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65 Terms
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Radiology
has both a people-centered & a product-centered quality.
Quality
Has always been a part of health care, whether as a service or product.
improve patient care & provide a high-quality service
The ultimate focus in health care is to ___ so that patients will want to return.
Joint Commission on the Accreditation of Healthcare Organizations
JCAHO
Continuous Quality Improvement or Total Quality Management
Rather than quality, TJC currently uses terms
Quality Assurance
A plan for the systematic observation & assessment of the different aspects of a project, service, or facility to make certain that standards of quality are being met.
QA activities
are focused around people & service.
quantitative data
Most QA activities will produce ___ that can be analyzed.
Quality Control
Defined as a comprehensive set of activities designed to monitor & maintain systems that produce a product.
QC measures
are instituted to ensure that radiologic procedures are: ✓ performed safely ✓ appropriate for the patient ✓ performed efficiently ✓ produce a high-quality image
performed safely appropriate for the patient performed efficiently produce a high-quality image
QC measures are instituted to ensure that radiologic procedures are:
license
QC measures are required by law to maintain the ____ for the room or department.
designated individual
The data from the various activities are kept by a _____ within the department.
Acceptance Testing Routine Maintenance Error Maintenance
3 MAJOR CATEGORIES OF QC TESTS
ACCEPTANCE TESTING
Performed before newly installed or majorly repaired equipment can be accepted by the department.
ACCEPTANCE TESTING
Testing may be performed by a designated technologist, a radiation physicist, or by service personnel employed by the hospital.
ACCEPTANCE TESTING
Used to determine whether the equipment is performing within the vendors specifications & as promised.
ROUTINE MAINTENANCE
Performed to ensure that the equipment is performing as expected.
ROUTINE MAINTENANCE
Can catch problems before they become radiographically apparent.
ROUTINE MAINTENANCE
Testing may be performed by a designated technologist, a radiation physicist, or by service personnel employed by the vendor.
ERROR TESTING
When errors occur in equipment performance, corrective action must occur.
ERROR TESTING
Errors will be detected by poor equipment performance or poor quality outcomes.
ERROR TESTING
These corrections will generally be made by service personnel employed by the vendor.
Continuous Quality Improvement
Focus more on the process rather than on the people or the service.
Belief
If the process is good, health care workers will follow it, & service will be good.
QA/QC
The CQI does not replace ___ programs.
QA/QC programs
focus on maintaining a certain level of quality, not necessarily improving to a higher quality.
CQI
focuses on improvingthe process or system within which the people function as team members rather than focusing on an individual’s work
CONCEPT OF CQI
All levels of people within the organization must be involved in the process of improvement.
CONCEPT OF CQI
It is important that everyone participate because if one spoke is not involved, the wheel will fall off, & the quality cart cannot move forward.
QUALITY CONTROL
Comprehensive set of activities designed to monitor & maintain systems that produce a product.
QUALITY ASSURANCE
Systemic observation & assessment of the different aspects of a project, service or facility to make certain that standards of quality are being met.
DOCUMENTATION
very important in any QC activity & all paperwork must be kept up to date to make a valid performance measure
DOCUMENTATION
is the most difficult part of the process & the easiest part to not complete.
DOCUMENTATION
Without the _____ to back up the findings, it will be difficult to prove the need for repair or update of a system.
1. Display quality for both monitor & film 2. Processing speed 3. Network transfer speed 4. Data integrity (Data from archive)
QC ACTIVITIES to be monitored in a PACS environment includes:
ACR Technical Standard for Digital Image Data Management
“Any facility using a digital image data management system must have documented policies & procedures for monitoring & evaluating the effective management, safety & proper performance of acquisition, digitization, compression, transmission, display, archiving & retrieval functions of the system. The QC program should be designed to maximize the quality & accessibility of diagnostic information”
ACR
Also suggests that all the quality tests be carried out with a Society of Motion Pictures & Television Engineers (SMPTE) test pattern to ensure continuity of measurements.
Society of Motion Pictures & Television Engineers
SMPTE
American Association of Physicists in Medicine
AAPM
Task Group 18
TG18
American Association of Physicists in Medicine (AAPM) Task Group 18 (TG18)
is also becoming more widely accepted for use in these QC tests.
acceptance and annually
The AAPM suggests that the testing be performed on ___ ___ by a trained physicist
corrective action & continued monitoring
If any of the following tests fails or produces out-of-range readings, _____ should be done.
technologist
should follow the radiology department’s policy on equipment maintenance procedures.
radiation physicist
It may be necessary to contact a _____ to follow up on the findings.
Monitor
is often the weakest link in the digital imaging chain.
MONITOR QUALITY
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.
2K-3K
for digital projection images
1K-2K
cross-sectional images
Up to 4K
for mammography
PHOTOMETER
A device used to measure luminescence of areas on the monitor
Wet Laser Imager Dry Laser Imager
Printer Image Quality (2 types):
speed
Always a concern in the radiology department, whether it is the __ at which patients are brought back for their X-rays or the __ at which the radiologists gets a final report signed.
Workstation Processing Speed Image Transfer Speed
Speed (2types):
Data Integrity Compression Recall
Data Quality Control (2 types):
Data Integrity
Technologist should check on a daily basis to make sure all images sent to the PACS arrived on the PACS
Compression Recall
Used to reduce the size of the image files to increase the speed of the network transfer of the images.
Compression Recall
Radiologist/Radiation physicists established the compression protocol, and they determine the level of compression that will be acceptable for the institution.
Recognition of Nondiagnostic Images System Up-Time System Training
PACS Continuous Quality Improvement
Recognition of Nondiagnostic Images
Documentation of nondiagnostic image being forwarded to the PACS
EQUIPMENT MALFUNCTION OPERATOR ERROR
Poor-quality Image Causes:
System Up-Time
Monitor how often the system is down.
System Up-Time
A log should be kept, to note any time the system is down, the reason, how long, what had to be done to fix the problem, & who fixed the problem.
System Training
• An important activity that must never stop. • The vendor applications training is supposed to train several super users (people who are trained on all aspects of the system & are prepared to train others)