Quality management

Quality assurance is a system that sets out standard practice for error prevention.

  • “planned and systematic actions”

Quality control are the tools used to practice quality assurance for error detection.

  • “Set of operations” “maintain or improve quality”

Quality management for radiation safety

  • Documentation

  • Training

  • Audits

  • Monitoring

  • Testing and servicing equipment

    1. Radiation protection advisor: advise on radiation protection

    2. Medical physics expert: involved in medical exposures involving ionising radiation

Legislation

  • outlines duties of employer

  • ensures Quality Assurance is followed

  • recommended standards for routine testing of diagnostic imaging systems

    • provides performance tests required for each modality

    • ensures legal requirements are met, doses are ALARP, highlights trends in performance

Governance framework

  • cooperation between management structure, corporate structure and structure of the IRR and IRMER

  • Key stakeholders include employers, external specialists, clinical and radiation safety workers

  • Local QC testing

    • level A tests, local and frequent for inexpensive equipment

    • Level B tests, medical physics level, so less frequent for specialised equipment

Radiographic equipment life cycle

  • QC testing of new equipment and optimisation checks for medical physics

  • Medical physics not involved in routine maintenance

  1. Replacement or selection

  2. Installation and examination

  3. Clinical use, maintenance and optimisation

  4. Decommission and disposal

Practicalities

  • routine monthly local QC check

    • plain imaging QC equipment

      • Dosemeters

      • Filters

    • Fluoroscopy

      • filters

      • Image quality test objects

  • Full local QC check after every engineer reapair

  • Fault logging

  • Image reject analysis

  • Clinical audits

  • Patient dose audits

  • Handover forms (handing over equipment to external agency)

    • AXrEM handover forms

    • Handing over equipment

    • Finished work and its impacts

    • Accepting back system and area

  • Electronic record management found on imaging reference drive

    Common errors

    • incorrect setup, alignment and orientation

    • Incorrect exposure factors

    • Incorrect AEC settings

    • Handle removable digital detectors with care

Local QC results review

  • Acceptable results are accepted and recorded on spreadsheet

  • No notification required

  • Failed remedial results require LRSS for advise

  • Visual inspection, radiation dose for corrective action and image quality for corrective action

  • Suspension results require labelling equipment as such, repeated to ensure results

  • Many be used for limited practice and contact LRSS