavirus pandemic.

The actions of this diverse group of nurses highlight the extraordinary among us. Their stories give us a glimpse into the unique ways our nurses have fought this pandemic and made a difference in the lives of their patients and the communities they serve. Out of hundreds of nominations, we selected three nurses and one team of providers to spotlight as recipients of this award.

Honoree 1: Yoji Patil, MSN, RN, CNOR of Stamford Health (Stamford, CT)

Yojana Patil—who goes by Yoji—believes that nursing chose her. She accidentally stepped into her career when she took an entrance exam to support a friend who wanted to pursue nursing. Twenty-plus years later, Yoji found herself battling on the front lines of the COVID-19 pandemic. In response, she helped to launch the ICU Family Liaison Program at Stamford Health to keep ICU and palliative teams in communication with patients and their families while visitation restrictions were in place.

Yoji was nominated by her Stamford Health coworker Michelle Watson, who serves as Nurse Manager for the ICU and IMCU. Michelle wrote that Yoji’s ICU Family Liaison Program initiation felt seamless, and that Yoji deserves full credit for what the program was able to accomplish.

The ICU Family Liaison Program has kept patients and their families connected in a time when communication is more important than ever. Yoji wrote the training and communication guide for the program, which covers four intensive care units for eight hours a day, seven days a week. She individually called and updated families of patients, organized patient care across multiple specialties, and facilitated conference calls—all on top of her regular nursing schedule.

Her nominator Michelle summed up Yoji’s efforts by saying, “I am proud to work with Yoji and to be a witness to such an important initiative that provides much-needed information and comfort to families.”

Yoji’s service to her patients did not stop when she was tired. Throughout the pandemic, she worked weekends and holidays to provide continuous care. On Mother’s Day, she organized a video call with all of her female patients’ children, allowing them to see their mothers even though they couldn’t be together in person.

Throughout the pandemic, Yoji has been a caretaker and advocate for those who lost their lives to COVID-19. She has held the hands of dying patients whose families couldn’t be there to comfort them. On multiple occasions, Yoji obtained permission to allow family members to visit and say goodbye to loved ones when a patient’s outcome looked grim. Yoji was and remains a steady support system to families facing the bereavement process.

Yojana Patil’s service to her patients, her colleagues, and her community is an emphatic demonstration of character, empathy, and commitment to nursing.

What inspired you to become a nurse?

Sometimes you choose a profession, but in my case, the profession chose me. I accompanied my friend to the entrance exam for a reputed nursing school in Mumbai. The principal was walking by and asked me, “Instead of waiting outside, why don’t you sit in for the exam?” I did end up taking the test, and now I can’t imagine choosing any other profession.

What’s one piece of advice for nursing students entering the field?

Nursing is a work of heART. Nursing is a way of living for the rest of your life. It’s not just a job—once a nurse, always a nurse.

What would you like to see change for nursing in the future?

I would love to see nursing at the forefront of healthcare. I want to see nurses advocating for patients, especially the population that has no voice.

How do you combat burnout in your professional life?

I have tremendous support from my family, friends, and coworkers. I use mindfulness in my daily activities, especially on hectic days. Emotional burnout is a real thing. Nurses around the world are feeling helpless and emotionally drained as an effect of this pandemic. Most of us have PTSD from our experiences and the difficult outcomes we’ve witnessed.

Taking care of your physical and mental health is just as important as taking care of your patients. A quick five-minute deep breathing session before walking into unknowns, such as receiving a new patient or beginning a shift, goes a long way.

What’s your passion outside of nursing?

I love Zumba. I also went skydiving on my 40th birthday! I have traveled to four continents so far and would love to explore Africa next. To sum it up, I enjoy dancing, traveling, and adventure sports. I’m not the best at sports, but that doesn’t stop me from trying!

If you had to pick one song that describes you as a nurse, what would it be?

