It’s Not the Equipment — It’s the Communication Slowing Your Department Down

By Dr. Nicole Dhanraj

Clear communication isn’t just helpful, it’s the hidden engine that keeps your department running smoothly.

In radiology, we obsess over precision: imaging protocols, dose levels, safety checks, and turnaround times. But even the most advanced scanner can’t save a department that’s constantly miscommunicating.

Most operational delays, repeated mistakes, and even patient complaints come down to one thing: poor communication and documentation.

Whether you’re leading a 10-person outpatient imaging center or managing a large hospital department, improving how your team communicates and documents information will pay off fast. Here are some strategies to consider.

1. Audit the Way Your Team Actually Communicates

Let’s say your MRI scanner goes down at 6:00 AM. A lead tech sends a group text to a few team members, but the front desk doesn’t find out until a patient arrives an hour later. No one called service. No update was shared across teams. Now you’re behind schedule, the patient is frustrated, and the team is scrambling.

What can you do? Conduct a three-day audit. Ask each modality lead to log:

• What critical updates they received.

• How the info was delivered (text, huddle, PACS, email, etc.).

• Whether the information was clear and timely.

Then meet as a team and highlight the communication patterns. You might find that CT relies on sticky notes, MRI depends on verbal updates, and X-ray gets left out entirely. From there, build a unified system, whether it’s Teams messages, a shared downtime log, or structured handoff notes.

2. Build and Use a Fast Fail Log

A patient came in for a CT chest with contrast. The order included a note: “Patient must get labs prior to procedure.” That message never made it to the front desk or tech. The patient showed up expecting the scan, only to be turned away. The appointment was rescheduled. The patient was upset, the referring provider was frustrated, and the team was left playing catch-up.

But the bigger issue? Nothing was documented.

Instead, try this approach and log it in a simple Fast Fail Log:

• Issue: Missed lab requirement for contrast CT.

• Cause: Prep instructions were not passed to the front desk or technologist.

• Impact: Scan rescheduled; delays in patient care.

• Solution: Add a standardized prep checklist at check-in that includes lab confirmation.

This simple habit builds a feedback loop that helps teams prevent future issues — without finger-pointing.

3. Visual Chain of Command: No More Guessing Games

One weekend, a new tech couldn’t find the on-call PACS admin. She texted the modality lead (who was out sick), then tried two more people before giving up, delaying the report transmission until Monday.

To avoid this delay in the future, create a visual chain of command that lists:

• Modality leads and contact preferences.

• Admins (PACS, service engineers, IT).

• After-hours and weekend protocols.

Print and post it near workstations and save a PDF in a shared folder. A 10-minute setup can save hours of delay and stress.

4. Align Messaging to Patients and Providers

Inconsistent communication erodes trust. For example, a radiologist tells a provider results will be ready in 24 hours, but the front desk says three to five days. A patient receives different exam prep instructions from the scheduler and the technologist.

You can fix this by creating core communication scripts for common scenarios:

• Equipment downtime or delays.

• Result turnaround expectations.

• Exam prep, contrast, and NPO instructions.

Working from a shared script will ensure your communication is not only aligned across your team, but for the benefit of the patient as well. Consistent messaging builds credibility and reduces callbacks. Role-play these scripts in monthly huddles and especially during new staff onboarding.

It’s Not the Equipment — It’s the Communication

Radiology leaders often focus on metrics, staffing, and technology, but communication is the silent force behind all of it. If your department feels chaotic or reactive, don’t default to another meeting. Rethink how information flows and how well it’s captured.

Clarity isn’t just kind. It’s efficient. It builds trust. And it’s the one system upgrade you can implement today — without a purchase order.

Whether you’re navigating communication challenges in your radiology department, trying to streamline operations, or just want to swap stories about scanner downtime chaos, I’m always up for a chat. Email me at nicoledhanraj@gmail.com.

Let’s build stronger, clearer, and more human-centered radiology departments together.

Dr. Nicole B. Dhanraj is a powerhouse in radiology, business operations, and education, with roots as a U.S. Army diagnostic imaging and CT technologist. Today, she is a fractional operations executive, business consultant, and educator, specializing in strategic operations, project management, human resources, and radiology process improvement and accreditation.

She owns a continuing education company (STAR) that provides CE credits for radiology professionals and offers workforce development through her company 424 Business Group. In addition, she is a partner in a veteran and military spouse recruitment and staffing initiative through Service To Success, connecting top military talent with mission-aligned employers. 

Dr. Dhanraj is also a dissertation mentor, adjunct professor, and speaker, teaching topics ranging from organizational behavior and healthcare leadership to strategic transformation and operations.

She sits on the boards of two nonprofits, one serving military families and another expanding radiology career access for underserved communities. Her leadership and dedication have earned her numerous honors, including the Stanley Drazek Teaching Excellence Award (University of Maryland), two AHRA Excellence Awards, and the President’s Lifetime Achievement Award for Volunteering. She was featured on the cover of ASRT Scanner.

Dr. Dhanraj holds degrees in psychology, international relations, and organizational management, alongside certifications across multiple industries. She’s a passionate advocate for education, equity, and empowerment — dedicated to transforming systems, uplifting communities, and shaping future leaders.