MODULE 10: Ensuring Quality in PACS

Question 1

In Quality Aspect, What does Radiology have?

Answer 1

Radiology has both a people-centered & a product-centered quality.

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

Answer 3

improve patient care & provide a high-quality service

Question 4

JCAHO/ TJC

Answer 4

Joint Commission on the Accreditation of Healthcare Organizations/ The Joint Commission

Question 5

What term does the TJC currently use instead of quality?

Answer 5

Continuous Quality Improvement or
Total Quality Management

Question 6

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 6

Quality Assurance

Question 7

QA Activities are focused around?

Answer 7

People and Service

Question 8

Most QA activities will produce
_______________ that can be
analyzed.

Answer 8

Quantitative Data

Question 9

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

Answer 9

Quality Control

Question 10

QC measures are instituted to ensure
that radiologic procedures are: (papp)

Answer 10

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

Question 11

are required by law to
maintain the license for the room or department.

Answer 11

QC measures

Question 12

3 MAJOR CATEGORIES OF QC TESTS

Answer 12

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

Question 13

• 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.

Answer 13

Acceptance Testing

Question 14

• 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

Answer 14

Routine Maintenance

Question 15

• 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.

Answer 15

Error Testing

Question 16

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

Answer 16

CQI - Continuous Quality Improvement

Question 17

True or False:
The CQI does not replace QA/QC programs.

Answer 17

True

Question 18

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

Answer 18

maintaining

Question 19

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.

Answer 19

Documentation

Question 20

QC ACTIVITIES
to be monitored in a PACS environment
includes:

Answer 20

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

Question 21

“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 21

ACR Technical Standard for Digital Image Data Management

Question 22

ACR suggests that all the quality tests must be carried out with this test pattern to ensure continuity of measurements

Answer 22

SMPTE - Society of Motion Picture and Television Engineers Test pattern

Question 23

Another test pattern developed by the
________________________________________ is
also becoming more widely accepted for use in these QC tests.

Answer 23

AAPM TG18 - American Association of Physicists in Medicine Task Group 18

Question 24

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.

Answer 24

Monitor

Question 25

True or False:
It is not cost-effective to provide the
highest-quality monitor for all viewing situations.

Answer 25

True

Question 25

True or False:
It is not cost-effective to provide the
highest-quality monitor for all viewing situations.

Answer 25

True

Question 26

Radiologist Workstation
2K-3K monitors for ____________________
1K-2K for __________________
Up to 4K for _____________

Answer 26

digital projection images
cross-sectional images
mammography

Question 27

Radiologist Workstation
2K-3K monitors for ____________________
1K-2K for __________________
Up to 4K for _____________

Answer 27

digital projection images
cross-sectional images
mammography

Question 28

Daily Monitor QC
(T,M,R,G,G,L,R)

Answer 28

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 29

A device used to
measure luminescence
of areas on the
monitor

Evaluate the results in
comparison to previous
measurements

Answer 29

Photometer

Question 30

Printer Image Quality

Answer 30

Wet Laser Imager
Daily/Weekly quality control

Dry Laser Imager
Daily/Weekly quality control

Question 31

Speed

Answer 31

Workstation Processing Speed
Weekly/Monthly quality control

Image Transfer Speed
Weekly/Monthly quality control

Question 32

Data Quality Control

Answer 32

1. Data Integrity
2. Compression Recall

Question 33

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

Answer 33

Data Integrity

Question 34

• 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.

Answer 34

Compression Recall

Question 35

PACS
Continuous Quality Improvement

Answer 35

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

Question 36

Documentation of nondiagnostic image being
forwarded to the PACS

Answer 36

Recognition of nondiagnostic image being forwarded to the PACS

Question 37

Poor-quality Image Causes:

Answer 37

1. Equipment Malfunction
2. Operator Error

Question 38

• 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.

Answer 38

System Up-Time

Question 39

• 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)

Answer 39

System Training