general radiography image review exercise a trial towards best practice yu chi wai ronald, rad i, dr...

GENERAL RADIOGRAPHYIMAGE REVIEW

EXERCISE

A TRIAL TOWARDS BEST PRACTICE

YU CHI WAI RONALD, RAD I, DR

POK OI HOSPITAL

GENERAL RADIOGRAPHYIMAGE REVIEW EXERCISE

• What is it .......

Quality assurance and training program for Digital Radiography in DR, POH

Part of the General Radiography Re-engineering initiative promoted by Department Manager of DR in NTWC

Focus on radiographic techniques


• Targets.......

Establish and understand the standard criteria of “Good” images by all radiographers

Statistic return of “Good” images compliance in POH.

Root cause analysis of suboptimal images with a holistic team/workflow approach.


• Our footprints.......

Each RAD II was assigned to focus on one examination

Establish standard images criteria which were set with reference to the highest theoretically achievable standards (with reference to Radiographic manuals of Merill’s Atlas, Clark’s positioning and the European Guidelines)



Complied with all the must fulfill criteria will be graded as “GOOD”

Failed to comply with ANY must fullfill criteria will be graded as “suboptimal”

Screen ALL images of the focused examination and monthy “GOOD” images quality compliance report was generated every six months



Root causes analysis of “Suboptimal” images with a holistic team / workflow approach

Possibility of quality improvementSharing of practical tips and quality enhancement

suggestion in report presentations / discussion sessions


• Assumptions.......

All images that passed / endorsed by our fellow colleagues are with adequate diagnostic value

The “Good” images are excellent / sample images indeed as they are of the highest achievable standards in text book reference

X-ray equipments are in proper functional state


• Criteria for CXR.......1 Collimation Include the whole lung field, i.e, from

apices to the costophrenic angle

2 No rotation distances between sternal ends of theclavicles are the same

3 Trachea visibility trachea visible in the midline up to the level of T4

4 Lung marking visibility from the hilum to the periphery of the lung

5 Sharpness of the heart, aorta, diaphragm, and lateralcostophrenic angles all should have sharp outline

6 Position of the Scapulae Scapulae projected outside the lung field

7 Full inspiration unless specify either 6 anterior ribs or10 posterior ribs above the diaphragm


• Results.......


• Discussion.......

Radiographers (especially the RAD II) are familiar with the criteria for “Good” images

The standard criteria of “Good” images were established and understood by radiographers

At least one-tenth of radiographs are of excellent quality

Patient’s cooperation and intrinsic condition play a key role in failing the must fulfill criteria


• Limitation.......

No detail breakdown of percentage failing of must fulfill criteria

No account of NG radiographs


• Conculsion.......

A successful attempt to benchmark general radiography in DR POH

Prepared to the journey to Best Practice


• Acknowledgement.......

All the enthusiastic and devoted radiographers in Department of Radiology, Pok Oi Hospital, especially the RAD IIs.

THANK YOU

YU CHI WAI RONALD, RAD I, DR

POK OI HOSPITAL

general radiography image review exercise a trial towards best practice yu chi wai ronald, rad i, dr...

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