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Conduct of Film Analysis. For midterm topic 3. Topics to be covered. Repeat Analysis Analysis Of Reject Versus Repeated Films Determination Of Rejection Rate Distribution Of Rejected Film Guide To Good Practice. - PowerPoint PPT Presentation
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CONDUCT OF FILM ANALYSISFor midterm topic 3
Topics to be covered•Repeat Analysis•Analysis Of Reject Versus Repeated Films
•Determination Of Rejection Rate
•Distribution Of Rejected Film•Guide To Good Practice
The desired outcome of a diagnostic x-ray study is the
creation of an acceptable diagnostic image, a correct
diagnosis, and the satisfaction of all internal and
external customer.
•Quality control testing can only minimize the risk of obtaining sub-quality images but cannot prevent them entirely.
•Quality management program must also include looking at the final outcome of a diagnostic x-ray procedure and determining the quality of outcome to see if further improvement can be achieved.
Outcome assessment•Repeat analysis of images•Artifact analysis of images•Accuracy, sensitivity and specificity analysis of diagnosis.
Repeat analysisIt is a systematic process of cataloging rejected films and determining the nature of the repeat so that repeat images
can be minimized or eliminated in the future
Importance of repeat analysis• It provides knowledge of data about:
• Equipment and accessory performance• Departmental procedures• Skill level of the technical staff
•With this knowledge, solutions can be found to minimize repeats and also document the effectiveness of quality control and quality assurance protocols
Advantages • Repeat analysis can show how many repeats in the depart w/c in turns address the party concerns of what are the problems.
• With lower department repeat rates:• Improved department efficiency• Lower department cost• Lower patient doses
Improved department efficiency• With number of repeats are kept low, the amount of time
that patient must spend undergoing diagnostic procedures decreases.
• This in turns increases patient satisfaction and allows the department to service more patients in the same period.
Lower department costs
•When the number of repeats are reduced, the costs associated with film, processing, labor and depreciation of the equipment decrease significantly.
Lower patient doses
•Images that are unacceptable results in the repeat of the particular view, which means that the patient must be re-exposed to ionizing radiation.
Causal Repeat rate• In repeat analysis studies performed on departments without quality control procedures for the darkroom, processor and equipment, 75% of all repeats were caused by improper optical density of film.
• With quality control protocol in place, studies shows that most repeats are results of positioning errors.
National average of repeat causes for departments with quality control proceduresCategory % RepeatPositioning 30Light films 14Misc. (artifacts) 14Darkrooms 11Black films 9Tomography scouts 8Fog 5Patient motion 5Mechanical problems 4
Repeat analysis •For a study to be done, a worksheet for radiographic imaging departments should be used, so that the proper statistical information is obtained and recorded.
Worksheet
•A worksheet should include the radiographic procedures performed in the department, along with the possible causes of rejection, such as positioning, overexposure, under exposure, motion, artifacts, and miscellaneous causes
Causal repeat rate• The causal repeat rate is the percentage of repeats from
a specific cause and is calculated with the following equation:
Causal repeat =
rate
Number of repeats for a specific cause
Total Number of repeatsX 100
Example • A total repeat of a department has 200 films in a month,
and 90 out of 200 films are the result of positioning errors.• So the percent of repeats caused by positioning error is
45% of the total repeat films.
Total repeat rate• The total department repeat rate is determined with the
following equation:
Total repeat rate =
Number of repeat films
Total number of views takenX 100
Example • If a department has a total of 2300 views during a month
and has incurred a 300 rejected film.• A 13% percent the department has incurred in a month
• Department repeat rates should not exceed 4% to 6% and should be less that 2% for mammographic procedures.
• Any department exceeding 10% to 12% should be examined seriously, because of inefficiency and contribute to high patient dose.
LABORATORY WORK
•For a department to evaluate its efficiency a worksheet should be used for any repeat film.
•As a QA/QC officers a worksheet can aide in identifying problems if it is mechanical/technical or by human errors.
Laboratory Exercise • Instruction
• Each group are assigned with a number of films.• Analyze the films.• After analyzing the films, the film should be rotated to other groups
for analysis.
Survey period to location
repeat category examinati
on
Position Over-exposed
Under-expose
Motion Artifacts Other Total %
UGI 12 4 3 1 5 8 33 23%Ba. Enema
15 1 1 20 3 1 41 28%
IVP 5 2 3 1 7 1 19 13%OTHER 10 1 3 11 25 1 51 35%TOTAL 42 8 10 33 40 11 144
% 29% 6% 7% 23% 28% 8%
Total films
viewed
1320 Total repeat
144 Total Repeat Rate 11%