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QAQC PRELIM-ZBalbarada

The document outlines the importance of Quality Assurance (QA) and Quality Control (QC) in medical imaging, emphasizing structured QA models and tangible QC processes to ensure optimal patient care and equipment performance. It details the steps involved in QA, the components of an effective QC program, and specific measurements and standards for radiographic systems, including filtration, collimation, and exposure accuracy. Additionally, it discusses maintenance protocols for processors and the significance of radiographic technique charts in standardizing imaging practices.

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szbalbarada
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9 views4 pages

QAQC PRELIM-ZBalbarada

The document outlines the importance of Quality Assurance (QA) and Quality Control (QC) in medical imaging, emphasizing structured QA models and tangible QC processes to ensure optimal patient care and equipment performance. It details the steps involved in QA, the components of an effective QC program, and specific measurements and standards for radiographic systems, including filtration, collimation, and exposure accuracy. Additionally, it discusses maintenance protocols for processors and the significance of radiographic technique charts in standardizing imaging practices.

Uploaded by

szbalbarada
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF, TXT or read online on Scribd
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QUALITY ASSURANCE AND QUALITY CONTROL (LEC&LAB)

Professor Rhea Torrato │ PRELIM Reviewer │ 1st Semester


BALBARADA, Zhane A.

All fields of medicine and hospital department are required to develop and conduct
programs that ensure the quality of patient care and management. Diagnostic imaging
department are leaders in promoting quality patient care.

QUALITY ASSURANCE
 Deals with people

QUALITY CONTROL
 Deals with instrumentation and equipment

QUALITY ASSURANCE
Health care organization often adopt formal, structured QA models. The joint commission
(TJC) promotes the "The 10 steps monitoring and evaluation process”
1. Assign responsibility
2. Delineate scope of care
3. Identify aspects of care
4. Identify outcomes that affect the aspect of care
5. Establish limit of scope of assessment
6. Collect and organize data
7. Evaluate care when outcomes are reacted
8. Take action to improve care
9. Assess the document actions
10. Communicate information to organization wide quality assurance programs

QUALITY CONTROL
 Is more tangible and obvious than QA
 Is design to ensure that the radiologist is provided with an optimal image produced
through good equipment performance and resulting in minimal patient radiation exposure
 QC begins with xray imaging systems used to produce the image and continues with the
routine evaluation of imaging processing facilities
 QC concludes with a dedicated analysis of each image to identify deficiencies and artifacts
and to minimize reexaminations

Acceptable QC program consists of 3 steps


 Acceptance testing
 Routine performance monitoring
 Maintenance

QC Team
 Medical physicist- he/she performs routine activities, monitoring measurement and
observation
 QC technologist
 Radiologic engr.

RADIOGRAPHIC QUALITY CONTROL


Filtration
 Perhaps the most important patient protection characteristic of a radiographic imaging
system
 State statutes require that general purpose radiographic units have a minimum total
filtration of 2.5 mm Al.
 Should be evaluated annually (yearly) at any time after a change has occurred in the x-ray
tube or tube housing

Collimation
 X-ray must coincide with the light field of the variable aperture light localizing collimator, if
these field are misaligned intended anatomy will be missed and unintended anatomy
irradiated
 Misalignment must not exceed 2% of the source to the image receptor distance (SID)

Focal Spot Size


 Spatial resolution of a radiographic imaging system is determined principally by focal spot
size of the x-ray tube
 New equipment or replacement x-ray tube is installed, the focal spot size must be
measured
 Should be evaluated annually or when x-ray tube is replaced

3 TOOLS USED FOR MEASUREMENT


 Pinhole camera - difficult to use and requires excessive exposure time
 Star pattern - easy to use but has limitations for focal- sizes less than 0.3 mm
 Slit camera - standard for measurement for focal spot size

kVp Calibration
 Should be evaluated annually or whenever high voltage generator components have
changed significantly
 Measured kVp should be within 10% of the indicated kVp

