Quality Assurance in Radiology


Quality Assurance in Radiology

Quality assurance is a term that has emerged in the past few years that is intended to connote a broader sphere of action than was usually assigned to the older term quality control. Quality assurance, as practiced in hospital radiography departments today, encompasses equipment, accessories, and radiography personnel. Generally, quality control is a term referring to the hardware or equipment in radiology departments.

Every hospital radiology department has a quality assurance program. (This type of program is a requirement by law.) It involves all radiology personnel in how they will perform their tasks, as well as the equipment for function and safety. Large departments may designate one person to be responsible for the program. However, the current trend is toward making all technologists responsible for quality assurance within their scope of practice.

Quality is often defined as a degree of excellence. Everyone who enters a health care facility expects to receive the highest possible quality—or excellence—of service. The radiologic technologist plays an important role in maintaining that quality of service.

Every new radiologic technology student is overwhelmed by the complexity of the equipment and the sophisticated techniques used by staff radiologic technologists. However, as a student, several steps can be taken to ensure quality, even in the early stage of your clinical education, such as making sure the cassettes are free of dirt and debris, checking for broken hinges and latches, making sure barcode labels are in good condition, and making sure imaging plates are erased before reuse. As you spend more time in clinical education, you will soon become accustomed to using complex machines and methods to produce radiographs. However, an important point to remember is that radiographic services are very complex and sophisticated, no matter how familiar they may become. In fact, this complexity is the primary problem in maintaining quality radiographic services in today’s radiology departments.

Remember that no matter how complex the problem may seem, the solution is usually very simple and obvious. In this chapter, you will be presented with a few simple rules that will assist you in solving some of your early problems and help you maintain an optimal level of quality in the radiographic services you provide your patients.

Administrative pyramid

Most radiology departments operate under a pyramidal administrative structure. This type of structure allows a few administrators to manage a large number of employees (Fig. 17-1). Generally, the tip of the pyramid represents the highest-paid employees and the bottom of the scale the lowest-paid employees. This arrangement is economical in that most employees are on the lower end of the wage scale. Communication from the top down is usually formal so that when an order is issued from a top administrator, it is passed down to the lower levels of the pyramid without undue difficulty. However, when attempts are made to transmit a message back up the pyramid, a problem similar to what occurs in the telephone game played by children is encountered. In this game, participants relay a message from one end of a line of people to the other end by each participant whispering it to the next. In this manner, a statement such as “I’m happy to be here” may exit the telephone line as “I’ve snapped the beads, dear.” Although each participant tried to relay an accurate message, each one introduced a personal perception of the message into the original, thereby changing the real meaning as the message progressed along the telephone line (Fig. 17-2).

A similar process takes place in an imaging department when a problem occurs. As each person in the pyramid relays the problem, a personal perception of the problem and its cause are added to the original message. Thus what began as a small problem can soon take on the appearance of a monstrous problem.

Fig. 17-3 demonstrates how the production of a radiograph can be described by a pyramid that is, in many ways, very similar to the pyramid in Fig. 17-1. The various administrative levels shown in Fig. 17-1 are replaced by various radiographic equipment and personnel to create Fig. 17-3.

It should be apparent that, as a very simple error in radiographic equipment or method passes through the pyramid of radiograph production, the error could easily become magnified until it appears to be a major problem. In this chapter, you will discover the ways in which radiologic technologists solve their big problems by working back through the pyramid structure to find the source of the trouble.


You will encounter a significant number of roadblocks in your efforts to achieve an optimal quality rating. Not only do your patients come in various heights, weights, and widths, but they also arrive for your care with various temperaments and attitudes. You will study in depth the art and science of selecting proper exposure factors; these studies will help you to solve the problem of your patients’ various body sizes and conditions. The problem of your patients’ psychologic and emotional states, however, is one that you must constantly strive to solve. Many radiologic technologists who enjoy their work profess that solving these types of problems is the factor that makes their work interesting and rewarding.

Psychologic and Emotional Aspects

You should learn to evaluate your patients before you begin to prepare them for examination. Treat older patients with respect, younger patients with smiles and interesting questions, extremely ill patients with gentleness, and dying patients with compassion but not pity. You will soon learn the best methods for “getting on the good side” of each of your patients. If you remember that most patients enter the radiology department with some apprehension and uncertainty, you will have a good basis for understanding how to approach their psychologic and emotional problems. You must relieve their apprehensions by demonstrating that they are special to you and that you are competent in your job. You can relieve their uncertainty by explaining exactly what you are going to do before you begin the radiographic examination.

Creating Good Physical Conditions

Creating the proper physical conditions for your patients is one of the most effective methods for alleviating their apprehensions. You can accomplish this task in several ways:

All of these procedures help create a cooperative and responsive patient.

Administrative Evaluation

The radiology department administration is usually very interested in how staff technologists deal with patient problems. Managers might use any of the following techniques to discover the quality of patient care.

Mar 2, 2016 | Posted by in GENERAL RADIOLOGY | Comments Off on Quality Assurance in Radiology

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