QA failures and actions

Radionuclide calibrator

Repeat- check background, ensure source is correctly positioned, correct calibration factor, check reference source

Do not use clinically, place do not use sign to warn others.

Inform MPE for further investigation

Use other dose calibrators if available

Worry- inaccurate activity administration

Might be useful to do a cross calibration with Tc-99m if other dose calibrators to check deviation. Might need to do accuracy testing and adjusting calibration factor before putting into clinical use. All MPE decision.

Extrinsic flood

Repeat test- check if anything in background, check positioning of flood source, and even condition of flood source itself, check acquisition parameters, check image produced itself for any pattern of high or low counts -contamination maybe on collimators (do wipe tests, decon procedure) or if specific region- might be PMT or crystal defect.

Inform MPE

Dont start injecting more patients until passed.

Worry- wont know if patient or camera related

Depending on what clinical info is needed might be able to go ahead with patients already injected e.g/ if the artefact is on outer edges

Solution- iterative calibration or new flood correction

Decontamination

Report to RPS and RPA

If unable to decontaminate further consider using more abrasive cleaner or covering/sealing area of contamination. Monitor area, do wipe tests, find dose rate, If high close area off. Use signs.

Communicating risk

Compare doses from government website e.g/ CT scan of chest, transatlantic flights, reassure patient on justifcation, benefits> risks

Hardships in my MSc project

• getting NEMA phantom, had to modify a jaszak phantom using mould team- creativity.

• getting radioactivity under EPR permit limit- understanding legislation, trying to explore options on ordering before asking for supervisor help- leftover used- resourceful and inexpensive

• radiologist feedback took months of chasing up- persistence

Improving SEHCAT waiting times

Since covid long backlog of patients waiting for sehcat test looking at bile acid absorption

made wait times our driver metric

weekly meetings to discuss cause:

e.g/ lack of admin team,lack of confidence in booking- training staff

patients not confirming appointment- maybe different modes of communication needed

also a big blocker was DNA’s increasing waiting times, EPR team and our admin team collaborated

sucesfully reduced waitlist.