HealthManagement, Volume 8 - Issue 5, 2008

Good Governance in Radiology:

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How to Optimise Team Performance and Establish a Good Working Culture

Dr. Richard

O. Binswanger

School of Leadership



Landschlacht, Switzerland

[email protected]


During my career, I was responsible for radiology at the Kantonsspital Münsterlingen, Switzerland. The department includes diagnostic radiology, nuclear medicine and radiooncology. The hospital provides services for a population of about 100,000 (240,000 for radio-oncology) in internal medicine, general surgery, orthopaedic surgery, hand surgery, urology, gynaecology and obstetrics, paediatrics, oncology, pulmonology, gastroenterology, cardiology and neurology. Working with such a diverse blend of specialties allowed me to develop certain guidelines for optimising team performance, which I share here.

Key Criteria to Optimise Performance

Define the task of your department. Do this together with your team and repeat it constantly so that it is borne in mind by all at all times.


The mission is more then the task. Enlarge the task to the mission, taking into account the preceding and further steps of the process of patient investigation and treatment. Include into the mission the context and external influences, even non-medical matters.


Be a real service provider. Service patients and clinicians. Radiology and the clinical departments don’t stand alone, they provide an integrated healthcare product only if they work together. The clinicians themselves are also service providers.


Add value to the examination. At our institution, this is mainly done by more than 40 clinical-radiological interactions per week and by radiologists being available for consultation at any time. Real needs of the patients are fulfilled, supported by the empathic attitude of technicians and physicians in radiology. Respect the patients’ needs. Teach this repeatedly in staff conferences.

Take Over a Part of the Responsibility From the Clinicians.

Radiologists not only read the examinations but also take over some part of the responsibility from the clinician by a meaningful report and a clinically useful conclusion.

Demand Professional and Social Excellence From Your Team.

Mediocrity is not acceptable in your institution. Each team member must be able to work with everybody.

Hand Over Important Decisions to the Clinicians.

This is mainly the scheduling of patients (as far as possible) and the determination of the urgency of the examination without exception. Our team was afraid of abuse, but this didn’t occur

Decide Organisational Conflicts Following Clear Priorities.

Our decisions are taken regarding firstly the interests of patients, secondly the interests of the clinicians and only thirdly the interests of the radiology team.

Don’t Write E-Mails to Your Team Members.

Walk around and speak with them. By this you enhance the culture of communication in your department.

“Not Concerned” Doesn’t Exist!

Our own team members have elaborated on this key paradigm. Since then, conflicts have sharply diminished in our department.

Encourage Your Team Members to Take Pride in Their Work.

Pride, though it has only slowly developed in our team, is a powerful motivator.


These guidelines were established over the course of several years with growing experience. Our efforts were not only rewarded by a high degree of approval from the side of patients and clinicians but also by a good culture in the department and a growing job satisfaction of our personnel. So we conclude, that job satisfaction is not a precondition but the result of good teamwork. The latter is always a consequence of good leadership.

Guidelines for Radiology

The radiology department is a service provider for patients and clinicians. The task is to:

Perform radiological examinations;

Interpret them;

Communicate the results to the clinicians;

Add value for the clinician, and

Add value for the patient..

How to Optimise Team Performance and Establish a Good Working Culture<br>Author<br> Dr. Richard O. Binswanger School of Leadership Bodensee Munst

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