Quality Management in Diagnostic Imaging Quality Control in Diagnostic Imaging V.G.Wimalasena Principal School of Radiography

Need for quality management in Diagnostic imaging Diagnostic Imaging is a multi-step process by which information concerning patient anatomy and physiology is gathered and displayed with the use of modern technology. There are various sources of variability in both human factors and equipment factors that can produce subquality images if not properly controlled.

…..Need for quality management in Radiology Sub quality images can result in Decreased accuracy of image interpretation Repeat exposures that Increase patient dose Increase department cost This in turn can result in, Decreased customer (physicians, patients, employees…) satisfaction Lost business & revenue

The purpose of a quality management programme To Control or minimize the errors in following variables as much as possible: Equipment Image receptor Processing Viewing conditions Competency of the technologist Support staff Interpreter

Levels of quality of patient care & diagnostic images Considered in 3 levels Expected quality: The level expected by the customer . This may be influenced by outside factors such as what he has heard from the others. Imaging professionals have least impact on this. Perceived quality: The customer’s perception of the product or service. It is highly subjective. How well the imaging professional performs his respective responsibilities will have the greatest impact on this.

Levels of quality of patient care & diagnostic images Actual quality: This is the level of quality judged by using statistical data and all factors that can influence the; Quality of the image. Accuracy of the diagnosis Timeliness of report to the physician It can compare the quality of the product or service with that of competitor.

Quality assurance (QA) ? QA is an all-encompassing management programme used to ensure excellence in healthcare through the systematic collection and evaluation of data. The primary objective is the enhancement of patient care. This includes: Patient selection parameters and scheduling Management techniques Departmental policies & procedures Technical effectiveness & efficiency In-service education Image interpretation & timeliness of reports The main emphasis is on the human factors that can lead to variations in quality care

Quality assessment? Refers to the measurement of the level of quality at some point in time with no effort to change or improve the level of care.

Quality Control (QC)? QC is the part of the QA programme that deals with techniques used in monitoring and maintenance of the technical elements of the systems that affect the quality of the image. It deals with instrumentation and equipment. A QC programme includes three levels of testing: Noninvasive and simple Noninvasive and complex Invasive and complex

QC testing levels Noninvasive and simple – can be performed by any technologist Noninvasive and complex – require a technologist specially trained in QC procedures Invasive and complex – involves some disassembly of the equipment and are performed by engineers of physicists

Types of QC tests… Acceptance testing :- is performed on new equipment or equipment that has undergone major repairs : To demonstrate that it is performing within the manufacturer’s specifications and criteria. To detect any defects that may exist. To establish the baseline performance that may be used as reference point in future testing

Types of QC tests… Routine performance evaluations :– are specific tests performed on the equipment in use after a certain period of time; To verify that the equipment is performing within previously accepted standards. To diagnose any changes in performance before becoming radiographically apparent.

Types of QC tests Error correction tests:- are tests performed on malfunctioning equipment; To evaluate the equipment To verify the correct cause of the malfunction so that proper repair can be made.

Continuous quality improvement This is the newest term used for the concept of QA/Quality control programme . It means that instead of just ensuring and maintaining quality, it continually improves quality by focusing on improving the system or process in which individual workers function rather than on the individuals themselves. Every employee should be actively involved in CQI for the programme to be successful.