Adding a Biopsy Service to Ultrasound.

*The changing climate in healthcare has led to some very hard decisions regarding revenue generation and cost avoidance. A decision was made to not allow the nephrologists to perform renal biopsies utilizing interventional radiology resources that had previously been available. *For nephrologists that wanted to continue performing their own biopsies, the plan was to redesign how they were performed using only an ultrasound technologist in the room. *The sonographers had never been required to perform any invasive proce- dure at this facility, and would be required to obtain skills and competencies in a short period of time for this to be successful. *This is a guide through the change pro- cess for the technologists and physicians to ultimately lead to an efficient and safe way to perform procedures for the renal transplant physicians.