If I had to pick a song, it would be “Heal the World” by Michael Jackson. But this excerpt from a poem—which I wrote with my coworker and fellow nurse, Seema Pillai—really describes me as a nurse:

Today I feel like a soldier, waging a war,
With limited weapons, I return home each day with many a scar.
But I will fight valiantly and will not despair,
‘Cos I go to work each day with weapons invisible—faith, hope, trust, and a prayer.

Nursing is my calling
And when duty calls, I will not fail,
I know there’s light at the end of the tunnel, I know I’ll live to tell this tale.

Thank you, Yoji!

Your hard work and dedication to exceptional patient care is recognized and appreciated by your colleagues and the team at PerfectServe. We wish you all the best in your continued efforts to make life better for the individuals and families who trust you with their care.

Read the Full Winners List

Clinical Collaboration Systems for Hospitals—Complete Guide

Collaboration SystemsClinical communication and collaboration are critical to a healthcare organization’s delivery of effective patient-centered care. But for healthcare leaders looking to make a tangible impact on key performance metrics, terms like “clinical collaboration” and “care team communication” can feel a bit abstract.

Some may question:

What’s the best way to improve care team communication? Is it as simple as HIPAA-compliant text messaging? Is there more to “clinical collaboration” than juggling workarounds and niche vendors?

Whether you’d like to understand the effect that communication can have on patient care and clinician satisfaction, you’re trying to choose the best clinical communication app, or you just need to know where to focus first, this guide can help.

Index

Impact of Communication in Healthcare | Improving Communication and Patient Safety | Top Digital Solutions | Choosing the Right Solutions | Infographic: 8-Step Overhaul Checklist | Future of Technology in Healthcare

What is the impact of communication in healthcare?

80% of all medical errors involve miscommunication.1

Healthcare communication, sometimes known as clinical communication and collaboration (CC&C), is one of the most essential—and deceptively complex—aspects of patient care. The quality and speed of patient care delivery rely on the care team’s ability to communicate critical information accurately and rapidly.

Yet 14% of messages go to the wrong clinician at the wrong time.2

Poor communication is a key contributor to:

  • Medical Errors
  • Care Delays
  • Declining Patient Satisfaction
  • Increasing Provider Burnout

Patient expectations, which are critical in shaping their experience with healthcare organizations, continue to evolve in the age of value-based care. Mistakes, care delays, confusion, and frustration among care teams impact patient outcomes and are now reflected in HCAHPS scores and CMS reimbursements.

Joining patient satisfaction is the priority of provider satisfaction and its impact on burnout and turnover. Recently, pandemic-related surges in patient demand and declining resource availability have made care coordination more exhausting, making smooth collaboration more essential in combatting burnout.

Improving Clinical Communication and Patient Safety

Hospitals and health systems looking to improve clinical communication and patient safety should start by taking an honest look at the workflows and potential gaps that exist within and across your organization’s various roles and departments.

Where are your opportunities for improvement? Think about answers to the following questions.

Accelerating Speed to Care

  • Does communication at your organization always reach the right provider in a timely manner?
  • Could your teams accelerate speed to care by reducing the number of steps in the existing communication workflows?

Eliminating extra steps reduced UT Medical Center’s time to initiate clinical communication by 76.3%.

Reducing Provider Interruptions

  • Do physicians get nonurgent interruptions during patient encounters, surgery, or other critical moments while administering care?
  • Do your providers have the ability to “unplug” and recharge during their time off to help prevent burnout, or do they get interrupted with misdirected communication?

Burned out physicians are 2x as likely to be involved in patient safety accidents.

Enhancing Patient and Family Communication

  • Do you provide appointment reminders or virtual check-in to support patient safety and satisfaction?
  • Can nurses easily and securely communicate with patients and update their family members?

Texting patients helped Park Nicollet reduce patient readmissions by 32% and cut nurse phone calls by 25%.

If you answered “No” to any of the questions above, you have identified an opportunity for improvement. Fortunately, healthcare technology has come a long way in a short period of time, and it is easier than ever to replace siloed tools and systems with integrated clinical collaboration solutions.

What are the top digital solutions for clinical communication?

