1 / 27

Housekeeping: PACS cleaners and sweepers

Housekeeping: PACS cleaners and sweepers. Dr Nicola H Strickland Consultant Radiologist Hammersmith Hospitals Trust London, UK. Why this title?. PACS is not like a fridge! It needs looking after “a PACS nursemaid” sweeper and cleaner to keep database tidy. Jobs to be done.

kailey
Download Presentation

Housekeeping: PACS cleaners and sweepers

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Housekeeping:PACS cleaners and sweepers Dr Nicola H Strickland Consultant Radiologist Hammersmith Hospitals Trust London, UK

  2. Why this title? • PACS is not like a fridge! • It needs looking after • “a PACS nursemaid” • sweeper and cleaner to keep database tidy

  3. Jobs to be done • daily housekeeping • pre- and post upgrade housekeeping

  4. Daily housekeeping • unspecified exams • exams erroneously marked dictated • unreported exams • unverify exams on request • CR / DR problems • “unfetchable exams”

  5. Unspecified exams • appear as, eg. “unspecified CR” • problem caused: historical exams of same body part and same modality not displayed automatically • action: exam needs to be merged with correct folder for that exam on PACS

  6. Common causes of “unspecified” • RIS DICOM modality worklist (on modality) PACS “order entry” • RIS update no update to modality worklist PACS updates correctly • no DICOM modality worklist • typographical / demographic errors

  7. Common causes of “unspecified” • later follow-up images added to same exam • eg. nuclear medicine white cell scan • eg. ultrasound post micturition • solution: DICOM perform procedure step (PPS) needs to be supported on the modality and on PACS. • PPS allows a “step” of the exam to be completed without closing the whole study

  8. Common causes of “unspecified” • bizarre equipment malfunction! • unpredictable change of demographics eg. nuclear medicine workstation

  9. Daily housekeeping • unspecified exams • exams erroneously marked dictated • unreported exams • unverify exams on request • CR / DR problems • “unfetchable exams”

  10. Exams erroneously marked dictated Causes: • human error (by radiologist) hit the dictated key/click dictated icon by mistake • report “lost” • tape lost / corrupted • dictation system malfunction • report typed but not sent to PACS

  11. Exams erroneously marked dictated Action: • decide date range, eg. up to 4 weeks ago • identify status “reported” but not “completed” • check no typed report exists on RIS / speech recognition system • if none does......

  12. Exams erroneously marked dictated Action: • restore “unreported” status so exam reappears on worklist for reporting • identify and alert radiologist responsible (for specials only) • if typed report does exist on RIS / speech rec system: • resend to PACS • correct error sending to PACS

  13. Daily housekeeping • unspecified exams • exams erroneously marked dictated • unreported exams • unverify exams on request • CR / DR problems • “unfetchable exams”

  14. Unreported exams 1.very old (months ago) unreported exams ●status may change automatically: “dictated off-line” ● only a problem when you first start housekeeping ● re-instate unreported status  back on worklist ● alert appropriate radiologist (for specials)

  15. Unreported exams 2.“missed” recent unreported exams (specials) ● eg. ●at session handover for CT/MR ● on call (junior radiologist) – verbal report given ● re-instate unreported status ● alert appropriate radiologist (for specials)

  16. Daily housekeeping • unspecified exams • exams erroneously marked dictated • unreported exams • unverify exams on request • CR /DR problems • “unfetchable exams”

  17. Unverify exams on request • on request by radiologist ● so that post-processed images can be sent to PACS, eg. CT reformats ● needed because PACS does not yet support DICOM perform procedure step

  18. Unverify exams on request 2. on request by radiographer ● extra image taken later eg. - IVU delayed image - further view requested by radiologist ● exam already dictated and completed by radiologist before all (CT/MR) images sent to PACS by radiographer! (viewed by radiologist on 3D workstation)

  19. Daily housekeeping • unspecified exams • exams erroneously marked dictated • unreported exams • unverify exams on request • CR / DR problems • “unfetchable exams”

  20. CR / DR problems • wrong plate put through CR reader • another patient’s image assigned to the exam • unverify exam • reassign image correctly • wrong processing algorithm used • Reapply algorithm on plate reader / DR

  21. Daily housekeeping • unspecified exams • exams erroneously marked dictated • unreported exams • unverify exams on request • CR / DR problems • “unfetchable exams”

  22. “unfetchable” exams • old exams not retrieved from long term archive • a rare problem • alert PACS engineer = a de-archiving problem

  23. Jobs to be done • daily housekeeping • pre- and post upgrade housekeeping

  24. Upgrades housekeeping • print film / CDs of critical key images requested by clinicians, eg. NNU • merges +++ post upgrade • no RIS  modalities worklists • no RIS  PACS order entry

  25. Policies! • anything sent to PACS must have a RIS entry • digitization • CD uploading • out of hours exams (especially ultrasound!) • restricted digitization / CD uploading • requires radiologist authorization • restricted film printing / CD burning • requires radiologist / radiographer authorization

  26. The “nappy changing team”!! Imaging support systems group (ISSG) • 4 radiographers (2 full time posts, one at HH, other at CX) • why 4? • covers annual and sick leave • why radiographers? • understand difference between study types and body parts

  27. The “nappy changing team”!! Imaging support systems group (ISSG) • pattern of errors noticed early: • corrected, working practices changed etc. • report to the “POG” (PACS operational group) • team cohesion

More Related