Implementation of a quality control program in a radiology department Poster No.:
B-0602
Congress:
ECR 2013
Type:
Scientific Paper
Authors:
M. Leão, L. P. V. Ribeiro, A. F. Abrantes, J. Pinheiro, R. P. P. A. Almeida, K. B. Azevedo, S. Rodrigues; Faro/PT
Keywords:
Professional issues, Management, Conventional radiography, Audit and standards, Education, Radiation safety
DOI:
10.1594/ecr2013/B-0602
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Purpose In a healthcare increasingly demanding, where quality is very important, it is expected that professionals and institutions meet the patients' needs. Health Quality is understood as the systematization of all processes, in all areas of the management world, and the ISO (International Organisation for Standardisation) 9001/2008 standards, which ensure the certification of many health organizations, report that there are eight principles for a quality management system. On health, in general, and on radiology, in particular, it is expected the same levels of quality in all locations, and it is recommended that the Radiology departments come to develop from quality control programs to total quality management programs (Vidigal, 2010). The main goal of this research was to evaluate the importance that radiographers give to the implementation of a quality control system programs in their radiology departments, since many of them are still not certified by quality standards. It was intended to understand the importance of implementation of the quality system; if radiographers know in what consists a system of quality control; and to investigate the importance that they give to Radiological Protection criteria.
Methods and Materials This research was a quantitative, descriptive and transversal study. Sample and Data Collection The data collection for this study was take place in the District of Évora and Beja (Portugal), more specifically on public hospitals and healthcare centers with radiology department. The study sample was consisted of 47 radiographers who works in the institutions mentioned above (in a total of 62 radiographers; response rate of 75.8%). For the statistical analysis we considered two sub-samples (31 radiographers from public hospitals and 16 radiographers from healthcare centers). Instrument
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The instrument applied in this study was a 30-item questionnaire which is divided into 5 parts: • • • • •
Part 1 - 5 sociodemographic questions Part 2 - 8 items in order to situate the radiographers in relation to the quality control programs. Part 3 - composed by a scale of quality assessment importance (7 items on a 5 point Likert scale) Part 4 - composed by a scale of radiological protection importance (5 items on a 5 point Likert scale) Part 5 - 5 questions to check for radiological protection materials in the institutions concerned.
The original instrument was developed at the University of Trás-os-Montes e Alto Douro in 2008 by the authors Helga Macedo e Vitor Rodrigues. The use of the questionnaire was authorized by the authors; and in accordance to institutional guidelines, the approval of this study was obtained from the review board. Variables In this study, the independent variables were the importance given to quality control and the importance given to radiological protection. The dependent variables evaluated were the gender, age, professional experience, academic degree, training in the quality area, institution/radiology department with or without accreditation/certification, existence of quality control programs. Statistical analysis Statistical analysis was made using descriptive statistics, Mann-Whitney and KruskalWallis tests in order to verify correlation between items.
Results
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Fig. 2: Sample distribution regarding radiological protection equipment References: Department of Radiology, Health School - University of Algarve Sociodemographic Characterization Gender: The data collected shows that the majority of the sample was male, 13 (27.7%) of radiographers are female and 34 (72.3%) were male. Age: In relation to age was verified that most of Radiographers is between 40 to 49 years (31%). The mean, maximum and minimum, can be viewed in figure 1.