The simplest answer is: It depends. There are various clinical collaboration tools that exist to serve specific purposes. Since each health system, hospital, and even department has unique needs, the best choice is to work with a solution that offers broad integration capabilities. Select a vendor that operates as a care delivery partner and has the agility to evolve with your organization’s needs over time.

Identifying the right clinical collaboration system for your organization will require collaboration among your internal leadership if you hope to minimize your vendor footprint, avoid creating more silos, and maximize ROI.

How to Choose the Right Clinical Communication Software

Sometimes for hospitals and health systems, the hardest part about improving clinical communication and patient safety is figuring out where to start. To help, we created a checklist infographic summarizing the eight steps to a strategic clinical communication upgrade outlined by Julie Mills, DNP, MBA, RNC-OB, C-EFM, Sr. Director of Clinical Solutions at PerfectServe.3

8 Steps to a Clinical Communication Upgrade

  1. Create a multidisciplinary decision-making team.
  2. Calculate the financial impact.
  3. Start your list of requirements with HIPAA compliance.
  4. Recodify time-tested policies.
  5. Pilot while priming physician buy-in.
  6. Work through communication workflows.
  7. Choose your hardware.
  8. Create a closed loop for continual improvement.

Want more detailed information about completing each step to shape your clinical communication strategy? Download our clinical communication checklist.

What is the future of technology in healthcare?

Technology will continue to provide new and better ways to support healthcare processes, streamline clinical communication, and enhance patient safety. That’s why it is important to be selective when considering new vendors and systems. The right choices can unify and simplify care team collaboration, but the wrong choices could add silos, waste resources, and impede patient-centered care.

Prioritize integration and look for solutions that unify as many workflows as possible—clinical communication, provider scheduling, patient communication, patient family updates—into one user-friendly platform accessible from anywhere on any device.

Sources

  1. Joint Commission Center for Transforming Healthcare Releases Targeted Solutions Tool for Hand-Off Communication, Aug. 2012: jointcommission.org
  2. Paging Dr. Right, ACP Hospitalist, Stacey Butterfield, May 2012: acphospitalist.org/archives/2012/05/success.htm
  3. Checklist for a successful clinical communication overhaul, Nursing Management, Mills, Julie MBA, RNC-OB, C-EFM, Vol. 52, Issue 1, p. 10-13, Jan. 2021: journals.lww.com/nursingmanagement/Fulltext/2021/01000/Checklist_for_a_successful_clinical_communication.4.aspx#

Partnering With Our Customers to Accelerate Speed to Care

Covid Year in Review

The past 12 months have been difficult in more ways than we can count. But, while we lament the struggles and mourn the hundreds of thousands of lives lost in the United States, we can also take stock of the victories, accomplishments, innovations, and breakthroughs achieved in the age of COVID-19. We can even appreciate some of the ways healthcare has changed for the better.

To quote our Chief Clinical Officer Kelly Conklin, who spent 20 years as a trauma and ER nurse, “These ‘unprecedented times,’ challenging and sad though they’ve been, are the impetus for a lot of promising change in the world of healthcare, and I’m optimistic that the ‘new normal’ is going to be a friendlier, more convenient, and more modern experience.”

COVID-19 Demanded a Flexible Response

At PerfectServe, our COVID experience has been focused on supporting the hundreds of healthcare organizations that use our technology every day. Infectious disease doesn’t ask permission to spread, so deploying PerfectServe’s technology quickly and effectively has been key to our efforts. We started with an offer of free software and services for customers. As time went on, use cases became more varied.

Initial Wave in March 2020

  • Supported curbside testing coordination.
  • Built a new platform to enable hospitals on lockdown to communicate with patients’ family members from the core PerfectServe system.
  • Facilitated news, announcements, and other mass communication for employee and clinician alignment on treatments, procedures, and protocols. (Core communication traffic increased by 400%.)

