Importance of Quality Assurance Programme for Radiology Department

Definitions:

“Quality assurance” means the planned and systematic actions that provide adequate confidence that a diagnostic facility will produce consistently high-quality images with minimum exposure of the patients and healing arts personnel. The determination of what constitutes high quality will be made by the facility producing the images. Quality assurance actions include both “quality control” techniques and “quality administration” procedures.

“Quality assurance program” means an organized entity designed to provide “quality assurance” for diagnostic radiology facilities. The nature and extent of this program will vary with the size and type of the facility, the type of examinations conducted and other factors.

“Quality administration procedures” are those management actions intended to guarantee that monitoring techniques are properly performed and evaluated and that necessary corrective measure are taken in response to monitoring results. These procedures provide the organizational framework for the quality assurance program. 

Purpose of Quality Assurance Programme for Radiology Department:

To address verification and validation of imaging methods, surveillance   of   imaging results, periodic calibration and maintenance of equipment’s and proper documentation of Corrective and preventive actions.

The QA programme for imaging should involve all stakeholders. It should be a comprehensive programme addressing equipment QA, Protocols, safety, education and surveillance. In addition, AERB requirement will have to be met.

Objective of Quality Assurance Programme for Radiology Department:

• To ensure the accuracy of the diagnosis.

• The minimum radiation dose should be delivered to the patient to achieve the objective of the diagnostic or interventional procedures.

• The Quality Assurance tests of machine should be carried out thereafter at regular intervals (periodicity-once in two years)

• To ensure the Regular Maintenance and Calibrations of the equipment

Quality Assurance Programme for Radiology Department:

Periodic Internal / External Peer Review of Imaging Protocols:

A peer review system will be in place to review the reports and outcomes of interventional procedures performed. This shall be done in a structured manner, and the sample size, periodicity for each modality shall be defined. The results of such reviews shall be discussed with all stake holders in "discrepancy meetings" and the same shall be documented. The peer review can be performed by the head of department or by a group of peers, with or without blinding of the original reports. Discrepancies in the reports will be graded on the severity and impact on changes on patient management strategy, and the corrective and preventive actions taken to minimize these will be documented. The purpose is to prevent errors in future, and continuous quality improvement rather than computation or error rates of the individuals.

Surveillance of Imaging Results:

Structured peer review of the imaging protocols and procedures shall be periodically performed and they should be modified in accordance of the current best practices. 

Surveillance of the quality of images, and completeness of the imaging procedures should be performed to ensure that they are appropriate for the indications for which the imaging has been performed.

For example: 

CT for acute renal colic requires only a low dose non-contrast CT and a multiphase CT urography would expose the patient to unnecessary radiation and contrast media injection; while for Obstructive uropathy with urosepsis will require it to be tailored for identifying abscesses, and hence would be multiphase CT.

Ensure the appropriateness of the investigations and procedures for the clinical indication:

The investigation orders are screened prior to performing of the imaging or interventional procedure to ensure that they are appropriate investigation (as per current best practice guidelines and patient safety) based on for the clinical indication, otherwise alternate investigations are offered in consultation with the treating doctor. 

For Example: 

Mammography for a lactating 25 yrs old lady with fever and a lump is inappropriate, and will never reveal the breast abscess; Ultrasound scan of the breast will be the best investigation.

Periodic Calibration and Maintenance of All Equipment:

Quality Assurance including calibration and maintenance of all equipment will be performed as per AERB guidelines, as well as the manufacturer's recommendations and records of the same shall be maintained. All such activities will be performed by persons who are appropriately trained and certified by the regulatory authorities for this purpose. Traceability certificates of all Calibrations done by calibrated equipment shall be maintained.

Documentation of corrective and preventive actions:

In case of any deviations noted from the laid down quality assurance programme, the organisation shall institute corrective and preventive actions as may be appropriate.

Quality Assurance Test for Radiology Equipment:

Written by:

Dr. Praveen Bajpai

Director of Ingenious Healthcare Consultants Pvt. Ltd.
Founder of Skill Sathi

MBA in Hospital administration, PG Diploma in Quality Accreditation, PG Diploma in Medico Legal System, M. Phil in Hospital Mgmt. from BITS Pilani, P.hD in Management, Certified NABH Auditor, Certified NABL Auditor, Certified Auditor for Clinical Audits, Green Belt in Six Sigma, Certified in Hospital Infection Control Practices, Certified trainer for International Patient Safety Goals, Certified Auditor for JCI 7th Edition Standards 

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