Fall Cleaning – Imaging Style (Part 2)

Welcome back to the Fall Cleaning series! Hope you found some helpful takeaways in part 1. As you might remember we explored several admin-level ideas for keeping your “imaging house” in top running order. If you missed Fall Cleaning – Imaging Style (Part 1) be sure to give it a read and make your 4th Quarter your most productive yet!

Today I’m going to share with you some of the more hands-on systems level tasks that I recommend tackling while you’re reaping the benefit of the Thanksgiving, RSNA and Christmas lull. So, without further ado, let’s dive in to some system’s work.

Disaster Recovery (DR) – When was the last time you did a DR failover … On purpose? With lower volume and some reduction of project-work this is the perfect time to schedule a failover and validate your procedures. Note: I don’t suggest you do this ON a holiday week, but before or after. Likely, there will be a few gremlins that need to be addressed and you will want to have some support staff around to help you sort these out.  This is also the perfect time to update your process documentation.

Configuration audit – If it ain’t broke, don’t fix it right? Well……. It could be “broke” but you just don’t know it yet. As systems become more and more complex you may have things misrouted, or misconfigured, but the redundancy in your system covers it up. This is an ideal time to dedicate some resources to giving system configurations a onceover to make sure all is as it should be. I would check routing, pre-fetch rules, storage locations, any prefixing or data manipulation (tag management), HL7 interfaces, compression, archive queues, unarchive counts, etc. As an example, a fast network may mask the fact that prefetching was turned off years ago, no biggie until you add in 5 tomo units and everything changes!

Storage storage storage – We all know that image sizes get bigger each year… tomo… but what about the system storage? Do you have cache storage where you need it? Are studies storing in the right location? How fast are you adding in data vs how much you have, ie. what is your run rate? If you are storing 5TB per year but only have 2 TB of storage you may want to look at this because, in addition to the new data, priors will be pulled back locally. Run your checks and make sure you have budgeted for storage both long term and short term!

Monitor backlight hours – If you’re not running an enterprise automated solution that preemptively alerts you it’s likely that you have little insight into the backlight hours of your diagnostic monitors. They do wear out! It makes an enormous difference in how your screensaver is setup, many times the backlight is running all night which reduces the monitor’s useful life because the monitor is still “on” when no one is reading. Take the time to run a good preventative check on your diagnostic monitors and order replacements if you need to.

QC issues – Data quality is a huge issue; in my experience I’ve found about 2% of studies didn’t match an order. Whether you are looking at PACS or VNA, there will be data sets that do not match. I have run into sites with thousands, and even hundreds of thousands, of studies flagged with QA issues that were left unresolved. You want the data to match as a prior and there is no benefit to leaving these issues to sit indefinitely. So, while it’s not necessarily the most fun of tasks, the 4th quarter tends to be a good time to dedicate 1-2 hours per day (possibly per person depending on your volume) to weed through and fix these data quality issues. 

Cable management – Most of us have been in a new server room, you start with good clean racks and tidy cable management then, as servers get moved in and out the whole space starts to resemble a consortium of octopi. Eventually, you have network cables tied to power cables tied to KVM cables strung between racks. Yes, it happens, but why not schedule a time to flip over to the DR system and clean up those racks? Anyone who has do to any work, ever, in your server room with thank you immensely!

Now that you’re armed with even more tips to a tidy and productive 4th quarter it’s time to get to work! As always, I greatly welcome your comments, thoughts and ideas so reach out on the blog, email or LinkedIn. And, if you’re going to be at RSNA this year and would like to connect in person let me know!

Fall Cleaning – Imaging Style (Part 1)

As the days get shorter and a bit cooler it is time to fill the heating oil, check the thermostat and … do your 4th quarter work.  Paradoxically it is both a busy time and a quiet time.  On one hand we often see an internal push to spend any extra money before the end of the year, along with vendors pressing to install or ship to reach their goals.  On the other hand, you have Thanksgiving, RSNA and the     Christmas holidays creating lots of OOO messages.  Between the holidays and RSNA we typically can lose up to a full month of work time in the 4th quarter.

So, what do you do when you find that you and your team are the only ones putting in full days at the office? How about all those things you’ve been puttingoff the prior 9 months?  This 4th quarter lull is a great time to get those tasks done without the interruption of things like patient care, trouble tickets or project meetings!  For my fellow early-birds, this is like that golden, extra-productive quiet time from 6 – 9AM before your phone starts blowing up, but now you get it all day long!

And, in case you’re having trouble remembering all those things you put off tidying-up all year, here are some ideas from the administrative side to get you going.

Renew quotes – If the fiscal year starts in January, you will need to get your quotes refreshed so you can issue purchase orders first thing.

Asset tags and invoicing – All those wonderful projects done throughout the year need to be closed out.  Many people “forget” to tag equipment and turn in the serial numbers.  Now is a great time to confirm those numbers, fill in the paperwork/close it out and keep that project from rolling over to next year’s to-do list.

New year schedules – The new year will be here before you know it, so take the time now to frame out all budgeted projects and resources.   Even if it’s only tentatively lined out by quarters, putting together an initial configuration of when projects will get done, and ensuring resources are aligned to cover each project, will make life much easier in 2019.

Documentation – When was the last time you reviewed your standard operating procedures?  For most of us the last time we reviewed them is when we wrote them.  4th quarter is a great time to pull out those SOP’s for a once-over.  One of the best ways I’ve found to “review” your SOP is to use it, literally.  Get someone who doesn’t work on the system day in and day out and have them follow the process.  If they can successfully accomplish whatever it is (add a modality, fail- over, create a new database, etc.) then you have a good process, check it off and move on to the next.  If not, you know the procedure needs an overhaul.

Management reports – Pretty soon you will be asked for tons of reports regarding studies stored, GB per location, trends and growth rates.  Time to dust off all of the queries if you run them yourself or reach out to vendors if they will be doing it.  Although most of your numbers won’t finalize until year-end you can get a jump start on those trends/growth rate numbers, as well as make adjustments to queries based on any projected new parameters.  Regardless of strategy, end of year management reporting is coming, better get a head start on it.

Future plans – Rarely do you get a chance to stop and think what if?  So, if you’ve done everything else and you have a little spare time, get creative!  Book a few whiteboarding sessions with the team and ask far-reaching questions.  What would I do with an unlimited budget?  What are some big changes we could make to improve reliability? Patient care?  Do this brainstorming without constraints, imagine a perfect world.  Then take the viable ideas and dial it back a bit, what is reasonable to do in 1-3 years?  Setup some concrete steps that you think management might fund.  Now you have some innovative ideas to move forward with.  Contact some vendors, get list pricing and put together a proposal.  Even if it doesn’t get funded there is tremendous value in the exercise, not only for team development, but in knowledge sharing and fostering open dialogues on how you can improve your systems.

Be on the lookout for Fall Cleaning Part 2 where I’ll share some ideas for system level cleanup.  Here’s to a productive 4th quarter!

As always, love to hear your comments, thoughts, and ideas so reach out on the blog, email or LinkedIn.