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JRCERT Update

a range of inconsistencies, most projects had a single top-down managerial approach, as is often the case,
iteration, failed completely, or both. If optimally used, but by identifying leaders throughout all levels of the
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PDSA has the capability to truly implement the scien- system and actively engaging them in a well-organized
tific method as a process for change. change process.

Discussion
Given the mutuality of radiology and innovation, Melissa A Davis, MD, serves on the Joint Review
it is imperative that radiologists understand how to Committee on Education in Radiologic Technology board of
approach change in their organizations in a thought- directors and is associate professor and vice chair of medical
ful and systematic manner. With changes in payment informatics in the Department of Radiology and Biomedical
structures and enhanced computing capability, radi- Imaging at Yale School of Medicine in New Haven,
ology needs to be proactive, rather than reactive, to Connecticut.
change. The way to do this is by understanding how James V Rawson, MD, is vice chair of operations and
change happens and ways to guide it effectively. special projects in the Department of Radiology at Beth
Often overlooked in change management at the Israel Deaconess Medical Center in Boston, Massachusetts.
organizational level are the individuals in that organiza-
tion and an understanding of the social structure and References
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The transtheoretical and diffusion of innovation mod- Information Technology. U.S. Department of Health and Human
els can help leaders reveal who in their organization Services; 2006.
is moving toward the change sought and who is not. 2. Zheng K, Haftel HM, Hirschl RB, O’Reilly M, Hanauer DA.
Quantifying the impact of health IT implementations on clinical
The transtheoretical model can further identify which workflow: a new methodological perspective. J Am Med Inform
stage an individual or group is in and strategize ways Assoc. 2010;17(4):454-461. doi:10.1136/jamia.2010.004440
to increase exposure and education about the desired 3. Chockley K, Emanuel E. The end of radiology? Three threats to
outcome; for example, the model can help identify who the future practice of radiology. J Am Coll Radiol. 2016;13(12 Pt
is in the precontemplation phase and devise ways to A):1415-1420. doi:10.1016/j.jacr.2016.07.010
move toward the next step and ultimately to action. The 4. Fleishon H, Muroff LR, Patel SS. Change management for radi-
ologists. J Am Coll Radiol. 2017;14(9):1229-1233. doi:10.1016
diffusion of innovation model can help identify change /j.jacr.2017.02.053
agents and opinion leaders in an organization, which 5. Kim CS, Spahlinger DA, Kin JM, Billi JE. Lean health care:
can be used strategically to disseminate change every- what can hospitals learn from a world-class automaker? J Hosp
where. Although these models focus on the types of Med. 2006;1(3):191-199. doi:10.1002/jhm.68
individuals involved in making positive improvements, 6. Brookes E. Transtheoretical model: stages of health behavior
change. SimplyPsychology. Updated November 9, 2023. https://
the PDSA model puts a scientific framework around www.simplypsychology.org/transtheoretical-model.html
change and allows for data collection and tracking of 7. Rakowski W, Dube AC, Goldstein MG. Considerations for
progress through several iterative cycles. The authors extending the transtheoretical model of behavior change
propose that using these models will affect positive to screen mammography. Health Educ Res. 1996;11:77-96.
change for radiology organizations and groups. doi:10.1093/her/11.1.77
8. Armitage CJ. Is there utility in the transtheoretical model?
Conclusion Br J Health Psychol. 2009;14(Pt 2):195-210. doi:10.1348/135
910708X368991
Technologists are constantly faced with new tech- 9. Prochaska JO, Velicer WF. The transtheoretical model of
nology and the need to redesign, improve, or replace health behavior change. Am J Health Promot. 1997;12(1):38-48.
existing processes. By applying these methods to doi:10.4278/0890-1171-12.1.38
proposed changes, change management projects can 10. Prochaska JO. Decision making in the transtheoretical model
be implemented successfully and benefit long-term of behavior change. Med Decis Making. 2008;28(6):845-849.
doi:10.1177/0272989X08327068
patient care and quality. This is not completed with a 11. Schwartz LH, Panicek DM, Berk AR, Li Y, Hricak H. Improving

RADIOLOGIC TECHNOLOGY, January/February 2024, Volume 95, Number 3 233
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