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Final ID: Paper #: 083

Standardizing QI in Head and Abdominal CTs to Improve Technologist Performance and Diagnostic Quality of Exams

Purpose or Case Report: Repeat imaging is often a result of unnecessary errors in 1 or more diagnostic categories. To minimize the number of Head and Abdominal CTs with suboptimal diagnostic quality, we set out to create a standardized list of criteria that assess the quality of the study. This list of standards and evaluation criteria successfully provided the technologists knowledge and insight into what our radiologists require to diagnose our pediatric patients.
Methods & Materials: Six criteria for grading CT Head and CT Abdominal exams were agreed upon by consulting body and neuro radiologists. Head exams were graded on: gantry angle, presence of artifacts, written protocol followed, appropriate radiation dose, appropriate scan coverage and acceptable motion. Abdomen/Pelvis exams were graded on: contrast timing, presence of artifacts, written protocol followed, appropriate radiation dose, appropriate scan coverage and acceptable motion. Baseline data was collected from October 1st, 2018 to August 31st, 2019 and 15% of each Staff Technologist's exams were then graded under the supervision of the consulting radiologists. Points were assigned accordingly in each category (1 point/acceptable; 2 points/unacceptable). The target cumulative score was 6/6 representing optimal diagnostic quality. A given score higher than 6 contains one or more unacceptable elements within the exam carrying the potential of requiring a repeat study. On August 26th, 2019, an education stand down was held for all Staff Technologists
Results: From October 2018 to August 2019, 47.9% of CT Head exams and 52.9% of CT Abdomen Pelvis exams had met the target goal of 6/6. Our cumulative quality score for all graded exams was 49.7%. Immediately following technologist education in August 2019, 62.2% of CT Head exams and 55.6% of CT Abdomen/Pelvis exams scored 6/6 bringing our cumulative quality score up to 60%. The average score that was not a 6 pre education was 7.35. The average score that was not a 6 post education was 7.05. Pre and post education scores per category were as follows: Artifact – 97.8% to 100%; Contrast Timing: 76.7% to 66.6%; Head Angle: 57.0% to 70.3%; Motion: 97.0% to 98.2%; Radiation Dosage: 97.5% to 98.2%; Scan Coverage: 97.8% to 100%; Written Protocol: 89.4% to 92.7%. The Head Angle category was given extensive, hands-on training and was, by far, the most improved category
Conclusions: Knowledge of the QI project and education on what the radiologist wants reduces the number of errors and increases the number of successful exams.
Session Info:

Scientific Session III-C: Healthcare Policy/QI

Informatics, Education, QI, or Healthcare Policy

SPR Scientific Papers

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