Crisis Management: Lessons Learned for Radiology Administrators

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A director shares her experiences in surviving – and thriving – through crises.

By Carmen Geerlings, MBA, RT(R) (ARRT), Director of Compliance and Regulatory Affairs, Raleigh Radiology.

Potential crises seem to be waiting perpetually in the wings for radiology administrators and our facilities. Sources of crises can include hostile contract takeovers, loss of business partners, data loss, cybersecurity attacks, accreditation loss, natural disasters, staffing shortages, strikes, motor vehicle accidents, emergent MRI quenches, burst pipes causing floods, office fires, or a pandemic such as COVID-19. Our radiology practice has experienced some of these. Based on my experience, I would like to share some crisis management lessons learned for radiology administrators.

Lesson: Incorporate change management principles

In spite of undergoing a series of crises, our organization remains a robust and growing imaging practice. We’ve doubled our radiologist pool, expanded hospital contracts, and quadrupled the number of imaging centers in our area.

How have we survived – in fact, thrived – in the midst of these crisis? An essential factor was incorporating change management principles into our responses to crises.

Crisis management and change management share some fundamental and common approaches. They are both dynamic in nature and have elements of uncertainty and complexity. Both require stakeholder and employee engagement, and strong leadership and decision making. They also share some common phases, such as planning and preparedness, communication, and learning and adapting.

However, change management has an increased emphasis on pre-planning, change readiness, and recovery and learning. Let me start with a definition of change management: Change management is a discipline that combines organizational philosophy, communication, leadership, and project management principles to facilitate smooth transitions and enable successful organizational change.

To break it down a little further, it:

• Is a structured approach to transition from current to future state.
• Involves planning, coordination, and management.
• Aims to minimize resistance and maximize adoption.
• Involves understanding impacts of change.
• Encompasses a variety of activities.

Lesson: Bolster the scope and effort of your pre-planning

A crisis is unforeseen and disruptive; however, change management is “structured”. It is planned and intentional. Your crisis planning also should be more intentional as well as broader in scope. For example, if you were undergoing a major organizational change that would require a shift in responsibilities, you would review your employees’ skills and their willingness to change their duties. You would provide training to close up gaps in required skills and resources.

Similarly, you should do a “readiness” evaluation of your staff’s skills to deal with a crisis. For example, simulate fire drills and phishing email campaigns. These trial runs will help you identify areas of weakness and strengthen your action plans. Having adequate skills and resources in place will achieve two objectives. One, it will help you resolve the crisis sooner. Two, your practiced response will give your staff confidence. Without adequate skills and resources, your response to the crisis will feel chaotic to your staff, and demoralize them even further.

Lesson: Evaluate your department’s change readiness

Change is a very big part of a crisis, and it extends well beyond the period of when the incident first erupts. In every crisis that we faced, the event affected the way we operated every day and the changes lasted for months. For this reason, I recommend you evaluate your organization’s culture. How flexible and open to change is your organization? What about within your department?

Staff involvement is an important foundation of change readiness. How engaged are your staff today? A low level of engagement will slow down considerably your efforts to put in places changes that are required to address the crisis. Also, do you know who your employee champions are? Identify them and cultivate them. You will need your champions to drive the changes necessary to deal with a crisis.

Lesson: Emphasize recovery and learning

Although most crisis response models include the term “recovery”, this phase often applies more to recovering the organization’s good standing in a community, or its financial recovery. Within the change management model, the recovery is also about the people.

Undoubtedly, you experienced the emotional and mental damages that the COVID-19 pandemic incurred on your team and yourself. There are also strong emotional reactions to an accreditation loss, mergers, and other significant changes. Provide your staff with the space, communications, and resources they need to work through their personal responses to the situations. Don’t expect everyone to just “move on” after a crisis and act like nothing has happened.

Additionally, change management puts a stronger emphasis on evaluation and reflection after a crisis has passed. Reflection and learnings should go deeper than evaluating merely the response to the crisis. Organizations should view crises as opportunities to look back, learn, and change.

Final lessons learned

In addition to illuminating the role of change management principles, my experiences also highlighted for me the importance of the following tactics that should be a part of your response to every crisis:

• Communication: I can’t emphasize enough the importance of frequent and ongoing open and transparent communications.
• Stakeholder engagement: Be inclusive of all your stakeholders in your communications and give them opportunities to respond. We were open and transparent with our community when we lost our accreditation. Our open communications with them was essential to maintaining our trust with them.
• Engaged and effective leadership: This is another element that is critical to getting your facility and your staff through a crisis. Leadership needs to be engaged and visible. Their guiding presence will give your team a sense of confidence that is essential to getting through the crisis.

I hope these lessons learned have given you insights into the resilience and adaptability that can be achieved by incorporating change management principles into your crisis management planning and response.

Keep Reading: Responding to a Ransomware Attack in Radiology by Dr. Niall Sheehy, MB, MRCP, FFR RCSI, St James’s Hospital -Trinity College Dublin.

Carmen Geerlings, MBA, RT(R) (ARRT), is the Director of Compliance and Regulatory Affairs at Raleigh Radiology in Raleigh, NC. She has worked in the field of medical imaging since 2002, and has held positions ranging from film librarian to technologist to manager and director. She gave a presentation on this topic at ARHA 2023.

Ms. Geerlings is married to her partner, Brian, and their family lives in Raleigh, NC.  In her spare time, she enjoys golf, chess, and the occasional trivia or karaoke night at a local pub.