Quality assurance and Quality control in medical radiographyTopic 2

Objectives

• Departmental standards for radiographic image quality

• QA/QC group establishment• Quality Management

Diagnostic procedure chain

“Quality assurance as applied to medical radiography is the organized effort of the staff to ensure that the

diagnostic images produced are of high quality. Its purpose is to provide

adequate diagnostic information with the least possible cost and the least possible radiation exposure to the

patient and staff”

“Quality assurance as applied to medical radiography is the organized effort of the staff to ensure that the

diagnostic images produced are of high quality. Its purpose is to provide

adequate diagnostic information with the least possible cost and the least possible radiation exposure to the

patient and staff”

“Quality assurance as applied to medical radiography is the organized effort of the staff to ensure that the

diagnostic images produced are of high quality. Its purpose is to provide

adequate diagnostic information with the least possible cost and the least possible radiation exposure to the

patient and staff”

“Quality assurance as applied to medical radiography is the organized effort of the staff to ensure that the

diagnostic images produced are of high quality. Its purpose is to provide

adequate diagnostic information with the least possible cost and the least possible radiation exposure to the

patient and staff”

“Quality assurance as applied to medical radiography is the organized effort of the staff to ensure that the

diagnostic images produced are of high quality. Its purpose is to provide

adequate diagnostic information with the least possible cost and the least possible radiation exposure to the

patient and staff”

Requirements of a QA/QC program

• It requires the combined efforts of the whole radiology staff.

• A hospital qa/qc committee and a qa/qc team must be created to institutionalize the program.

Hospital QA/QC team

i. Hospital chief radiologist- head of the x-ray section/department

ii. Chief x-ray/radiologic technologistiii. Hospital physicistiv. Other radiologists and radiology

resident physiciansv. Other x-ray/radiologic technologist

Hospital QA/QC committee

i. Chief of hospital ii. Administrative officeriii. Chief radiologistiv. Chief x-ray/radiologic technologistv. Chief physicistvi. Hospital maintenance engineer/technicianvii. Others

Responsibilities of these groups are as follows:

Hospital QA/QC team

I. Do periodic film analysis and monthly film analysis report to the QA/QC committee

II. Establish additional radiographic technique charts when needed, or revise existing technique charts when appropriate.

III. Establish additional darkroom processing charts or revise existing ones when necessary

IV. Do periodic quality control test of x-ray equipment, accessories, and darkroom equipment and accessories

V. Keep a room logbook which contains all the test data on equipment, accessories and all the changes/repairs done to all equipment/accessories in the room, sample images, procedures for QC tests, etc.

VI. Keep all brochures and technical manuals pertaining to equipment and accessories.

Hospital QA/QC committee

I. Meet regularly to discuss film analysis report, QC test results, other reports and problems of the x-ray department/section.

II. Decide on corrective action to be implemented and on other matters related to the program

III. Keep a record of minutes of meetings.

In planning and establishing a QA/QC programthe following should be consideredIn medical radiography

A. Commitment and support of radiology personnel to sustain the program

B. Establishment of standards of image quality

C.Conduct of film analysis every monthD.Establishment of standard darkroom

techniques and conduct darkroom QC checks

E. Conduct of preventive maintenance and quality control checks

F. Establishment of standard protocols in performing different examination

G.Establishment of a radiation safety program

H.Conduct of continuous education and training

The purpose of A QC testing program

The purpose of a QC testing program

• Is to maintain the quality of diagnostic images.

• This is done with routine monitoring of photographic and x-ray equipment parameters to detect deviations of equipment performance and take prompt corrective action.

QC test

• QC test equipment • Equipment acceptance testing • QC testing program • X-ray equipment QC • Photographic equipment QC

Quality assurance deals with people

• A program of QA monitors proper patient scheduling, reception, and preparation and answers the following questions;

• Is the scheduled examination appropriate for the patient?

• If so, has the patient been properly instructed before the time of the examination?

QA test

• Equipment performance records and record keeping

• Equipment appraisal and replacement policy • Standardization of exposure • Acceptance criteria for diagnostic radiograms • Reject-repeat analysis program

QA also involves image interpretation or outcome analysis.

• Refer to TJC 10 step quality assurance program

• Quality control deals with instrumentation and equipment.

Quality control is more tangible and obvious because in this program the

radiologist is provided with optimal image produced through good equipment

performance and resulting in minimal patient radiation exposure.

Quality management program

Components for quality management program

• It should consist of at least the FF. Components:• Equipment quality control• Administrative responsibilities• Risk management• Radiation safety program

Equipment quality control

• It involves evaluation of equipment performance to ensure proper image quality, as well as patient and operator safety.

Administrative responsibilities

• It involves the establishment of various processes to accomplish the specific departmental task.• Procedure manuals• Data collections• Scheduling and routing of patients• Education of personnel• Equipment acquisition• Communication with other department

Risk management

• It is the ability to identify potential risk to patients, employees and visitors at the healthcare institution.• Nosocomial infections

Radiation safety program

• It is to ensure patient exposure is kept as low as reasonably achievable (ALARA), medical staff, dept. Personnel, and member of the general public are protected from overexposure to ionizing radiation.

•Personnel protection•Time •Distance•Shielding

Other Quality Management/ Quality Improvement Models

•FADE•5 STAGE PLAN•SWOT analysis•FOCUS-PDCA •FMEA

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