The Quality Standard for Imaging (QSI) covers all aspects of your service. If you take a look at the front few pages, the sections include patients, staff, equipment, buildings, governance, and all aspects of your documentation.  

After that you have all the modalities – CT, MR, ultrasound, nuclear medicine and interventional radiology.  So it is no surprise that when a Band 7 radiographer is asked to look at QSI for their service they immediately become overwhelmed.  

Delegation when working in quality improvement is not only encouraged, it is essential. One person in any department could never ensure quality throughout a whole imaging service. An understanding of the finer details is needed of where improvements can be made. 

When I was looking up quotes for this article there were so many on delegation that it was hard to choose the best one because all of them would have been relevant. This alone demonstrates what an important skill it is.

I had never heard of Eli Broad (above) but I have heard of his book: The Art of Being Unreasonable: Lessons in Unconventional Thinking. When he died in 2021 he had an estimated net worth of $6.7 billion which was entirely self-made. His parents were a house decorator and a seamstress, and he qualified as an accountant. He didn’t become this successful businessman, entrepreneur, and philanthropist by working alone. 

Here’s another quote from his book: ‘Once you’ve identified your crucial tasks and sorted out your priorities, try to find a way to delegate everything else.’ QSI needs someone to pull it all together and to have an oversight on the end goal that is their crucial task. 

One of the advantages to having someone with governance oversight is the sharing of good practice.  For example, your CT team might be struggling with one aspect of their service but because they have oversight they know that the MR team worked out a solution. Modality leads are very busy and may not have time and the oversight to be able to join up dots like a quality lead can. 

By delegating out you can play to the strengths in your service. However, delegating is not just dumping work onto someone else and, also, you may feel reluctant to add to people’s already heavy workload. You need to ensure that the right person is being asked for each task and that they understand how the quality improvement aspect fits into their job or the service and can help them.  It must be a two-way conversation.  

It is important, and part of the QSI lead’s job, to explain to staff in lead roles where their area fits into QSI. However, it is not up to the QSI lead to micromanage how the lead then accomplishes the tasks involved. The modality leads may be, and probably will be, further delegating some tasks within their team. Therefore, it is really important to build in some feedback times and deadlines for certain tasks so that work is completed. 

As with any delegation, you need to allow the people you are asking to complete work to do it their own way. You may have done the work a different way but that does not necessarily mean it is better or worse - just different. As long as the end goal is met, different paths can be taken. With QSI the end goal is written in the standard so at least this aspect can be agreed on before you start.

I will give you an example from QSI. Standard XR-204 requires that services have a preceptorship programme in place to support new staff and for staff going into a new role. When the QSI lead comes to look at this aspect they might find that either a) there isn’t a preceptorship programme b) there is one that has been used for many years but it has never been reviewed and needs updating, or c) there is one, it is regularly reviewed and updated. 

There might be a named person in charge of the preceptorship programme. If there is a lead, the QSI lead can then explain to them what is expected from a QSI point of view. If there is not a lead, then the QSI lead will need to work with the management team to allow someone to take on this role. Once in place the task is then delegated to them and they would be named on the QSI lead’s gap analysis. A time frame will be agreed for the preceptorship programme to be implemented and then a system of review put in place. 

Finally, one of the most important aspects of delegation is giving credit. Recognising the help you have had from a lead is very important. Never pass off work as your own - this is a guaranteed way to make your lead or team feel slighted and definitely less inclined to contribute in future tasks. Delegating tasks to more junior members of your service will build their confidence and grow them as future leaders.