Implementing good staff assessments in the medical imaging department begins at recruitment level. Making sound hiring decisions in the first place ensures as few later difficulties as possible. Don’t hire anyone who isn’t well qualified or who has questionable career history, is the first piece of advice; it makes assessing staff afterwards much more straightforward.
One of the main challenges in recruiting medical imaging staff in Europe is posed by the national variations in standards throughout Europe and beyond, on what constitutes an adequately qualified radiologist. For example, in Russia it takes a mere three years to become a practicing radiologist, with not even a fixed curriculum for residents by which to assess what areas an applicant has covered. This is in complete contrast to countries such as the United Kingdom and Germany, where curricula are highly regulated. Personality is also important – making sure an applicant has the right personality and can engage effectively in cooperation and teamwork will make their place in your department much smoother.
Keeping Abreast of Evolving Procedures
A candidate’s initial education, while important, must be backed up by continuing medical education to ascertain whether or not they are up-to-date with current practice. The US is further evolved in this respect, due in part to the rise in malpractice suits and a more litigious culture. US board examinations, while not mandatory, are generally taken by all, as no decent hospital will hire a radiologist who has not taken and passed these exams. There, radiologists view board exams as a desirable addition to their resumé, an attitude similar to the one in the UK.
The US has also developed e-Learning as a tool to offer continuing specialty-based exams that are again not mandatory, but demonstrate that a medical professional is actively ensuring their education is relevant. It is inevitable that Europe must follow the US in these practices and formalise continuing education with a homogenised set of standards.
For example, in Europe, many medical staff attend such courses, but due to a lack of regulation, it is possible for them to obtain the relevant CME credits without actually attending the course. Big meetings such as the ECR have taken steps to regulate this absenteeism, but smaller courses don’t have a formal structure in place to ensure that absent participants are not credited for courses they have not in fact attended.
Document, document, document! It is essential to maintain a comprehensive dossier on complaints about all employees to back up any formal procedures that may eventually take place when a member of staff underperforms or is involved in a negative situation with patients or other staff members.
An annual review is a great forum for thrashing out any workplace issues – with a positive ‘how can we help you’ attitude, where one can give a warning that an incident or behaviour/attitude in the department was inappropriate. This is the generally accepted formal setting for dealing with underachieving staff. The informal way is to evaluate performance amongst peers within the department. In our department, colleagues send each other their cases for second opinion so that at the end of the year we are then able to say how many judgement calls are valid, and how many if at all, adversely affected patients. We hope to formalise this process and I believe it will be a valuable tool in assessing staff.
Other Evaluation Tools
Job descriptions are broken down into secondary task lists for each individual team member. At the annual review, this allows us to compare results to the original standard document. We also maintain a coordinating member of staff for each modality, for example, MR, and their role in this task is also up for annual evaluation to talk about the changes they have experienced over the past year, if they are satisfied with the way they are going and if there are any future changes they wish to implement. It allows us to develop a realistic and fulfilling career path for all members of staff.
Using Staff Information Responsibly
Confidentiality is key in staff assessment. We can use information about staff to inform our decisions in hiring, extending contracts or reviewing performance. We can let it be known to other members of staff if we have a general feeling of reservation about a certain individual, but sharing negative information is clearly discriminatory and must be avoided. All records from staff reviews are held in a central repository only accessible by the record keeper, the board of directors and the Chairman to ensure complete confidentiality.