10. Ensuring Quality in PACS

Question 1

Radiology has both _______ quality

Answer 1

people-centered & product-centered

Question 2

Has always been a part of health care, whether as a

service or product

Answer 2

Quality

Question 3

The ultimate focus in health care is to ___________ so that patients will want to return

Answer 3

improve patient

care & provide a high-quality service

Question 4

JCAHO

Answer 4

Joint Commission on the Accreditation

of Healthcare Organizations

Question 5

Voluntary but necessary to obtain Medicaid
Certification, hold certain licenses, obtain
reimbursements from insurance companies, &
receive malpractice insurance

Answer 5

Joint Commission on the Accreditation

of Healthcare Organizations (JCAHO)

Question 6

Rather than quality, TJC (The Joint Commission) currently uses terms

Answer 6

Continuous Quality Improvement or

Total Quality Management

Question 7

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

Answer 7

Quality Assurance

Question 8

QA (Quality Assurance) activities are focused around

Answer 8

people & service

Question 9

Most QA activities will produce _______ that can be analyzed

Answer 9

quantitative data

Question 10

These data can be used to
monitor the processes &
determine whether the process is working as it should & whether the standard of quality
has been met

Answer 10

quantitative data (Quality Assurance)

Question 11

Defined as a comprehensive set of activities
designed to monitor & maintain systems
that produce a product

Answer 11

Quality Control

Question 12

QC measures are instituted to ensure

that radiologic procedures are:

Answer 12

✓ performed safely
✓ appropriate for the patient
✓ performed efficiently
✓ produce a high-quality image

Question 13

QC measures are required by law to maintain the _____ for the room or department

Answer 13

license

Question 14

The data from the various activities are kept by a

________ within the department

Answer 14

designated individual

Question 15

Most QC activities are part of a _____, & the data

are used to improve the quality of the processes& the department

Answer 15

QA program

Question 16

3 MAJOR CATEGORIES OF QC TESTS

Answer 16

1. Acceptance Testing
2. Routine Maintenance
3. Error Maintenance

Question 17

Performed before newly installed
or majorly repaired equipment can
be accepted by the department

Answer 17

Acceptance Testing

Question 18

Testing may be performed by a designated technologist, a

radiation physicist, or by service personnel employed by the hospital

Answer 18

Acceptance Testing

Question 19

Used to determine whether the equipment is performing within the vendors specifications & as
promised

Answer 19

Acceptance Testing

Question 20

Performed to ensure that the equipment is performing as expected

Answer 20

Routine Maintenance

Question 21

Can catch problems before
they become radiographically
apparent

Answer 21

Routine Maintenance

Question 22

Testing may be performed by a designated technologist, a
radiation physicist, or by
service personnel employed by the vendor

Answer 22

Routine Maintenance

Question 23

When errors occur in equipment performance, corrective action must occur
These corrections will generally be made by service personnel employed by the vendor.

Answer 23

Error Testing

Question 24

Errors will be detected by poor equipment performance or poor quality outcomes

Answer 24

Error Testing

Question 25

CQI

Answer 25

Continuous Quality Improvement

Question 26

Focus more on the process rather than on the people | or the service

Answer 26

Continuous Quality Improvement (CQI)

Question 27

Belief is: If the process is good, health care workers | will follow it, & service will be good

Answer 27

Continuous Quality Improvement (CQI)

Question 28

The ____ does not replace QA/QC programs

Answer 28

Continuous Quality Improvement (CQI)

Question 29

The QA/QC programs focus on ______ a certain level of quality, not necessarily improving to a higher quality

Answer 29

maintaining

Question 30

``` focuses on improving the process or system within which the people function as team members rather than focusing on an individual’s work ```

Answer 30

Continuous Quality Improvement (CQI)

Question 31

All levels of people within the organization must be involved in the process of improvement

Answer 31

CONCEPT OF CQI (Continuous Quality Improvement)

Question 32

It is important that everyone participate because if one spoke is not involved, the wheel will fall off, & the quality cart cannot move forward

Answer 32

CONCEPT OF CQI (Continuous Quality Improvement)

Question 33

``` Systemic observation & assessment of the different aspects of a project, service or facility to make certain that standards of quality are being met ```

