Conduct of Film Analysis

Film Reject/Repeat Analysis

is an important aspect of a quality

management program in an imaging department.

To avoid future repeats

Film Reject/Repeat Analysis Goal:

- Radiographic Equipment Performance

- Radiologic Technologist Competence

- Efficiency of Departmental Protocols

Film Reject/Repeat Analysis is a statistical representation of the following key performance indicators:

Rejects

Refers to all rejected images, including repeats.

Repeats

Refers to patient images repeated, resulting in additional exposure

1. Improved department efficiency

2. Lower department costs

3. Lower patient doses

Film Reject/Repeat Analysis, Advantages:

Additional workload, in terms of administrative tasks

Film Reject/Repeat Analysis, Disadvantages:

Repeat Analysis Program

is a systematic process of cataloguing rejected

images and determining the nature of the repeat, so that repeat images

can be minimized or eliminated in the future

- Equipment and accessory performance

- Departmental Procedures

- Skill level of the Technical Staff

Repeat Analysis Program provides the following important data:

American Association of Physicists in Medicine, Task Group 151

suggested that reasons for rejection should be standardized and included in all RAP programs. An option to add additional

user-specified reasons should also be available.

1. Rotation

2. Anatomy cut-off

3. Incorrect projection

4. Incorrect marker

Positioning error:

1. Overexposure

2. Underexposure

Exposure error:

1. Cut-off

2. Decentering

3. No grid

4. Grid lines

Grid error:

1. Detector

2. Foreign body

3. Table/Support/X-ray Tube

Artifact:

Causal repeat rate

is the percentage of repeats from a specific cause, such as positioning error or technique error

Causal repeat rate

... concept can also be utilized to do an in-depth quality and performance of imaging department staff

Determine the percentage of repeats for a specific cause

Main function of Causal Repeat Rate:

- Radiologic Technologist

- RT Intern

- X-ray Room

- Shift (Team)

Causal repeat rate,

Secondary function:

Determine the percentage of repeats for a specific cause:

total repeat rate

The ... is the percentage of repeat films in a departmental aspect.

Total repeat rate

This presents the overall repeat rate of an imaging department

- Equipment Quality

- Technical Staff (RT) Competence

- Patient Population

- Data Collection Method

- Shift

- Number of images accepted by the radiologist to diagnose

Total repeat rate presents the overall repeat rate of an imaging department and is

influenced by the following:

8%

Repeat rates for radiographic procedures should not exceed ... for general

radiography

5%

Repeat rates for radiographic procedures should not exceed ... for pediatric radiography

±2%

Repeat rates for radiographic procedures should not exceed 8% for general

radiography and 5% for pediatric radiography, with corrective action limits

of ... (AAPM TG 151).

±2%

Mammographic repeat rates cannot change by more than ... each quarter (AAPM TG 151)

10% to 12%

Any departments with repeat rates exceeding ... should be examined seriously.

inefficient and high patient dose

Any departments with repeat rate exceeding 10% to 12% should be examined seriously.

Any department exceeding these values are considered ... and contributes to ...

compliance and acceptance of poor-quality images

A department repeat rate that is too low may signal problems with ... and ...

film analysis programs

After establishment of the QAP, ... programs should be created to minimize repeats.

Monthly, QA/QC Committee

... reports of film analysis should be kept on file and reviewed by the designated ...

- Tabulated Data

- Graphs

- Charts

- Trend

Methods to present a Film-Reject Analysis:

- Assess the efficiency of the whole department

- Assess the efficiency of equipment

- Assess the efficiency of technical staff

A Film-Reject Analysis can be used to:

- HR Decisions

- Staff Training

- Equipment replacement/upgrade

A Film-Reject Analysis can also be used to justify the following: