PACS Systems and Quality Control Part 3 - Quality Management

00:17:51
https://www.youtube.com/watch?v=VY22mZ40-Fc

Summary

TLDRThe video details quality management processes within a radiology department, focusing on quality assurance (QA) and quality control (QC). QA involves improving processes affecting patient care, while QC ensures equipment operates correctly to produce high-quality images. It outlines activities such as monitoring patient wait times, equipment performance, and implementing technical standards. The American College of Radiology's guidelines require facilities to have policies for managing digital imaging systems. Different organizations like ACR and AAPM have diverse timelines for QC testing, which involves regular evaluation of equipment and image quality. The medical physicist plays a crucial role in conducting these evaluations, ensuring devices are efficient and procedures are safe for patients. The module also emphasizes reducing patient exposure and dealing with image artifacts efficiently.

Takeaways

  • 📊 Quality management in radiology is vital for patient care and image quality.
  • 🔍 QA activities involve improving processes at all levels of patient interaction.
  • 🛠️ QC ensures radiology equipment operates at optimal performance consistently.
  • 📅 ACR advises monthly QC testing while AAPM suggests more frequent checks.
  • 💻 Test patterns are essential for assessing display monitors in radiology.
  • 🧑‍🔬 Medical physicists undertake detailed QA and QC procedures annually or semi-annually.
  • 🔄 Regular data collection and analysis are key to identifying and solving quality issues.
  • ⚙️ Digital image data management requires stringent policies for effective functioning.
  • 🎛️ Monitor settings and test patterns help identify potential image issues like artifacts.
  • 💡 Proper equipment maintenance reduces unnecessary patient exposure and improves diagnostic accuracy.

Timeline

  • 00:00:00 - 00:05:00

    Quality Management in the radiology department encompasses quality assurance (QA) and quality control (QC) to enhance patient care. QA focuses on all factors affecting patient care, such as process assessment and problem identification, followed by improvement plans. An example is evaluating patient wait times. QC, a component of QA, involves technical operations to maintain equipment performance, ensuring high-quality image production. The American College of Radiology mandates facilities to document procedures for monitoring digital image data management. Effective QC testing prevents overexposure and involves regular tests, which must be consistent and documented.

  • 00:05:00 - 00:10:00

    The quality control program aims to optimize diagnostic information quality and accessibility. Testing involves using test patterns from bodies like the American Association of Physicists in Medicine. Regular QC testing, as recommended by major standards bodies, checks parameters like contrast and Noise. Differences exist in testing frequency recommendations: ACR suggests monthly tests, while AAPM advises daily and monthly tests by radiographers with annual checks by medical physicists. QC testing also involves cleaning monitors and evaluating image quality, among other technical assessments.

  • 00:10:00 - 00:17:51

    Technology, like vendor software, facilitates the analysis of reject or repeat rates for consistent high-quality image production. Radiographers are tasked with inspecting image receptors and cleaning them per guidelines, disposing of any irreparable ones safely. The medical physicist conducts periodic QA and QC procedures—reviewing logs, equipment history, and performance standards. Digital detector corrections are necessary regularly to address field uniformity and ghosting effects. Also, issues like electronic or software artifacts in digital systems are identified and rectified to maintain image integrity.

Mind Map

Video Q&A

  • What are the two broad categories of quality management in radiology?

    Quality assurance and quality control.

  • What is quality assurance in a healthcare facility?

    QA activities address everything affecting patient care, including managerial processes, image quality, and technical standards.

  • How are quality control activities related to technical operations?

    QC activities monitor equipment performance to ensure consistent, high-quality image production.

  • How often should QC testing be performed according to the ACR?

    The ACR recommends testing at least monthly.

  • What tools are used to evaluate display monitor performance?

    Test patterns developed by the American Association of Physicists in Medicine and the Society of Motion Pictures and Television Engineers.

  • What is the role of the medical physicist in quality management?

    They perform QA and QC procedures, check performance, and analyze logs and department records.