Mid-Pandemic

  • Reduced infection risk for clinicians by allowing them to use their mobile devices to round on less acute COVID patients.
  • Enabled quick and app-less telehealth visits as clinics remained closed.
  • Offered a Rapid Surge Scheduling solution to help organizations easily build and update provider schedules as available staff, patient load, and even hospital facilities changed rapidly.

Reopening

  • Enabled a virtual waiting room capability to help clinics adhere to safety protocols as certain facilities reopened

Vaccine Rollout

  • Facilitated the communication of vaccine procedures and distribution of information within clinical care teams.
  • Currently leveraging Lightning Bolt’s Access Optimization capability to build optimized provider schedules based on time taken to vaccinate patients—using average vaccination throughput as a driver for provider schedule creation.

The growing list of new use cases reflects how PerfectServe has embraced the agility required to be an effective technology partner for healthcare organizations. To echo Sachin Jain’s recent column for Forbes, Change does not have to be slow, plodding, and hyper-rational. At the height of the COVID-19 crisis, healthcare organizations showed remarkable agility because the situation demanded it.”

We know how important communication and coordination are for care delivery, and we’ve delivered solutions that meet the needs of a once-in-a-century moment.

  • Pull together a team to launch a new patient communication platform in a few weeks?
    We can do that.
  • Rethink our implementation protocols to execute a virtual multi-site go-live for a large health system?
    We can do that too.
  • Launch an easy-to-use, fast-to-deploy video visit platform that enables providers to reach more of their patient population while in-person visits are discouraged?
    We’re on it—and we’ll do it quickly.

A couple of customers shared some thoughts about the support PerfectServe provided as their organizations ramped up COVID-19 response efforts:

“When COVID hit, we had to look for alternative virtual solutions in an attempt to connect with all of our patients. PerfectServe was able to quickly help us stand up their video platform to assist in certain situations. They were able to understand and meet our patients’ needs.”

– Andrew Bradford, Director of Virtual Health, St. Elizabeth Physicians

“As far as COVID support from PerfectServe, implementing the Lightning Bolt Rapid Surge Scheduling solution was a very simple process. I was able to add and change assignments as needed, which I have always been able to do, but the most helpful was when we had to add more support personnel on the fly. Having that flexible scheduling capability was critical during such an uncertain time, and the whole PerfectServe team was a huge help.”

– Sandee Leslie, Practice Program Coordinator, St. Luke’s Health System (Nampa and Meridian Medical Centers)

Amplifying Diverse Voices

2020 challenged companies to think differently in many ways. We’ve been reminded time and time again that recognizing and amplifying diverse voices makes a business stronger, wiser, and more inclusive. PerfectServe’s Diversity & Inclusion (DE&I) Advisory Council led the charge to adopt a revamped diversity charter for the company, and a simple but powerful new motto permeates all DE&I efforts:

“Different is Perfect.”

PerfectServe works with hospitals and practices in every corner of the country, and we want our team members to reflect the diversity of thought, background, and experience that we see in our customers—and our customers’ patients—every single day. This work never ends, and our CEO, Guillaume Castel, constantly emphasizes the egalitarian nature of healthcare:

“No matter who you are, where you come from, what you believe, or what you look like, we all need care at some point in our lives.”

– Guillaume Castel, Chief Executive Officer, PerfectServe

Healthcare affects everyone, and that means everyone should have a seat at the table.

To recap, a lot has been learned in the last year:

  • We listened closely to customers so we could address their most pressing needs with our solutions—and we created new solutions along the way.
  • We tweaked, reworked, and updated processes to get work done more efficiently than ever in a virtual environment.
  • We found new ways to reinforce a company culture that starts with inclusivity and committed to growing on that momentum.
  • We saw real life in stark relief as Zoom calls were graced with—not interrupted by—pets, family members, friends, and everything in between.

More than 100 million COVID vaccine doses have now been administered in the United States, and as a glimmer of normalcy looms on the horizon, rest assured that PerfectServe will emerge from the pandemic with clarity of purpose and a steadfast commitment to customers: With our technology and the talented employees who make our company tick, we will continue to accelerate speed to care by making collaboration more intuitive, scheduling more optimized, and communication more effective.

