MODULE 10: Ensuring Quality in PACS Flashcards
In Quality Aspect, What does Radiology have?
Radiology has both a people-centered & a product-centered quality.
Has always been a part of health care, whether as a
service or product.
Quality
The ultimate focus in health care
improve patient care & provide a high-quality service
JCAHO/ TJC
Joint Commission on the Accreditation of Healthcare Organizations/ The Joint Commission
What term does the TJC currently use instead of quality?
Continuous Quality Improvement or
Total Quality Management
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.
Quality Assurance
QA Activities are focused around?
People and Service
Most QA activities will produce
_______________ that can be
analyzed.
Quantitative Data
Defined as a comprehensive set
of activities designed to monitor & maintain systems that produce a product.
Quality Control
QC measures are instituted to ensure
that radiologic procedures are: (papp)
✓ performed safely
✓ appropriate for the patient
✓ performed efficiently
✓ produce a high-quality image
are required by law to
maintain the license for the room or department.
QC measures
3 MAJOR CATEGORIES OF QC TESTS
- Acceptance Testing
- Routine Maintenance
- Error Testing
- Performed before newly installed or majorly repaired
equipment can be accepted by the department. - Testing may be performed by a designated technologist, a radiation physicist, or by
service personnel employed by the hospital. - Used to determine whether the equipment is performing within the vendor’s specifications & as
promised.
Acceptance Testing
- Performed to ensure that the equipment is performing as expected.
- Can catch problems before they become
radiographically apparent. - Testing may be performed by a designated
technologist, a radiation physicist, or by service personnel employed
Routine Maintenance
- When errors occur in equipment performance,
corrective action must occur. - Errors will be detected by poor equipment performance or poor quality outcomes.
- These corrections will generally be made by service
personnel employed by the vendor.
Error Testing
Focus more on the process rather than on the
people or the service.
Focuses on improving the process or system
within which the people function as team members rather than focusing on an individual’s work
CQI - Continuous Quality Improvement
True or False:
The CQI does not replace QA/QC programs.
True
The QA/QC programs focus on ________ a certain level of quality, not necessarily improving to a higher quality.
maintaining
very important in any QC activity & all paperwork must be kept up to date to make a valid performance measure
the most difficult part of the process & the easiest part
to not complete.
Documentation
QC ACTIVITIES
to be monitored in a PACS environment
includes:
- Display quality for both monitor & film
- Processing speed
- Network transfer speed
- Data integrity (Data from archive)
“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 Technical Standard for Digital Image Data Management
ACR suggests that all the quality tests must be carried out with this test pattern to ensure continuity of measurements
SMPTE - Society of Motion Picture and Television Engineers Test pattern
Another test pattern developed by the
________________________________________ is
also becoming more widely accepted for use in these QC tests.
AAPM TG18 - American Association of Physicists in Medicine Task Group 18
is often the weakest link in the digital imaging chain.
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.
Monitor
True or False:
It is not cost-effective to provide the
highest-quality monitor for all viewing situations.
True
True or False:
It is not cost-effective to provide the
highest-quality monitor for all viewing situations.
True
Radiologist Workstation
2K-3K monitors for ____________________
1K-2K for __________________
Up to 4K for _____________
digital projection images
cross-sectional images
mammography
Radiologist Workstation
2K-3K monitors for ____________________
1K-2K for __________________
Up to 4K for _____________
digital projection images
cross-sectional images
mammography
Daily Monitor QC
(T,M,R,G,G,L,R)
- Turn on the monitor, allow it ample time to warm up.
- Make sure that the monitor is dust free on the
viewing surface & near the airflow areas. - Retrieve a QC monitor test pattern (SMPTE or AAPM
TG18-QC) - General image quality & appearance
- Geometric distortion
- Luminance, reflection, noise & glare (luminance
meter or photometer) - Resolution
A device used to
measure luminescence
of areas on the
monitor
Evaluate the results in
comparison to previous
measurements
Photometer
Printer Image Quality
Wet Laser Imager
Daily/Weekly quality control
Dry Laser Imager
Daily/Weekly quality control
Speed
Workstation Processing Speed
Weekly/Monthly quality control
Image Transfer Speed
Weekly/Monthly quality control
Data Quality Control
- Data Integrity
- Compression Recall
- Technologist should check on a
daily basis to make sure all
images sent to the PACS arrived
on the PACS - Daily/Weekly/Monthly
Data Integrity
- Used to reduce the size of the image files to increase the speed of the network transfer of the
images. - Radiologist/Radiation physicists established the compression protocol, and they determine the level of compression that will be acceptable for the institution.
Compression Recall
PACS
Continuous Quality Improvement
- Recognition of Nondiagnostic Images
- System Up-Time
- System Training
Documentation of nondiagnostic image being
forwarded to the PACS
Recognition of nondiagnostic image being forwarded to the PACS
Poor-quality Image Causes:
- Equipment Malfunction
- Operator Error
- Monitor how often the system is down.
- 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 Up-Time
- 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)
System Training