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Subtitles
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  • 00:00:00
    [Music]
  • 00:00:11
    procedures in the Pax environment
  • 00:00:15
    Quality Management in the radiology
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    department
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    assesses all aspects of the department
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    that have an impact on patient care
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    and the level of quality of that care
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    quality management of concern to staff
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    technologists is divided into two broad
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    categories
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    quality assurance and quality control
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    quality assurance or QA activities in a
  • 00:00:56
    health care facility attempt to address
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    everything that affects patient care
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    including managerial processes and
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    procedures
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    image quality and Technical standards
  • 00:01:13
    as well as the medical aspects of
  • 00:01:16
    patient care
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    QA activities begin with observation of
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    department and institution processes
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    that impact the delivery of patient care
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    those processes should periodically be
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    assessed for the level of quality and
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    for problems
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    once a problem or potential problem is
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    identified and clearly defined
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    monitoring the data collection can begin
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    to more completely understand the source
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    and the extent of that problem
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    at this point an improvement plan can be
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    developed with input from stakeholders
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    implementation of the Improvement plan
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    will require further data collection at
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    identified points in this process
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    data collected from the implementation
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    phase
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    show the plan has created
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    improvements in the process
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    if there is no improvement the process
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    must begin again and accurately identify
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    the problem
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    examples of QA activities in the
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    radiology department could be evaluating
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    patient wait times such as how long an
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    emergency department has to wait
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    for x-rays to be taken and the
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    turnaround time which determines the
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    average amount of time
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    it takes from The Ordering of a
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    procedure
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    to when the radiologist's report is
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    available for viewing
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    both of these are common QA activities
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    in the radiology department
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    quality control or QC activities
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    are related to the technical operations
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    of the department
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    and are part of the overall QA program
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    quality control activities monitor
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    equipment performance to ensure it is
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    operating at a consistent level
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    and is properly maintained
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    QC processes attempt to ensure high
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    quality images are produced safely
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    consistently and efficiently
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    the American College of radiology
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    technical standards for Digital Image
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    data management
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    policies States
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    any facility using a digital image data
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    management system
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    must have documented policies and
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    procedures for monitoring and evaluating
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    the effective management
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    safety and proper performance of
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    acquisition
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    digitization
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    compression transmission display
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    archiving and retrieval functions of
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    that system
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    the quality control program should be
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    designed to maximize the quality and
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    accessibility of the diagnostic
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    information
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    the ACR requires monitoring of digital
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    imaging systems for contrast spatial
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    resolution and Noise
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    these parameters along with the
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    performance of the display monitors can
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    be checked using test patterns developed
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    by the American Association of
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    physicists in medicine
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    task group 18.
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    or the test pattern that was developed
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    by the Society of Motion Pictures and
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    television Engineers or smpte
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    in order to be effective in preventing
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    unnecessary exposures or repeat images
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    and overexposure of the patient
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    QC testing must be performed on a
  • 00:06:20
    regularly scheduled basis
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    be consistent in methodology and be
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    documented
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    deviations must be reported to the
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    physicists and followed up with service
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    personnel
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    in addition to the Quality parameters
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    previously discussed
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    Digital Imaging QC activities are also
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    related to the Pax
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    workstation and reading monitors and to
  • 00:07:00
    image artifacts
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    as previously stated
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    both the ACR and the aapm recommend
  • 00:07:19
    regular QC testing
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    however they differ in their timelines
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    the ACR recommends testing at least
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    monthly
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    while the aapm recommends daily and
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    monthly procedures that may be carried
