Nov. 14, 2014
In the U.S., R.T.s have access to many resources to learn, grow and improve our clinical and patient care skills. Continuing education, sophisticated equipment, applications training and professional societies help us stay on the cutting edge in the profession. But these resources are limited in underprivileged communities in developing countries. Skilled and compassionate technologists, however, can help address inadequate health care in these populations by providing education about safe, effective imaging.
Founded by a team of radiologists, RAD-AID International is a nonprofit organization dedicated to the mission of increasing international radiology services in developing countries. Through the RAD-AID ASRT Foundation Radiologic Technologist Fellowship Program, the Foundation provides funded opportunities for R.T.s to assist RAD-AID with international initiatives that improve access to quality medical imaging and radiation therapy for populations in need.
ASRT members who participate in the Foundation’s R.T. Fellowship Program become part of a multidisciplinary medical team that provides patient care services and educates local health care personnel about medical imaging and radiation therapy equipment, positioning and patient safety. Teams also comprise radiologists, nurses, public health officers and business leaders.
Finding a Need
RAD-AID’s thoughtful and measured approach to coordinating radiology outreach involves five initial steps to determine where its services are needed and how it can best apply those services to achieve the greatest impact. These steps involve:
- Evaluating the health profile of the country or region where a potential partner site is located and obtaining current information on health systems already in place.
- Assessing “radiology readiness” by examining whether radiology can be effectively and efficiently integrated into a community or facility’s health care system.
- Determining the potential partners (government,nongovernment organizations and intergovernmental organizations) operating in the region.
- Providing the personnel and training for health professionals based on the specific region’s needs.
- Monitoring the progress of the implemented program and maintaining an active role in the continuation of that program.
A survey called the Radiology-Readiness Assessment helps RAD-AID determine a site’s radiology readiness. Survey data provide a comprehensive, baseline picture of a potential partner site, including its infrastructure, technical parameters of engineering, staff availability, medicine supply and complementary laboratory testing. This data set is important because it reveals the needs of a hospital or clinic. Rather than say, “They still have film-screen here, so we’ll donate a computed radiography system,” RAD-AID obtains a deeper understanding of the needs of a region or country. The survey asks questions such as:
- Can the electrical grid support digital systems?
- Is film-screen more appropriate right now until the electrical grid is stabilized?
- How can RAD-AID promote the goal of stabilizing the electrical grid?
After completing the five-step evaluation process, RAD-AID builds on its relationships at the potential partner site by listening and fully understanding the needs of the site’s radiology team. Using the Radiology-Readiness Assessment results as a reference, RAD-AID can put the right resources to use in an effective, sustainable manner.
One critical resource is education — initial and continuing. For example, the RAD-AID program “Asha Jyoti,” which means “ray of hope” in Hindi, will send multiple teams of technologists to India over the next few years to conduct workshops for local mammographers on breast imaging positioning and radiation protection. Internet-based education provided through the RAD-AID Online Learning Center is available as a supplement to the on-site training.
Building Relationships
Relationships are key to promoting radiology access and establishing global partner sites around the world. RAD-AID has formed partnerships with colleagues in India, Ghana, Haiti, Guyana, Kenya, Jamaica, China, Malawi and many other countries, and currently oversees more than 10 partner sites.
One way RAD-AID builds international relationships is through its Chapters Program. Radiology professionals in the U.S. can establish a RAD-AID chapter at their academic institution. Chapter members reach out to institutions in other countries to see if there is a radiology need, as the University of North Carolina at Chapel Hill’s RAD-AID Chapter did. In September 2013, the technologist-based UNC chapter conducted an initial site visit at Kamuzu Central Hospital in Malawi, where the UNC School of Medicine’s Center for Infectious Diseases has been working for many years. Based on the initial needs assessment, the chapter sent an additional team in March 2014 to provide guest lectures and assist with curriculum development.