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Fig. 1: Sample distribution according to age at Healthcare Centres and Public Hospitals References: Department of Radiology, Health School - University of Algarve Professional Experience: We have found that most radiographers has between 10 and 19 years of professional experience, in this case 15 (31.9%) radiographers. Academic Degree: it was found that more than half of the sample (53,2%) are graduated radiographers. 9 (19,1%) have the bachelor's and the others are post-graduated radiographers. Quality Control Institution/Radiology department with or withoutt accreditation / certification: The majority of radiographers (n=45; 95.7%) responded that the institution where they works is not currently in the process of accreditation/certification. Only 2 (4.3%) answered
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yes, and one of them mentioned the joint commission on accreditation of healthcare organizations. It was also observed that 45 radiographers (95,7%) claim there is no quality control program in their departments. Quality Training In relation to training activities in the quality area, 7 (23.3%) of radiographers in healthcare centers have reported training activities at the institution where they work. 2 of them say that these formations are not periodic. In hospitals only 1 (6.3%) radiographer said attend to training activities in the quality area. Quality control area - What is it? About this question, 19 radiographers claim to know what a quality control program is. Of all these, the aspects more often mentioned were image quality control, equipment calibration, radiation protection and equipment quality control. Training and education in quality? 25,5% of radiographers have training in quality programs and 72,3% don't have any kind of training. Importance of Quality Control Promotion of quality training and implementation of quality control program 80,9% of radiographers claim it is important the need of promoting quality training and 70,2% consider necessary the implementation of a quality control program, while only 4,3% say it is of little importance. 40,4% would like to collaborate in the implementation of a quality control program. Implementation of quality control program as a motivational factor 38,3% of radiographers consider quality control programs as a motivational factor and 12,8% say it is a moderate motivational factor. Implementation of quality control program as a patient satisfaction factor
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When asked if the implementation of a quality control program would promote patient satisfaction 42,6% say it would have a moderate impact, 34% claim it is very important, and 14,9% refer that is it low importance. Importance of Radiological Protection Dose assessment in the radiology department When asked about dose assessment in the exam rooms, 38,3% say that measurements are rarely done, 27,7% refer that they are never done. Regarding individual dose assessment of radiographers, 85,1% say that these are always made, equipment consistency tests are rare (36,2%) or never done (12,8%), but 34% are always calibrated. Radiological Protection Existence and condition of radiological protection equipment Concerning the existence of radiological protection equipment, the radiographers refer that all institutions have this equipment (figure 2) and all of these have physical protection barriers. Regarding ionizing radiation signage, almost all institutions (96,% in the hospitals and 93,8% in healthcare centers) have this warning in their departments, but only half (48,4%) have signage for pregnant women.
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Fig. 2: Sample distribution regarding radiological protection equipment References: Department of Radiology, Health School - University of Algarve Mann-Whitney and Kruskal-Wallis tests We verified, through Kruskal Wallis test, that there is significant statistical differences between age groups and importance of quality control (p=0.027) (figure 3), between academic degree and importance of quality control (p=0.003) (figure 4). For all other variables considered there were no significant statistical differences.
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Fig. 3: Kruskal wallis test for the importance of quality control and age group References: Department of Radiology, Health School - University of Algarve
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Fig. 4: Kruskal wallis test for the importance of quality control and academic degree References: Department of Radiology, Health School - University of Algarve Images for this section:
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Fig. 1: Sample distribution according to age at Healthcare Centres and Public Hospitals
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Conclusion More than half of radiographers don't know what a quality control program is, nor they have any kind of training in quality, however almost all radiographers considers this topic to be very important. Some of institutions analyzed don't have a quality control program implemented; therefore we weren't able to verity the existence or not of the relation between the importance of a quality control program and radiological protection. Quality control programs are essential to the radiology department and radiation safety guidelines must be implemented. Despite that some radiology departments have radiological protection equipment often applied by radiographers, their effectiveness and condition must be checked regularly.
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Vidigal, R. R. (2010). Contributo para a Gestão da Qualidade Clínica num Serviço de Radiologia. Universidade Nova de Lisboa, Lisboa.
Personal Information M. Leão, Department of Radiology, Health School - University of Algarve, Portugal. email:
[email protected] L. P. V. Ribeiro, PhD, Department of Radiology, Health School - University of Algarve, Member of Cdaf (Research Center of Sports and Physical Activity), Portugal. email:
[email protected] A. F. Abrantes, PhD, Department of Radiology, Health School - University of Algarve, Member of CESNOVA (Sociology Studies Center of New University of Lisbon), Portugal. email:
[email protected] J. Pinheiro, Department of Radiology, Health School - University of Algarve. email:
[email protected] R. P. P. Almeida, Department of Radiology, Health School - University of Algarve, PhD student at Faculty of Health Sciences - University of Beira Interior, Portugal. email:
[email protected] K. B. Azevedo, Department of Radiology, Health School - University of Algarve, Portugal; PhD student at Cranfield University, UK. email:
[email protected] S. Rodrigues, Master, Department of Radiology, Health School - University of Algarve. email:
[email protected]
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Fig. 5 References: Department of Radiology, Health School - University of Algarve
Images for this section:
Fig. 5
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