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Quality Assurance and Quality Control

All fields of medicine and all hospital departments are required to develop and conduct programs that
ensure the quality of patient care and management. Diagnostic departments are leaders in promoting
quality patient care. Two areas of activity are designed to ensure the best possible diagnosis at an
acceptable radiation dose and with minimum cost. These areas are quality assurance (QA) and quality
control (QC). Health care organization often adopt quality assurance and quality control programs to
provide high quality service and care and this is designed to assist in the maintenance of the highest
quality work that can be achieved.
Quality management consists of coherent system designed to monitor equipments performance
through a variety of quality assurance and quality control standards or benchmarks.
The overall management programs, put in place to ensure that a comprehensive range of quality
control activities work effectively. This program monitors the various quality control measures being
used which involved in producing high quality radiographs. This program should be cost effective and
achieve its aims.
The World Health Organization has defined quality assurance in x-ray medical diagnosis as:

An organized effort by the staff operating a facility to ensure that the diagnostic
images produced by the facility are of sufficiently high quality so that they
consistently provide adequate diagnostic information at the lowest possible cost and
with the least exposure of the patient to radiation.

The objective of a quality assurance program in an x-ray department is to monitor the performance of
all the factors which could influence the quality of the image and to try to reduce any film wastage
within the department.
In a variety of studies that have been prepared on film wastage, it is often suggested that in some
departments wastage can be as high as 20%. In any department, this represents a significant sum of
money. Allowances must be made for teaching departments where of necessity; there must be a
higher rejection rate of film. However, an average wastage figure would be of the order of 12%, in a
department with no form of quality assurance.
If a quality assurance program is designed for x-ray department it should ideally fulfill four
main criteria:

It should be simple. The program should not require sophisticated equipment or advanced
scientific techniques.
It should be inexpensive, for obvious reasons. No program should cost more to run than the
saving film costs!
It should be quick. All the basic check should be done in a matter of minutes rather than
Perhaps most important of all it should be semi-quantitative, so that repeatability of result is
Quality assurance, all planned and systematic action necessary to provide adequate confidence
that a facility, system, or administrative component will perform safely and satisfactorily in
service to a patient. It includes scheduling, preparation, and promptness in examination or
treatment, reporting of results, and quality control. Stewart Carlyle Bushong, Radiologic
Science for Technologist

Quality assurance deals with people. A program of quality assurance monitors proper patient
scheduling, reception, and preparation, and answers the following questions: Is the scheduled of
examination appropriate for the patient? If so, has the patient been properly instructed before the
time of the examination? QA also involves image interpretation. Did the patients ultimate disease or
condition agree with the radiologists diagnosis? This is called outcome analysis. Was the report of the
diagnosis promptly prepared, distributed, and filed for subsequent evaluation.

Quality assurance consists of activities that provide adequate confidence that a radiology
service will render consistently high quality images and services. It is an evolutionary process
that assesses everything affects patient care. It may be medically, technically or managerially
oriented. Quality assurance includes evaluating activities such as interpretation of
examinations, maintenance of equipment, performance of procedures, filing systems, staff
development, scheduling of examinations and supply lines.

The quality assurance process operates by identifying problems or potential problem areas, monitoring
involve several steps, including establishing criteria, performing monitoring, and collecting, analyzing
and evaluating data. It is these steps of monitoring process that are of greatest concern to the quality
assurance radiographer. Richard Carlton, Principles of Radiographic Imaging.

Assign responsibility.


Delineate scope of care.


Identify aspect of care.


Identify outcomes that affect the aspect of care.


Establish limits of the scope of assessment.


Collect and organize data.


Evaluate care when outcome are reached.


Take action to improve care.


Assess and document actions.

10. Communicate information to organization-wide quality assurance programs.