Preparing a cultural strategy for PACS

Health Central Hospital in Ocoee, FL, performs in excess of 100,000 studies per year. In September 2003, it was determined that a picture archiving and communication system (PACS)--already an agenda item set for the current fiscal year-would have a go-live date of no later than July 1, 2004. That meant 9 months to research, develop, and implement the project. The objective was to bring PACS to fruition quickly and smoothly, have buy-in from all parties concerned, and not interrupt the daily flow of patient care in the process. The first step in the project was to select the vendors to be considered. Working closely with the radiology leadership team, a list of physicians who most frequently requested film was compiled. Among them, the team targeted 3 or 4 that it was believed would help champion the effort with their fellow physicians. Along with these pieces, the radiologists, physicians on staff at the hospital, and, of course, the nursing and administrative teams would be an integral part of the project. The groundwork was laid for hiring a consultant to assist in the process. A PACS coordinator job description was created. Then, a staff meeting was called to discuss routine business issues and bring PACS to the table. It is extremely important to bring all relative new data to the staff throughout the project. After that initial meeting, PACS was a regular agenda item. A project team was comprised of 6 persons from radiology, information systems (IS), and administration, as well as a radiologist. Each member was required to make all 4 site visits, give a brief written evaluation of the product seen, and provide a brief narrative for and against the equipment. The vendor was selected, a final proposal was obtained, and contract details were negotiated. A PACS Steering Committee was appointed, and a PACS coordinator and consultant were hired. The PACS was installed, and a computed radiography (CR) system was purchased and integrated with the PACS. Training was paramount to the project's success. The PACS coordinator had experience educating physicians on using the technology; therefore, Health Central was able to provide the staff, radiologists, and hospital physicians with on-site, hands-on training. The hospital's culture has changed since PACS. Complaints have been reduced, and the number of exams waiting for radiologists to read each morning has been reduced by more than 50%.