Exposure Time Accuracy


 Operator selectable on most radiographic consoles
 Should be within 5% of the indicated time for exposure times greater than 10ms
 Should be assessed annually or more frequently if a component of operating console or
high voltage generator has undergone major repair

Exposure Linearity
 Ability of a radiographic unit to produce a constant radiation output for various
combination of mA and exposure time
 Must be within 10% for adjacent mA station

Exposure Reproducibility
 Sequential radiation exposures should be reproducible to +- 5%

Elements of a Quality Control Program for Radiographic Systems


Measurement Frequency Tolerance
Filtration Annually ≥2.5 mm Al
Collimation Semiannually +2% SID
Focal-spot size Annually +50%
Calibration of kVp Annually +10%
Exposure timer accuracy Annually 5% ＞10ms
+20% ≤ 10ms
Exposure linearity Annually +10%
Exposure reproducibility Annually +5%

RADIOGRAPHIC INTENSIFYING SCREEN


 Screen should be cleaned with a soft, lint free cloth and a cleaning solution provided by
the manufacturer
 The frequency of cleaning depends on the workload in the department but certainly should
not occur less often than every other month.

PROTECTIVE APPAREL
 All protective aprons, gloves and gonadal shields should be radiograph or fluoroscope
annually for defects.
 If cracks, tears, or holes are evident, the apparel may require replacement.

FILM ILLUMINATORS
 Viewbox illumination should be analyzed photometrically on an annual basis.
 This is done with an instrument called a photometer.
 If the bulbs requires replacement, all bulbs in the illuminators should be replaced and
matched to the type of bulb used in adjacent illuminators.
 Intensity should be at least 1500cd/m2 and should not vary by more than +-10% over the
surface of the illuminator
Photometer - measures the light intensity at several areas of the illuminator

PROCESSSOR QUALITY CONTROL


 QC in any activity refers to the routine and special procedures developed to ensure that
the final product is of consistently high quality.
 QC in diagnostic radiology requires a planned continuous program of evaluation and
surveillance of radiologic equipment and procedures
 When we applied in automatic processing, such program involves periodic cleaning,
system maintenance and daily monitoring

PROCESSING CLEANING
 The first automatic processor had a dry- to- drop time of 7 minutes, soon this was
shortened to 3 mins by what are known as double capacity processors.
 Processing time was reduced further with the fast access system which todays most
popular 90 second processor, processor can handle up to 500 films per hour
 Development temperature (95 deg F, 35 deg C) and development immersion time of 22
second
 Wash temp should be (87 deg F, 31 deg C)
 Cleaning is conducted weekly, records of such cleaning should be maintained

PROCESSOR MAINTENANCE
 If equipment is not properly maintained, the processor may fail when least expected
3 Types of Maintenance Program
1. Scheduled maintenance
2. Preventive maintenance
3. Non scheduled maintenance

Scheduled Maintenance
 Refers to routine procedures that performed usually weekly or monthly
Include:
 Observation of all moving parts for wear
 Adjustment of all belts, pulleys and gear
 Application of proper lubrication to minimize wear

Preventive Maintenance
 Plan program of parts replacement at regular intervals
 Requires that a part be replaced before it fails

Nonscheduled Maintenance
 The worse kind, a failure in the system that necessities processor is repair

QUALITY CONTROL PROGRAM FOR RADIOGRAPHIC PROCESSOR


Activity Procedure or Item Schedule
Processor cleaning Crossover racks Daily
Scheduled maintenance Entire rack assembly and Weekly
processing ranks
Observation of belts, pulleys, Weekly
and gears
Lubrication Weekly or monthly
Processor monitoring Planned parts replacement Regularly
Check developer temperature Daily
Check wash water Daily
temperature
Check replenishment rates Daily
Sensitometry and Daily
densitometry

RADIOGRAPHIC TECHNIQUE CHART


 Is a table that contains exposure settings used for specific anatomical exams. It is unique
to each radiographic unit and facility. The chart includes information:
1. Object to be imaged (e.g., skull, hand, foot)
2. Beam strength (X-ray energy in kilovolts peak, kVp)
3. Beam exposure time (in milliamperes per second, mAs)

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