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Brave step into uncharted territory for community-based radiology service

15 May, 2020
Swanage Hospital radiology team, left to right: Angela Holmes, radiographer/sonographer; Karyn Hunt, lead radiographer/sonographer; Suzanne Holloway, radiology manager; Angela Gray, radiographer; Gail Walsh, admin lead; Helen Hogg, HCA/A&C; and Angela Barrow, HCA.
Swanage Hospital radiology team, left to right: Angela Holmes, radiographer/sonographer; Karyn Hunt, lead radiographer/sonographer; Suzanne Holloway, radiology manager; Angela Gray, radiographer; Gail Walsh, admin lead; Helen Hogg, HCA/A&C; and Angela Barrow, HCA.

A true team effort over a period of more than two years, together with complete dedication to the project by staff, has been the key at a community trust to successful accreditation to the Quality Standard for Imaging (QSI).

According to Suzanne Holloway, radiology manager of the Dorset HealthCare University Foundation Trust (DHC) community radiology service, the project began as a workstream target of the Radiology Dorset Clinical Network (DCN) Group, between DHC, Poole, Royal Bournemouth, and Christchurch and Dorset County Hospitals.

“QSI accreditation has provided a benchmark, so we can now challenge ourselves to improve further going forward. We also found the whole process very therapeutic… it felt like a complete service overhaul. A chance to get our house in order!” Suzanne said.

Dorset HealthCare has eight community hospitals with radiology services, including plain X-Ray and ultrasound. As radiology manager, Suzanne is operationally responsible for two sites, Victoria and Swanage Hospitals, and strategically responsible for all eight.
(Six sites function under service level agreements with the Dorset acute trusts.)

“We targeted Victoria and Swanage as pilot sites for accreditation, with a view to rolling it out to the other community hospitals over time,” Suzanne said.

“It was agreed there was appetite and an enthusiasm to undertake the project, but that it would require someone to drive forward and co-ordinate the work across the four Dorset trusts. We recruited a joint QSI accreditation manager, Tracey Chafe, and the work began.”

The approach
The accreditation manager arranged regular meetings with modality leads and the radiology managers to engage them into the QSI culture. Rather than look at the standards and agree what would be required to meet it, the manager encouraged blue sky thinking: "What would you like your service to look like in the ideal world?" and questioned where that would fit into the QSI standards.

This provided a gap analysis and the list of work being undertaken by each One Dorset Modality Lead group, took off. To underpin this, where practicable, policies and processes across the four sites were standardised and ratified through the DCN as ‘One Dorset’.

The challenges

  • Working across four sites meant that discussions and decision making at the monthly and quarterly meetings was slower. However, this also provided reassurance that staff were sharing best practice and that patients would receive the same high standard of care, whether they were imaged within a community or acute setting.
  • The length of time taken to complete the project meant it was pivotal to keep staff engaged and not to lose sight of the end goal. The accreditation manager’s role was vital in this respect as the project ‘driver’.
  • Finding time within the staff’s busy schedules to attend the cross-site meetings and complete the action plans ready for the next meeting.
  • As a community trust, we have a large portion of policies and procedures for service interaction with multiple service users and providers.

What worked well?

  1. Sharing best practice cross-site
  2. Learning from events cross-site
  3. Sharing the accreditation workload
  4. Having an accreditation manager to drive the project and keep staff focussed.
  5. Having One Dorset policies and procedures to standardise processes across all Dorset radiology departments
  6. Building robust relationships between staff across Dorset, especially within modality groups.
  7. Sharing the pain!

“It has been a very satisfying process for us and I was delighted that the staff got the recognition they deserved after all the hard work they had put in, over such a long period of time.

Victoria Hospital radiology. Front row l to r: Deborah Jones, interim lead radiographer; Claire Cox, lead reporting radiographer; and Claire Linwood, HCA/A&C. Back row l to r: Shane Smith, HCA; Susan Fisher, A&C; Lynne Drake, radiographer; Ian Brodie, lead sonographer; and Jane Bond, admin lead."They have proudly displayed their certificate in the waiting area! Now we can take a short breather and celebrate, before it is ‘heads down’ again for the year two submission!” Suzanne commented.

Photo caption: Victoria Hospital radiology. Front row l to r: Deborah Jones, interim lead radiographer; Claire Cox, lead reporting radiographer; and Claire Linwood, HCA/A&C.
Back row l to r: Shane Smith, HCA; Susan Fisher, A&C; Lynne Drake, radiographer; Ian Brodie, lead sonographer; and Jane Bond, admin lead.

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