Evolution of Quality Management in Radiology

1. Prelim 11/14/11 Quiz 1

2. 2nd Semester, 3rd Year Level Quality Assurance / Quality Control

3. History Of Quality Management • The Early 1900’s, With The Work Of An Industrial Engineer Named Frederick Winslow Taylor. • “Father Of Scientific Management”

4. Philosophy • “Planning functions and execution stage be separated and that numerous individuals be assigned W/ specific task to minimize the complexity of the task.”

5. Maximize Efficiency By Distributing Work And Because Complex Work Is Lessened Fewer Mistake Would Occur.

6. Maximize Efficiency By Distributing Work • Fewer Mistake Would Occur.

7. From Scientific Management To Quality Improvement • The scientific management philosophy taught by Frederick Winslow Taylor was replaced with the concept of quality improvement by W. Edwards Deming And Joseph Juran.

8. Quality Improvement Philosophy • Dr. W. Edwards Deming Taught That By Adopting Appropriate Principles Of Management, Organizations Can Increase Quality And Simultaneously Reduce Costs (By Reducing Waste, Rework, Staff Attrition And Litigation While Increasing Customer Loyalty).

9. “The Key Is To Practice Continual Improvement And Think Of Manufacturing As A System, Not As Bits And Pieces.”

11. Governmental Action Of QA/QC In Radiology • Federal governments first step was on 1968 with the Radiation Control for Health and Safety Act.

13. The Law Requires The U.S. Department Of Health, Education And Welfare (Health And Human Services) • To Develop And Administer Standards That Would Reduce Human Exposure To Radiation From Electronic Products. • The Bureau Of Radiological Health (BRH) Was Given The Task To Implement The Act.

15. In 1974 the BRH set forth regulatory actions W/ several amendments to control the manufacturing and installation of medical and dental diagnostic equipment to reduce useless radiation.

16. In 1981, The Consumer-patient Radiation Health And Safety Act Addressed Issues Such As • Unnecessary Repeat Exam, • Mass Screening Program, Etc • It Is Also Established Minimum Standards For Accreditation Of Educational Programs And The Licensure Laws.

17. Consumer Assurance Of Radiologic Excellence Act • On Sept 2000 The CARE Act was introduce in congress, w/c mandated educational and training requirements for to all technologist performing the imaging procedures.

18. Medical Imaging Demands Precision In The Production Of High-quality Diagnostic Images While Restricting The Amount Of Radiation Administered To Patients.

20. What Is QA And QC? • Quality Assurance: A set of activities designed to ensure that the development and/or maintenance process is adequate to ensure A system will meet its objectives. • Quality Control: A set of activities designed to evaluate A developed work product.

21. The Terms Quality Assurance (QA) And Quality Control (QC) Are Often Used Interchangeably (Or In Tandem), But They Have Different Meanings.

22. Quality Assurance • QA is an assessment of the process by which A product is created. • QA Often Is used as A description of A comprehensive overall testing program,

23. QA Also Refers To The Policies And Processes Of The Radiology Department And Thus Is Related Closely To Workflow.

24. Quality Control • QC is an assessment of the product itself. • QC Also Refers To The Final Quality Of Either The Images Or The Radiologists' Reports.

25. Radiation Dose Image Quality “Two Things Are Of Prime Importance: …

26. Diagnostic Imaging • Unfortunately, there are numerous sources of variability in quality, in both human and equipment factors, that can produce sub-quality image if not properly controlled.

27. Repeat Exposures – increases both patient dose and department cost and possibly decrease the accuracy of image interpretation and can result in decreased in customer satisfaction.

28. Three levels on W/C quality is determined • Expected Quality – Level of quality of the product or service that is expected by the customer. • Perceive Quality – Is the customers perception of the product or service or the care. • Actual Quality – Is the level of quality uses statistical data and considers all factors that can influence the final product.

29. Changes That Influence The Construction Of QA/QC • Advances In Technology, Equipment And Procedures. • Legislation And Government Regulations • Joint Commission On The Accreditation Of Healthcare Organizations Accreditation Procedures. • Corporate Buyouts And Mergers. • Methods Of Reimbursement For Services Rendered.

30. End

31. QA And QC Programs • The QA Program Should Include The Means To Provide Appropriate Training For All Personnel With QA Responsibilities And Especially Those Directly Involved With QC Testing.

32. The Purpose Of A QC Testing Program • Is To Maintain The Quality Of Diagnostic Images. • This Is Done With Routine Monitoring Of Photographic And X-ray Equipment Parameters To Detect Deviations Of Equipment Performance And Take Prompt Corrective Action.

33. QA/QC PROGRAMS • Radiology Department QA Committee • Radiology Department QA Program • QA Personnel Training • QC Technologist • Equipment Specification Writing

34. QC TESTING • QC Test Equipment • Equipment Acceptance Testing • QC Testing Program • X-ray Equipment QC • Photographic Equipment QC

35. QA TESTING • Equipment Performance Records And Record Keeping • Equipment Appraisal And Replacement Policy • Standardization Of Exposure • Acceptance Criteria For Diagnostic Radiograms • Reject-repeat Analysis Program

36. Quality Assurance Deals With People • A Program Of QA Monitors Proper Patient Scheduling, Reception, And Preparation And Answers The Following Questions; • Is The Scheduled Examination Appropriate For The Patient? • If So, Has The Patient Been Properly Instructed Before The Time Of The Examination?

37. QA Also Involves Image Interpretation Or Outcome Analysis.

38. Quality Control Deals With Instrumentation And Equipment. • Quality Control Is More Tangible And Obvious Because In This Program The Radiologist Is Provided With Optimal Image Produced Through Good Equipment Performance And Resulting In Minimal Patient Radiation Exposure.

39. Quality Management • Administrative Responsibilities • Threshold Of Acceptability • Communication Network • Patient Comfort • Personnel Performance • Record Keeping System • Corrective Action

40. Risk Management • Risk Analysis • Policies And Procedures • Radiation Safety Program • Patient Radiation Protection • Radiographic Examinations • Fluoroscopic Examinations

41. Visitor Protection • Personnel Protection • Time • Distance • Shielding