Program Information
Repeat/reject Analysis: It Is a Process Not Just a Number
J Kinner*, P Hardy , L Anaskevich , S Ferrin , A Kelly , J Zhang , University of Kentucky, Lexington, KY
Presentations
WE-AB-601-11 (Wednesday, August 2, 2017) 7:30 AM - 9:30 AM Room: 601
Purpose: Repeat/reject analysis(RA) was one of the key quality management tools in medical imaging departments using film-screen technology. With the transition to digital imaging, some have questioned the necessity of RA. For most medical centers, RA is just a rate or a focus on machine malfunction as discussed in TG-151. This study revisited the RA program and demonstrated that RA is still an essential tool for radiology, allowing the assessment of overall image quality, modification of examination protocols, in-service education, and tracking of patient radiation exposures.
Methods: Monthly repeat/reject records from each radiography unit were retrospectively collected, which included but not limited to examination date and time, procedures, operator, reasons for reject/repeat, patient information. A computer program was developed to analyze the frequency of rejected studies by reasons, operators, imaging unit, examination procedures, and patient population. The main practice reasons for repeat/reject include positioning, cut-off, motion, artifact, imaging technique. Operator’s education and experience were further considered. We also considered difficulty in imaging different body part (e.g., thoracic, abdominal, musculoskeletal imaging) and different type of patient (e.g., pediatric, adult, inpatient, outpatient).
Results: The repeat/reject rates are based on practice reason, individual operator, each imaging unit, different examination procedures, and patient group are generated and presented using dashboards. This information allows identification the most common reasons for rejection, individual operator who may need further training and specific patient group who needs special care. Our overall reject rate is approximately the same as TG151 recommended. However, a lower repeat/reject rate does not imply there is no room to improve.
Conclusion: RA should be rigorous component of any quality assurance program in radiology. It provides effective approach for quality improvement and the overall performance of the radiology department, and helps minimize patient radiation exposure.
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