Would you like to learn more about how we can help your organization thrive with better communication, scheduling, and/or collaboration?

How to Manage Complex Radiology Scheduling

Radiology scheduling is highly complex, with teams scheduling providers across numerous specialties and locations. As a result, building the schedule is a task often reserved for physicians or administrators with deep knowledge of how their teams operate. Without leveraging the right tools to build schedules, radiology groups get stuck with a time-consuming, inefficient process.

Why is radiology scheduling so difficult?


Creating shift schedules for radiologists is a major balancing act, with multiple scheduling variables that often compete with one another. Let’s explore just a few of the key issues that make radiology scheduling so complex.

1. Subspecialty coverage for diagnostic imaging exams.

Many diagnostic imaging exams and interventional procedures require specific subspecialty coverage. Radiologists are typically credentialed to work only one particular sub-specialty, with few able to provide cross-coverage. The increasing sub-specialization of radiology, coupled with the growing shortage of radiologists,1 makes this all the more challenging. Ensuring all shift types are covered without overutilizing certain providers is increasingly difficult.

2. Scheduling radiologists and technologists across multiple locations.

Radiologists and radiology technologists typically cover multiple locations, from imaging centers to hospitals, making it difficult to determine who is scheduled, when, and where. Add in the varying shift types at each individual location, and the equation becomes even more challenging.

3. Physician preferences and satisfaction are a top priority.

Radiology is quickly becoming one of the most challenging and expensive specialties for physician recruitment.2 The Association of American Medical Colleges estimates a shortfall of nearly 42,000 radiologists by 2033.1 As a result, it’s incredibly important to create schedules that minimize burnout and keep providers happy.

That means schedulers need to build schedules that factor in individual physician preferences, allow adequate time between long or taxing shifts, and ensure shifts are evenly distributed among providers. However, given the large number of scheduling variables, some radiology groups struggle to make provider satisfaction and well-being a priority when building schedules.

The Solution: An Automated Radiology Scheduler

Despite all the complexities associated with radiology scheduling, there are some radiology groups that still build shift schedules manually—by hand or spreadsheet—instead of using an automated solution.3 Unfortunately, manual scheduling leaves gaps in coverage, contributes to physician burnout, and fails to maximize existing physician resources. In contrast, an optimized radiology scheduling software is extremely efficient and cost-effective.

Interested in learning how optimized scheduling works? Hear from our clients at Eastern Radiologists in Greenville, North Carolina. Learn how their practice transitioned from manually scheduling providers in spreadsheets to auto-generating schedules with our automated scheduling solution.

Watch the Webinar

Sources

  1. Physician Specialty Shortage – Including Radiologists – Continues to Climb, MJH Life Sciences, Whitney J. Palmer, Diagnostic Imaging, 2020: diagnosticimaging.com/view/physician-specialty-shortage-including-radiologists-continues-to-climb
  2. [White Paper] Physician Recruitment: The Cost to Hire and Return on Investment, Jackson Physician Search, 2018: jacksonphysiciansearch.com/physician-recruitment-the-cost-to-hire-and-return-on-investment/
  3. In the Flow: Part 2 — Equitable Scheduling Prevents Burnout, Delivers Better Patient Care, Great Valley Publishing, Beth W. Orenstein, Radiology Today—Vol. 19 (No. 3), Page 24, 2018: radiologytoday.net/archive/rt0318p24.shtml

Radiology Productivity: Beyond the RVU

Radiology Productivity

The workload of US radiologists has increased over the past two decades.1 Unfortunately, the number of new radiologists entering the field hasn’t grown to match demand. The shortage of radiologists and increasing demand for imaging services make measuring radiologist productivity more important than ever. Explore why current productivity standards for radiology departments and groups might be missing the mark and how a digital scheduling solution can double as a radiology productivity software.

Radiology Productivity Metrics: Is the RVU enough?

Many radiology practices and departments measure productivity using Relative Value Units (RVUs), but the RVU system has known limitations.2 Compared to other services, interventional procedures are somewhat undervalued while MRI services are given a higher value.

