Transcript Hospital Survey on Patient Safety Culture

A Program for Paperless Recording of
Routine Nuclear Medicine Equipment
Quality Control Results
James R. Halama PhD, Medical Physicist
David A. Urani MBA, CNMT, Manager
Rebecca A. Sajdak BA, CNMT, Sr. Technologist
Robert H. Wagner MD
Project Purpose and Aim
To Eliminate the use of Paper Logs and Ensure the
Timely Completion of QC Tests
The AIM of this project is to develop a database program to store
the results from many routine tests into a single on-line database
eliminating the use of paper logs.
Integrating results into a single Microsoft Access Program has the
advantage that supervisors and physicists may systematically
review and track test results to ensure proper camera
performance and that those tests are completed in a timely
manner.
"Confidential: Quality Improvement Material"
Background Statement
A Nuclear Medicine Gamma Camera quality control program has
many routine tests, regularly assessing gamma camera uniformity,
spatial resolution and linearity, SPECT uniformity and Center of
Rotation (COR), spatial and contrast resolution. A Microsoft Access
program was developed to store all test results from all camera
systems into a single online database eliminating the use of paper
logs. Recording camera operating problems and downtime has also
been added.
Because proper camera performance is so important to a successful
Nuclear Medicine Department.
"Confidential: Quality Improvement Material"
Solutions Implemented
The Microsoft Access Program Improves Our
Ability:

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


To Audit Test Frequency
To Review Prior Test Results & Specifications
To Quickly Access the QC Procedure Manual
To Record Equipment Operating Problems & Downtime
To Ensure Proper Equipment Performance
and Tests are Completed According
to Schedule
"Confidential: Quality Improvement Material"
Results
• Our SPECT QC Compliance has greatly improved and it also has
greatly organized the Quality Control Protocols for our busy
department.
• The comprehensive review function allows the technologist to
easily determine whether a less frequently performed test needs to
be completed.
• This is also very convenient for review by outside accreditations
and inspections by the Joint Commission.
"Confidential: Quality Improvement Material"
Gamma Camera QC Main Screen
Daily QC Example
Hyperlinks to Procedure Manual
Center-of-Rotation Example
SPECT Phantom Review Screen
Monitoring Camera Performance
6.0
IU Index (%)
5.0
Gamma Camera Uniformity - FORTE1
Warning Le ve l
4.0
3.0
2.0
1.0
11/1/08

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
12/1/08
12/31/08
1/30/09
3/1/09
3/31/09
IU Index – Camera sensitivity variation to radiation across the imaging detector.
Uniformity test is performed every day before the gamma camera is used for
patient imaging begins.
If the IU Index exceeds the warning level for two consecutive days, further
evaluation is required before patients can be imaged.
SPECT QA Testing Compliance
% Tests Required Completed
SPECT QA Compliance

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250
Start of Paperless
Monitoring
Center-of-Rotation
200
SPECT Phantom
150
100
50
0
4/1/08
5/31/08
7/30/08
9/28/08
11/27/08
1/26/09
3/27/09
SPECT – Gamma camera tomographic acquisition.
Center-of-rotation validation acquired monthly on five gamma cameras.
SPECT phantom acquisition acquired quarterly on five gamma cameras.
Analysis

We have already reached our goal of “going green”
paperless program.

We can easily track equipment downtime operating
problems. Being able to report downtime is very important
when making decisions on major equipment purchases,
buying service contract, and

We have improved compliance to 100% on SPECT QC
testing and have identified tasks where we were over
performing. Our records for Quality Control are up to date.
"Confidential: Quality Improvement Material"
Next Steps

The program has been well received by the Nuclear Medicine
Staff so a next step might be to incorporate clinical protocols
onto an electronic database.

Further study actions would be to expand the program to the
other modalities in the Radiology Departments.
"Confidential: Quality Improvement Material"