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Sustained improvements in radiologist engagement and administrative alignment following structured leadership and
Felix M Gonzalez1, Midhir Patel1, Michele Edison1
1Department of Radiology, AdventHealth Central Florida Division, Orlando, FL, United States.
Background:
Radiologist burnout and disengagement threaten patient safety, diagnostic quality, and workforce sustainability. Although engagement is frequently measured, evidence linking specific, replicable leadership interventions to sustained improvement in radiology remains limited.
Methods:
We conducted a three-year observational study (2023-2025) using Press Ganey Physician Engagement Survey data administered to 211 employed radiologists within an integrated, multi-campus health system. Beginning in Q4 2024, six structured interventions were implemented: (1) weekly multi-campus in-person leadership rounding with closed-loop follow-up; (2) quarterly subspecialty listening forums (symposia) with open Q&A; (3) dedicated virtual engagement meetings every 2-3 months for remote and teleradiology radiologists; (4) standardized closed-loop communication pathways ('You said → We did → Next steps'); (5) structured 30- and 90-day early-career onboarding check-ins; and (6) formal integration of radiologists into key leadership and governance roles. Outcomes included the Legacy 6-Metric Engagement Indicator, the New 5-Metric Engagement Indicator, and the Administrative Alignment Index.
Results:
Engagement and alignment showed minimal change between 2023 and 2024, followed by substantial improvement in 2025. Legacy Engagement increased from 3.74 (26th percentile) in 2023 to 4.17 (62nd percentile) in 2025 (+0.43 points; p < 0.01). New Engagement improved from 3.67 (22nd percentile) in 2024 to 4.12 (63rd percentile) in 2025 (+0.45 points; p < 0.01). Administrative Alignment rose from 3.38 (26th percentile) in 2023 to 4.11 (79th percentile) in 2025 (+0.73 points; p < 0.001). Radiology gains substantially exceeded system-wide physician engagement trends over the same period.
Conclusion:
A coordinated, six-component leadership engagement strategy was associated with large-magnitude improvements in radiologist engagement and alignment. Each intervention is described with sufficient operational detail to support replication in other radiology practices.
