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A TOTAL QUALITY CONTROL SYSTEM

IDENTIFICATION OF IMAGING REQUIREMENTS

DEVELOPMENT OF EQUIPMENT SPECIFICATIONS

SELECTION OF EQUIPMENT

INSTALLATION AND ACCEPTANCE TESTING

CONTINUING EDUCATION

MONITORING EQUIPMENT PERFORMANCE

PROCESSING SYSTEM

EXTERNAL BEAM

EVALUATION

IDENTIFICATION OF IMAGING REQUIREMENT
It is not always apparent exactly what type of equipment is needed when new purchases are being
considered. Historically, this decision was made by the chief radiologist or administrative technologists.
Rarely are the actual operators of the equipment, the radiographer, consulted. The result has been
that nearly every x-ray department owns a radiological monstrosity that is avoided by radiographers
and radiologist alike. These units are often inconvenient, overly sophisticated, or unable to produce
quality images. Careful identification of imaging requirements can prevent these problems.
It is not necessary to be an expert in imaging physics and technology in order to be capable of
contributing to the process of identifying the imaging requirements. Each member of the radiological
team can contribute his or her expertise. The person who will make the final decision should interview
the radiologist, administrators, supervisors and staff technologist who will use the equipment. In many
instances the needs of the radiologist will determine the basic parameters for the purchase.
Administrators must often impose financial and space restraints, although they can also create new
funds and space when necessary. Supervisors are often able to provide important information on
patient flow and staffing needs. After the radiologist, the radiographers are the most important
persons to have input because their experiences with equipment provide a wealth of information.

MONITORING OF EQUIPMENT PERFORMANCE The final procedure of a total program is commonly considered to be the whole of quality control. Although they are interdependent. A pitfall in the process can occur when radiologist in the institution show a preference to a particular vendor. The quality control technologist must verify that the equipment specifications have been met. This will also reduce patient dose. and supply cost. as well as increase confidence in diagnostic consultation and boost departmental morale. The best specification includes detailed statements of what the equipment should be capable of doing. With simple equipment. In many institutions this pitfall should be expanded to include interference by administrative officers unfamiliar with imaging equipment.DEVELOPMENT OF EQUIPMENT SPECIFICATIONS Generic equipment specification should be developed from the interview information. The data from these tests will form the standard for all future quality control monitoring. and  Specify faults within these systems to allow corrective measures to be taken. When the bids arrive they can be compared for meeting specifications. Radiographers. Objectives for a performance monitoring system are to:  Monitor the quality of the film processing system  Measure the quality of the external radiation beams. cost and service. It is advisable to include both quality control and in-service education coordinators in the initial training demonstrations. should do the equipment monitoring. . the equipment manual may be sufficient for use in service training. It is important that the person formulating the specifications have the technical background to state exactly what is needed to meet the imaging requirements. such as ancillary devices. “maintain mA linearity within =/-10 percent to produce equal film density when mAs is maintained but mA is varied. patient waiting time. thus weakening the bargaining position of the department administrator. and to use these experts would be too costly. An initial cost outlay for testing equipment is required. When the specifications are complete they are sent to vendors for bidding. Monitoring equipment performance includes routine checks of all radiographic equipment. Normally this includes supervising the testing procedures and results. It is suggested that the exact methods for acceptance testing be included in the original specifications. To maintain a program. monitoring can be divided into two parts: 1 2 Film processing systems. An imaging physicist should be involved at this point. The actual decision is then academic. INSTALLATION AND ACCEPTANCE TESTING OF EQUIPMENT Installation and acceptance testing of equipment is the responsibility of the vendor and/or the manufacturer. RESPONSIBILITY Professional service personnel or medical physicists are not required to perform routine quality control procedures. More complex equipment should be demonstrated and explained by the vendor to at least two people as part of the purchase contract. CONTINUING EDUCATION It is normally the responsibility of the vendor to familiarize the users of the equipment with its proper operation. Continuing education must be ongoing procedure. A good in-service program will include an orientation procedure as well as period updates on all complex equipment. stall technologists must be given time to perform the procedures and to evaluate them. Evidence shows that a properly working quality control system will reduce equipment down-tine and the number of repeated exposures. For example. who are more available and knowledgeable about potential problems. SELECTION OF EQUIPMENT The actual selection of equipment becomes simple if the investigation into the first steps has been thorough. Many procedures must be done daily. and External beam evaluation.” This must be Include a change from highest to lowest setting.

contrast and base fog of film. Only a radiographer or processor maintenance person should perform the corrective actions. Computerized dosimeters are available that permit read-outs and print-outs of many quality control parameters from single exposure. A dosimeter is an essential piece of equipment and reasonable quality control cannot be performed without one. These tests may be performed by anyone who has been oriented to the use of equipment involved. also known as a safelight test. A room log should be kept to record test results. Some monitoring equipment can be made very inexpensively. other equipment must be purchased. These include a darkroom fog test. There are also several monitoring tests that should be done on a daily basis. A quality control program that is not backed up by a commitment to shut down processors that ate outside limits is of little value. Corrective action should be taken only by an authorized service person. Manufactures’ suggestion should be followed for the start-up and for the regular maintenance of the processor. These tests must be performed by a radiographer who has knowledge of the physical operation of the equipment and all related accessories. and processor sensitometry to monitor speed. Action must be to correct problems whenever the limits are exceeded. EXTERNAL BEAM EVALUATION: The second part of performance monitoring involves the evaluation of the external primary radiation beam.PROCESSOR MONITORING Processor monitoring is designed to permit an automatic film processor to fluctuate within set limits. . maintenance. and repair s performed on each x-ray tube and other system in each room.