RAD-AID not only invests heavily in relationships with local clinical facilities, but is also committed to collaborating with international institutions such as the World Health Organization. These large-scale partnerships enable RAD-AID to help develop solutions to global issues such as poverty and health care disparities. Similarly, RAD-AID highly values collaboration with radiology societies such as the ASRT, the American College of Radiology and the Association for Radiologic and Imaging Nursing.
Finally, RAD-AID has formed a robust network of university-based chapters at academic institutions accredited by the Accreditation Council for Graduate Medical Education. These institutional relationships generate a continual dialogue with knowledgeable medical professionals about ways to improve outreach strategies.
Learning From Each Other
The importance of relationships is also evident within RAD-AID’s organizational structure. Daniel Mollura, M.D., the CEO of RAD-AID, leads a management team of nine program directors who oversee projects. Program directors come from diverse backgrounds and include R.T.s, radiologists, radiology nurses, residents, attending physicians, business leaders, information technology personnel and others.
Each director is responsible for program operations in a specific country and has decision-making power regarding the RAD-AID projects developed there. Directors set goals for their relationships with the country and for their project sites based on the country’s needs. The focus of the Ghana program, for example, is PACS installation. In India, RAD-AID focuses on women’s health. In Haiti, the primary need is for general technologist and radiologist education.
Although the needs of project sites differ, the program directors strive for a unified set of goals defined in RAD-AID’s mission statement. It’s also important that all of the program directors support each other, so that each program is influenced by a wide range of backgrounds and areas of expertise. As a result, R.T. program directors have the opportunity to provide direct input about the development of international programs. These collaborations enable a strong exchange of ideas.
For example, RAD-AID’s director of International Program Development in Haiti guides visiting project teams on the goals and objectives for that country. To acquire a well-rounded approach, program directors of nursing, radiologic technology, sonography, learning management system and health care economics also offer ideas and assistance. Sharing information in this way enables RAD-AID’s programs to learn from each other.
RAD-AID teams model their outreach strategies on successful strategies used by past project teams to build partnerships with local institutions. As members of a project team, health care professionals, during their outreach trips, work one-on-one with local radiology personnel and patients. In turn, team members learn from their professional peers in the countries where they serve, gain respect for cultural differences and work together to improve radiology care.
Choosing the Right R.T.s for the Job
RAD-AID program directors, often in consultation with RAD-AID’s CEO and our overseas partners, request technologists who have qualifications and skill sets that fit a program site’s goals. In my role as the radiologic technology program director, I filter the database and give the program directors a list of qualified applicants to interview and rank according to the needs of the project team.
For example, the RAD-AID team in India requested R.T.s who could help teach stereotactic biopsy in their mammography workshops. RAD-AID’s Ghana team needed technologists with picture archiving and communication system expertise because their project involved the installation of a digital imaging system with an integrated PACS.
Radiologic technologists are working with RAD-AID International in other ways, too. The vice president of RAD-AID’s Instructional Resources Program is leading a group of radiologists, R.T.s, nurses and other health care professionals in the creation of an online learning center. This platform will provide free education modules to radiology personnel and institutions in areas of the world where educational resources are limited. Technologists are helping to write the modules and finalize the multimedia formats.
Radiologic technologists from all disciplines and specialties can apply to participate in the Fellowship Program. Previous projects have called for mammographers, sonographers, radiographers, CT technologists, PACS/IT technologists, educators and more. As RAD-AID programs grow, the need for technologists from additional modalities will too.
As R.T.s, we influence the lives of our patients and colleagues every day, and we have the opportunity to make a difference beyond our jobs, too. Since its inception, the RAD-AID ASRT Foundation R.T. Fellowship Program has sent 22 R.T.s to work on behalf of overseas projects. If radiology outreach interests you, consider sharing your knowledge and skills on the global stage.
This article was originally published in ASRT Scanner, Vol. 46, No. 5, Pages 42-45.