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    out by the radiographer
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    and annual tests that need to be
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    performed by the medical physicist
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    according to Carter and veal the monitor
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    should be turned on and given time to
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    warm up before proceeding with the test
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    check all areas of the monitor for dust
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    and clean if necessary
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    using either the Society of Motion
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    Pictures and television Engineers test
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    pattern
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    or the association of American
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    physicists in medicine
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    aapm test group 18's test pattern
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    evaluate the image of the test pattern
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    for overall image appearance noting any
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    non-uniformities or artifacts
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    to evaluate geometric distortion
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    look for variations in the shape of the
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    displayed image
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    the borders and lines of the test
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    pattern should be straight
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    luminance reflection noise and glare can
  • 00:09:08
    be evaluated with a luminance meter or
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    with a photometer and the test pattern
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    there are a number of
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    aapm
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    tg18 test patterns that are available
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    for testing other Imaging modalities and
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    additional aspects of the packs
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    reject or repeat analysis is not new to
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    Medical Imaging
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    in film screen Imaging
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    this was a manual process that required
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    a significant amount of time
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    and was usually performed by the lead
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    technologist or manager
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    today this can be accomplished using
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    vendor software
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    analysis of each radiographer's reject
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    or repeat rate is important in
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    consistently producing high quality
  • 00:10:21
    images
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    and reducing exposure for patients
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    the analysis should be used to correct
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    any deficiencies in staff knowledge
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    or to direct staff training
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    in addition to the reject analysis
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    technologists may be responsible
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    for inspecting image receptors for dirt
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    damage and artifacts
  • 00:11:01
    plates may be cleaned using cotton
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    gloves and manufacturer recommended
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    cleaning cloths and solutions
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    if artifacts are a result of damage to
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    the image receptor and cannot be
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    remedied the image receptor needs to be
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    disposed of according to the state and
  • 00:11:27
    U.S Environmental Protection guidelines
  • 00:11:39
    the medical physicist performs various
  • 00:11:43
    QA and QC procedures on either a
  • 00:11:48
    semi-annual or annual basis
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    the aapm has set forth recommendations
  • 00:11:56
    for the procedures that need to be
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    carried out
  • 00:12:00
    with all parameters followed
  • 00:12:04
    the medical physicist must
  • 00:12:07
    re-establish baselines for performance
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    review and analyze reject or repeat logs
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    check exposure indicator accuracy
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    evaluate Department QC records and the
  • 00:12:27
    service history of equipment
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    and finally check equipment performance
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    including collimation
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    focal spot size timer accuracy
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    kvp calibration
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    exposure linearity and exposure
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    reproducibility
  • 00:12:58
    this slide shows us additional digital
  • 00:13:02
    system tests that may be performed by
  • 00:13:06
    the radiographer
  • 00:13:08
    each is described on the following
  • 00:13:11
    slides
  • 00:13:19
    according to Carol digital detectors are
  • 00:13:23
    all inherently non-uniform and
  • 00:13:26
    Corrections have to be made on a regular
  • 00:13:29
    basis ranging from daily to
  • 00:13:33
    semi-annually
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    field uniformity can be tested using the
  • 00:13:40
    procedure listed and the image visually
  • 00:13:44
    scanned for defects
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    any defects should be reported to the
  • 00:13:51
    medical physicist
  • 00:14:07
    Phantom images or ghosting effects may
  • 00:14:11
    be the result of incomplete Erasure of
  • 00:14:16
    the Imaging plate after Extreme over
  • 00:14:20
    exposure
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    in Dr image ghosting or image lag is
  • 00:14:27
    caused when the electrical charge has
  • 00:14:30
    been trapped in the metastable sites or
  • 00:14:33
    F centers
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    of the amorphous selenium or silicone
  • 00:14:40
    and is released slowly over time
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    according to Carol
  • 00:14:59
    luminance response is the monitor's
  • 00:15:03
    ability to accurately display different
  • 00:15:06
    shades of brightness from a test pattern
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    these must be compared to a date
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    adjacent shades of brightness
  • 00:15:17
    this function is essentially identical
  • 00:15:21
    to a contrast test
  • 00:15:26
    artifacts occur in both CR and Dr
  • 00:15:30
    Imaging systems
  • 00:15:32
    the most common source of CR artifacts
  • 00:15:36
    is the Imaging plate
  • 00:15:39
    artifacts that appear on most or all
  • 00:15:42
    images are typically the result of
  • 00:15:46
    problems with the Plate Reader
  • 00:15:49
    Dr system artifacts may be caused by
  • 00:15:53
    electronic faults in the detector
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    elements or dels
  • 00:15:59
    and by software problems
  • 00:16:03
    electronic artifacts randomly occur on
  • 00:16:08
    Dr images for a variety of reasons
  • 00:16:14
    these can include Bucky motor
  • 00:16:17
    interference
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    x-ray tube rotor initiation
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    extraneous radio frequency signals and
  • 00:16:28
    other electronic interferences according
  • 00:16:31
    to Carol
  • 00:16:33
    software artifacts can result from
  • 00:16:37
    selecting the wrong procedure from the
  • 00:16:39
    menu
  • 00:16:40
    which leads to incorrect positioning
  • 00:16:44
    algorithms being applied to that image
  • 00:16:48
    poor positioning
  • 00:16:51
    metal prosthetic devices and other
  • 00:16:55
    anatomical abnormalities may cause
  • 00:16:58
    software artifacts in both CR and Dr
  • 00:17:14
    thank you for choosing medical
  • 00:17:16
    professionals as you're continuing
  • 00:17:19
    education provider
  • 00:17:21
    we hope you found this course
  • 00:17:23
    interesting and valuable
  • 00:17:27
    before you take the post-test please be
  • 00:17:31
    sure to look over the module objectives
  • 00:17:34
    to see if there are any areas you need
  • 00:17:38
    to review
  • 00:17:40
    of the information that was presented in
  • 00:17:43
    this module
Tags
  • Quality Management
  • Radiology
  • Quality Assurance
  • Quality Control
  • Equipment Performance
  • ACR Guidelines
  • Medical Imaging
  • Patient Care