Answer 33

Quality Assurance

Question 34

``` Comprehensive set of activities designed to monitor & maintain systems that produce a product ```

Answer 34

Quality Control

Question 35

When beginning a QC program, care must be taken to ______ all surrounding variables so that each quality measure can be repeated without harm to the process

Answer 35

document

Question 36

very important in any QC activity & all paperwork must be kept up to date to make a valid performance measure

Answer 36

Documentation

Question 37

is the most difficult part of the process & the easiest part to not complete

Answer 37

Documentation

Question 38

Without the ________ to back up the findings, it will be difficult to prove the need for repair or update of a system

Answer 38

Documentation

Question 39

QC ACTIVITIES to be monitored in a PACS environment includes:

Answer 39

1. Display quality for both monitor & film 2. Processing speed 3. Network transfer speed 4. Data integrity (Data from archive)

Question 40

Many vendors have suggestions for what | should be monitored for their systems

Answer 40

QC ACTIVITIES

Question 41

It is very important that vendor’s list & timetable for these various activities be followed

Answer 41

QC ACTIVITIES

Question 42

If any QC activity results in an ________ result, the appropriate personnel should be notified & actions should be taken to remedy the situation

Answer 42

unacceptable

Question 43

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

Answer 43

ACR Technical Standard for Digital Image | Data Management

Question 44

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

Answer 44

ACR (American College of Radiology)

Question 45

SMPTE

Answer 45

Society of Motion Pictures & Television Engineers

Question 46

AAPM

Answer 46

American Association of Physicists in Medicine

Question 47

TG18

Answer 47

Task Group 18

Question 48

A test pattern developed by the ________ is also becoming more widely accepted for use in these QC tests

Answer 48

American Association of Physicists in Medicine (AAPM) Task Group 18 (TG18)

Question 49

suggests that the testing be performed on acceptance & annually by a trained physicist & the daily & monthly/quarterly tests can be performed by a trained QC technologist or a physicist

Answer 49

American Association of Physicists in Medicine (AAPM)

Question 50

If any of the following tests fails or produces out-of-range readings, ______ should be done

Answer 50

corrective action & continued monitoring

Question 51

The ______ should follow the radiology department’s policy on equipment maintenance procedures

Answer 51

technologist

Question 52

It may be necessary to contact a _______ to follow up on the findings

Answer 52

radiation physicist

Question 53

is often the weakest link in the digital imaging chain

Answer 53

Monitor

Question 54

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

Answer 54

Monitor

Question 55

It is not ______ to provide the highest-quality monitor for all viewing situations

Answer 55

cost-effective

Question 56

Radiologist Workstation Monitor:

Answer 56

2K-3K monitors for digital projection images 1K-2K cross-sectional images Up to 4K for mammography

Question 57

QC recommendations for display monitors from AAPM Document entitled:

Answer 57

Assessment for Display Performance for Medical Imaging Systems

Question 58

Testing should be completed both by _____ & by _______ on a daily & monthly/quarterly basis on all monitors used to view images

Answer 58

physicists, | technologists/users

Question 59

Daily Monitor QC

Answer 59

1. Turn on the monitor, allow it ample time to warm up. 2. Make sure that the monitor is dust free on the viewing surface & near the airflow areas. 3. Retrieve a QC monitor test pattern (SMPTE or AAPM TG18-QC) 4. General image quality & appearance 5. Geometric distortion 6. Luminance, reflection, noise & glare (luminance meter or photometer) 7. Resolution

Question 60

A device used to measure luminescence of areas on the monitor

Answer 60

Photometer

Question 61

Evaluate the results in comparison to previous measurements

Answer 61

Photometer

Question 62

Printer Image Quality

Answer 62

- Wet Laser Imager | - Dry Laser Imager

Question 63

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

Answer 63

speed, | speed

Question 64

Speed

Answer 64

- Workstation Processing Speed | - Image Transfer Speed

Question 65

Data Quality Control

Answer 65

1. Data Integrity | 2. Compression Recall

Question 66

Technologist should check on a daily basis to make sure all images sent to the PACS arrived on the PACS • Daily/Weekly/Monthly

Answer 66

Data Integrity

Question 67

Used to reduce the size of the image files to increase the speed of the network transfer of the images

Answer 67

Compression Recall

Question 68

established the compression protocol, and they determine the level of compression that will be acceptable for the institution

Answer 68

Radiologist/Radiation physicists

Question 69

PACS Continuous Quality Improvement

Answer 69

1. Recognition of Nondiagnostic Images 2. System Up-Time 3. System Training

Question 70

Documentation of nondiagnostic image being forwarded to the PACS

Answer 70

Recognition of Nondiagnostic Images

Question 71

Poor-quality Image Causes:

Answer 71

1. Equipment Malfunction | 2. Operator Error

Question 72

QC test & appropriate service protocol | should be used

Answer 72

Equipment Malfunction

Question 73

Additional training or counselling

Answer 73

Operator Error

Question 74

Monitor how often the system is down

Answer 74

System Up-Time

Question 75

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

Answer 75

System Up-Time

Question 76

An important activity that must never stop

Answer 76

System Training

Question 77

The vendor applications training is supposed to train several _______ (people who are trained on all aspects of the system & are prepared to train others)

Answer 77

super users