RT202-MODULE 9-QUALITY ASSURANCE FOR MEDICAL IMAGING

The Joint Commission (TJC)

This accreditation is voluntary but necessary in many instances to obtain Medicaid certification, hold certain licenses, obtain reimbursements from insurance companies, and receive malpractice insurance.

QUALITY ASSURANCE (QA)

-typically focuses on the person rather than the process.

- defined as a plan for the systematic observation and assessment of the different aspects of a project, service, or facility to make certain that standards of quality are being met.

The Joint Commission (TJC)

This accreditation is voluntary but necessary in many instances to obtain Medicaid certification, hold certain licenses, obtain reimbursements from insurance companies, and receive malpractice insurance.

QUALITY ASSURANCE (QA)

-typically focuses on the person rather than the process.

- defined as a plan for the systematic observation and assessment of the different aspects of a project, service, or facility to make certain that standards of quality are being met.

QUALITY CONTROL (QC)

- subdivision of quality management that focuses on equipment functions.

- defined as a comprehensive set of activities designed to monitor and maintain systems that produce a product.

three major categories of QC tests

- Acceptance testing
- Routine maintenance
- Error maintenance

Acceptance testing

This type of testing is performed before newly installed or majorly repaired equipment can be accepted by the department

Routine maintenance

is performed to ensure that the equipment is performing as expected. This type of testing can catch problems before they become radiographically apparent.

Error maintenance

When errors occur in equipment performance, corrective action must occur. Errors will be detected by poor equipment performance or poor-quality outcomes.

Continuous quality improvement (CQI)

tends to focus on the process rather than on the people or the service.

PICTURE ARCHIVING AND COMMUNICATION SYSTEM EQUIPMENT QUALITY CONTROL

-When beginning a QC program, care must be taken to document all surrounding variables so that each quality measure can be repeated without harm to the process.

American College of Radiology (ACR) Technical Standard for Digital Image Data Management

"Any facility using a digital image data management system
must have documented policies and procedures for monitoring and evaluating the effective management, safety, and proper performance of acquisition, digitization, compression, transmission, display, archiving, and retrieval functions of the system.

Documentation

is very important in any QC activity, and all paperwork must be kept up to date to make a valid performance measure.

Society of Motion Pictures and Television Engineers
(SMPTE

test pattern to ensure continuity of measurements.

American Association of Physicists in Medicine (AAPM) Task Group 18 (TG1

A test pattern developed

Monitor quality

- is often the weakest link in the digital imaging chain.

- has a direct effect on the quality of the image that is presented to the radiologist for reading or to the referring physician for review.

radiologist workstation medical grade monitors

2K or 3K for digital projection images, 1K or 2K for cross-sectional images, and up to 4K for mammography

Luminance meter or Photometer

a device used to measure the luminescence of areas on the monitor.

Printer Image Quality

- the printed image is another way to distribute images around the hospital enterprise.

Workstation Processing Speed

- Determine a study to be used as the test. The same study must be used each time to ensure there are no variables. Choose a study with several images and a patient that has several studies.

Image Transfer Speed

- should be monitored from the modality to PACS and from the archive to a workstation.

- After acceptance of the system, this procedure should be followed weekly to establish a pattern.

Data Quality Control

- Data Integrity
- Compression Recall

Data integrity

Technologist should check on a daily basis to make sure all images sent to the PACS arrived on the PACS

Compression Recall

is used to reduce the size of the image files to increase the speed of the network transfer of the images

Recognition of Nondiagnostic images
System Up-time
System Training

PACS continous quality improvment

Recognition of Nondiagnostic Images

- This activity will be primarily carried out by the radiologists.

-If a poor-quality image is detected by the radiologist, the study and performing technologist are noted, and the information is shared with the lead technologist

System Up-Time

- It is a monitoring of how often the system is down for any reason

- A log should be kept to note any time that the system is down.

System Training

- an important activity that must never stop

- The vendor applications personnel are usually on site for 1 to 2 weeks during initial installation.

TOTAL QUALITY MANAGEMENT (TQM) OR CONTINUOUS QUALITY IMPROVEMENT (CQI)

- The overall efficiency and effectiveness of imaging systems are evaluated beyond the mechanics of producing radio graphic images.

QUALITY CONTROL STANDARDS

The American College of Radiology requires compliance with standards of practice to ensure quality in any imaging system.

Three general areas define digital image quality

-contrast
-resolution
- noise

Radiologic Technologist Daily Quality Control Duties

Inspect and clean cassettes
Inspect hinge and latch
Erase imaging plates
Verify digital interfaces and network transmission
Inspect laser printer

radiologic technologist

Is the first line of defense in preventing, recognizing, and reporting QC issues.

Radiologic Technologist Weekly Quality Control Duties

Clean and inspect receptors
Clear air intakes of imaging plate reader
Clean Display screen
Clean computer keyboard and mouse

Radiologic Technologist Monthly Quality Control Duties

Reject analysis
Reject reasons
Positioning errors
Marker errors
Equipment malfunction errors
Clean imaging plates
Artifact identification
Problem reporting

Preventative maintenance (PM)

- consists of a series of equipment tests that are performed by a service engineer.

Photostimulable Phosphor (PSP)

phosphor that produces light when stimulated by light or X -ray photons

Semiannually

Resolution of both PSP and flat-panel array systems should be checked every 6 months.

The following QC activities should take place on a prescribed basis:

-Daily and monthly/quarterly monitor QC
- Printer image quality
- Speed assessment
- Data QC