In addition to the issues inherent in the RVU scale, other factors including scheduling can impact a group’s ability to accurately measure productivity. For example, a physician working during a weekend shift may generate fewer RVUs than generated on a regular day shift. Unless your team equally distributes holidays, weekends, and other shifts, RVUs can’t reliably measure radiologist productivity.

RVUs also fail to provide insight into all the work providers are doing. Time spent on continuing education, professional development, teaching, and research are all valuable to your organization, but are not reflected in RVUs. Radiologists are increasingly required to spend more time on administrative tasks—which means they read fewer films and spend less time on patient care. Long story short: RVU metrics can not tell us how much work physicians are doing.

A Better Way to Track Radiology Productivity Benchmarks

If your organization is manually scheduling providers, you know that human error can impede your ability to see the number and types of shifts your providers are working. With a digital scheduling platform, your organization can automate the scheduling process and gain an accurate picture of your providers’ workloads. Digital scheduling gives you access to a lot of data that can streamline operational efficiency to effectively serve as radiology productivity software for your group.

Auto-Generate Radiology Schedules That Ensure Even Shift Distribution

Creating shift schedules that ensure full sub-specialty coverage, meet patient demand for different diagnostic imaging types, and distribute shifts evenly among providers is complex if tackled manually. But it is the first step to gaining better insight into the productivity of your providers. Without even shift distribution, you can’t be certain the data accurately reflects productivity.

“We can really coordinate what’s happening within our facilities, where our resources are going.”

– Jim Clabo, Director Systems and Scheduling Administration, Northwest Permanente

An advanced rules-based scheduling solution can automatically distribute your shifts evenly. You simply create highly customizable rules designed to schedule providers across subspecialties and locations in a way that is fair and equitable, and then, auto-generate the schedule.

Tag Shifts by Type of Work or Diagnostic Imaging Type

Once you’ve created the schedule, you can tag various shift assignments by type of work. For example, tag shifts for specialty imaging like neurology, breast imaging, pediatrics, and ultrasound. Plus, tag shifts for non-clinical time, including administrative work, continuing education, teaching, and research.

Tagged shifts reflect the type of work providers are doing, so you can generate granular reports about their type of work, when they are scheduled, and where each shift takes place.

Streamline Value Management and Resource Utilization

Your organization can take value management a step further to gain insight into resource utilization. Many clients use our scheduling solution to track exam room and OR utilization. The same can be done for imaging equipment. Assign radiologists and radiology technologists to specific equipment to identify inefficiencies and opportunities to increase revenue.

By scheduling providers with certain equipment and rooms, you can see which equipment may be underutilized and when. Capitalize on those opportunities by scheduling additional providers at specific times. Alternatively, you can see when equipment is in high demand and schedule faster readers during peak times to increase capacity.

Increase Radiology Productivity With a Radiology Scheduling Software

An advanced scheduling solution can help your organization streamline processes and gain better insights into your operations. Save time by streamlining complicated scheduling processes and access advanced workforce analytics that reveal actual value versus perceived value. Maximize productivity and value management with a clear picture of when your resources are and are not being utilized.

Hear from our customers at Northwest Permanente, who currently use Optimized Provider Scheduling powered by Lightning Bolt to streamline value management across the organization. The Permanente Medicine team uses our solution to schedule providers directly into exam rooms and operating rooms.

See How It Works

 

Resources:
1. Radiologists’ Variation of Time to Read Across Different Procedure Types, Society of Imaging Informatics in Medicine, Daniel Forsberg, Beverly Rospiko, and Jeffrey L. Sunshine, Journal of Digital Imaging– Vol. 30 (1), 86-94, 2017: https://doi.org/10.1007/s10278-016-9911-z
2. Leveraging the electronic health record to evaluate the validity of the current RVU system for radiologists, Elsevier Inc., Ronnie Sebro, Clinical Imaging, 2021: doi.org/10.1016/j.clinimag.2021.02.007