title: Interdepartmental problem-solving as a method for teaching and learning systems-based practice.
abstract: OBJECTIVE
  Systems-based practice (SBP) has been the most difficult competency to implement in radiology residency programs, and methods for teaching and learning SBP concepts are needed. Because systems problems are usually multifactorial, a multidisciplinary approach is required. In our institution, survey data indicated patient dissatisfaction with emergency care. Prolonged wait times for radiology procedures were identified as a systems problem. When hospital administration asked the emergency medicine and radiology departments to work together to improve patient care, residents had a "real-world" opportunity to achieve the SBP competency.
  
  
  METHODS
  Systems problems were identified and categorized. Data on patient transport were collected. Accurate time logs documenting when studies were ordered, performed, and interpreted were maintained. Data were analyzed at interdepartmental meetings and three improvements were planned and implemented.
  
  
  RESULTS
  A direct line of communication was established between radiology and emergency medicine via a dedicated cellular telephone. A joint emergency medicine/radiology teaching conference was established. Additional transport personnel were employed. Residents in both departments increased their understanding of their role in the health care system, demonstrated an ability to identify systems problems and appropriately implement improvements, and enhanced their professional relationships.
  
  
  CONCLUSIONS
  This innovative method integrated educational goals with patient care goals, was grounded in "real-life" experience, and held residents accountable for results. Competence in SBP, patient care, professionalism, and interpersonal and communication skills were demonstrated. We recommend this approach as an efficient and effective way to integrate SBP into everyday clinical practice.
authors.affiliation: University of Arkansas for Medical Sciences College of Medicine, Department of Radiology, 4301 W. Markham #556, Little Rock, AR 72205, USA.
authors.forename: Ralph C
authors.initials: RC
authors.lastname: Panek
authors.forename: Linda A
authors.initials: LA
authors.lastname: Deloney
authors.forename: Jong
authors.initials: J
authors.lastname: Park
authors.forename: Whit
authors.initials: W
authors.lastname: Goodwin
authors.forename: Sarah
authors.initials: S
authors.lastname: Klein
authors.forename: Ernest J
authors.initials: EJ
authors.lastname: Ferris
mesh_terms: D001131:Arkansas; D004501:Education, Medical / Q000458:organization & administration*; D004632:Emergency Medical Services / Q000458:organization & administration*; D015274:Interdepartmental Relations; D007396:Internship and Residency / Q000458:organization & administration*; D011340:Problem Solving; D011871:Radiology / Q000193:education*; D013663:Teaching / Q000379:methods* / Q000458:organization & administration