MOD 6 - Intro to QA/QC Tests

Quality Control in Imaging

the monitoring, testing and maintenance of the x-ray equipment to ensure it's working optimally to minimize patient dose and ensure high quality images

Total Quality Management (TQM)

• all members of an organization participate in improving processes, products, services and the culture in which they work

• everyone in the medical imaging department is involved in one way or another with QA and QC

Continuous Quality Improvement (CQI)

focusses on improving processes or systems in place

Quality Assurance (QA)

• what

• features

• the planned and systematic actions for personnel that provide confidence that a diagnostic x-ray facility will produce high-quality images with minimum exposure of patients and it's personnel

• Features Include:

  • Information Quality = provides diagnostic images and info

  • Clinical Efficiency = provides diagnostic images quickly and efficiently

  • Patient Dose = ALARA

Requirements to achieve a QA goal

• working equipment

• all staff understands the goal of the program

• all staff is fully committed to the program

Equipment Testing Step Process

1. Acceptance Testing and Establishing a Baseline

1. done before the equipment is put to use (eg. new equipment)

2. conducted by a medical physicist (who has no relation/bias towards the equipment)

3. calibrated and a reference image is stored

4. takes around 8-10 hrs

2. Routine Performance 

• daily inspections of equipment to weekly, monthly and annual testing and inspections

• done by medical physicists, biomed, QC team, techs

3. Error Correction

• a decision tree that answers the following

• done by biomed, vendor service

1. A repeat of the test to confirm

2. What to do if repeated test confirms performance failure

3. what to do if test fails only marginally 

4. what to do if the test shows a history of failure 

5. what to do if the test fails substantially

4. Evaluation

• if an equipment has a +/- 10% acceptable test limit in place, the equipment is deemed unsafe for patient use, if repaired it needs to be tested again before use

• done by med physicists, rads, chief tech

Implementation of a QA Program

1. list of personnel and their duties

2. policies to minimize dose to personnel

3.  policies to minimize dose to patients

4. Guidelines to QC Tests

5. Policies to acquire new X-ray equipment

6. Policies for Record Keeping  

QC Team

• owner of the facility = primarily responsible

• plan and managing = department supervisor, QC coordinator, physicist

• sets litmits, evaluates QC = physicist

• performs annual testing = physicist, biomed

• repairing equipment = biomed

• performs rest of QC tests = techs

Documentation

documented in the QC logbook

Format of a QC Test

1. Aim = overall goals of the test

2. Equipment = test tools/equipment needed for this test

3. Method = specific steps to conduct this test

4. Frequency = how often is the test completed

5. Data Record Keeping = QC log

6. Tolerances = setting max/min limits

7. Action = what to do after the results show equipment issues

• 1-6 is set by the med physicist, so we just have to follow

• 5 and 7 are our responsibility to record in the QC logbook

Determination of Testing Frequency

• If equipment is showing significant signs of wear and tear between testing, then testing frequency may need to increase.

• QC tests should NOT be less frequent if the QC tests always show stable results

Diagnostic Accreditation Program (DAP)

• a governing body assigned to monitor for upkeep and adherence to a Quality Standard

• regulated by College of Physicians and Surgeons of British Columbia