SErIES IAEA HumAn HEAltH SErIES IAEA Hum

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COPYRIGHT NOTICE All IAEA scientific and technical publications are protected by the terms of the Universal Copyright Convention as adopted in 1952 (Berne) and as revised in 1972 (Paris). The copyright has since been extended by the World Intellectual Property Organization (Geneva) to include electronic and virtual intellectual property. Permission to use whole or parts of texts contained in IAEA publications in printed or electronic form must be obtained and is usually subject to royalty agreements. Proposals for non-commercial reproductions and translations are welcomed and considered on a case-by-case basis. Enquiries should be addressed to the IAEA Publishing Section at: Marketing and Sales Unit, Publishing Section International Atomic Energy Agency Vienna International Centre PO Box 100 1400 Vienna, Austria fax: +43 1 2600 29302 tel.: +43 1 2600 22417 email: sales.publications@iaea.org http://www.iaea.org/books © IAEA, 2010 Printed by the IAEA in Austria January 2010 STI/PUB/1425 IAEA Library Cataloguing in Publication Data Comprehensive clinical audits of diagnostic radiology practices : a tool for quality improvement. — Vienna : International Atomic Energy Agency, 2010. p. ; 24 cm. — (IAEA human health series, ISSN 2075–3772 ; no. 4) STI/PUB/1425 ISBN 978–92–0–112009–0 Includes bibliographical references. 1. Radiography, Medical — Quality control. 2. Medical audit. I. International Atomic Energy Agency. II. Series. IAEAL 09–00611
FOREWORD The application of radiation to human health, for both diagnosis and treatment of disease, is an important component of the work of the IAEA. While much of this work has typically centred on components of radiation medicine such as quality assurance (QA), dosimetry and calibration, more recently it has become apparent that a comprehensive review of all aspects of radiation medicine, or comprehensive clinical audits, will deliver many benefits to patients that cannot otherwise be realized. This publication is intended to cover the practice of diagnostic radiology. Currently, there is much interest in QA processes and quality improvement in diagnostic radiology, which is driven by a number of factors. These include the high cost of radiological equipment, the ever increasing complexity of examination equipment and examination procedures due to technical advances, the acknowledgement of the possibility of increasing doses to patients, and the importance of radiological diagnosis to patient management within the health care environment. The importance of these matters has been acknowledged within Europe through a European Council directive (No. 97/43/Euratom), and is also under consideration in other regional areas. However, it has not been possible to find within the published literature any existing guidelines for comprehensive audit that could be adopted by Member States. Development of this publication was started in 2007 with the appointment of a drafting committee of international experts. The committee was informed by an earlier IAEA book, Comprehensive Audits of Radiotherapy Practices: A Tool for Quality Improvement, which was published in 2007. Two pilot audits have been carried out using the current publication, one in Asia and one in Europe. The current publication has been endorsed by the European Federation of Organisations in Medical Physics and the Asia–Oceania Federation of Organizations for Medical Physics. The IAEA acknowledges the special contribution of the drafting committee chaired by H. Järvinen (Finland), with B. Abdullah (Malaysia), P. Butler (United States of America), K. Faulkner (United Kingdom), M. Rickard (Australia). The American College of Radiology, which sponsored the participation of M. Pentecost, is also thanked. The IAEA officer responsible for this publication was I.D. McLean of the Division of Human Health.
Page 1 and 2: IAEA HumAn HEAltH SErIES no. 4 Comp
Page 3 and 4: COMPREHENSIVE CLINICAL AUDITS OF DI
Page 5: IAEA HUMAN HEALTH SERIES No. 4 COMP
Page 9 and 10: CONTENTS 1. INTRODUCTION . . . . .
Page 11 and 12: 5.1.3. Quality assurance processes
Page 13 and 14: 1. INTRODUCTION 1.1. CLINICAL AUDIT
Page 15 and 16: 1.1.3. Confidentiality of audits Co
Page 17 and 18: evidence based medical research is
Page 19 and 20: As a result of the comprehensive cl
Page 21 and 22: The facility/institution is respons
Page 23 and 24: 2.4.2. Review The review process wi
Page 25 and 26: 2.5.1. Title page and contents page
Page 27 and 28: 2.6. DISSEMINATION OF THE REPORT Th
Page 29 and 30: A QA committee should be establishe
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Page 33 and 34: —Medical support equipment such a
Page 35 and 36: (g) (h) (i) Make an assessment of t
Page 37 and 38: (c) (d) (e) (f) Examine the facilit
Page 39 and 40: (c) (d) Consider policy in regard t
Page 41 and 42: equire a written policy and procedu
Page 43 and 44: Once examination scheduling has bee
Page 45 and 46: Documentation of the details of the
Page 47 and 48: There should be a radiographer resp
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—Digital image receptors (compute
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(b) (c) (d) Ensuring that appropria
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5.1.2.2. Occupational and public ex
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(f) (g) Performance criteria for al
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Dosimetry for those subjected to ra
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5.2.1.3. Management support The aud
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(b) (c) Discuss the facility’s po
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(g) (h) (i) Discuss with the medica
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Professionals engaging in such prog
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6.2. THE AUDIT PROGRAMME 6.2.1. Edu
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(d) (v) Regularity of research meet
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Six months before audit Audited ins
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Day 1: Morning: All audit team memb
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Appendix III AUDIT REPORT FORMAT: S
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Appendix IV AUDIT REPORT FORMS The
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Audit criteria Adequacy Comments Su
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5.3. AUDIT REPORT FORMS FOR TECHNIC
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6.3. AUDIT REPORT FORMS FOR EDUCATI
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Appendix V NOTES ON PHYSICIST MEASU
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V.2.3. Other measurements The other
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[16] COMMISSION OF THE EUROPEAN COM
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Annex I APPLICATION FORM IAEA Clini
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Department Vision Statement and imm
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List of equipment Equipment type Id
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Annex II LIST OF ITEMS REQUESTED TO
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Annex III EQUIPMENT-SPECIFIC CHECKL
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Form RXR — Items to be reviewed b
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Form RXR — Items to be reviewed b
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Form FIF — Items to be reviewed b
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FORM FOR A MAMMOGRAPHY QA PROGRAMME
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Form MAM — Items to be reviewed b
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Form CTQ — Items to be reviewed b
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FORM FOR A SCREEN-FILM AND PROCESSO
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FORM FOR A COMPUTED OR DIGITAL RADI
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FORM FOR A VIEWING CONDITIONS (ANAL
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FORM FOR A QA PROGRAMME FOR HARD CO
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Form DPQ — Items to be reviewed b
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FORM FOR A QA PROGRAMME FOR ULTRASO
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FORM FOR A QA PROGRAMME FOR MRI For
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Form MRI — Items to be reviewed b
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TECHNIQUE OBSERVATION SHEET Radiogr
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Tube focus to tabletop distance d F
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K i Patient: Radiographic Calculati
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Manufacturer of phantom: __________
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P KA Patient: Fluoro 1 DETERMINATIO
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Phantom: MGD 1 CALCULATION OF INCID
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Phantom: CT1 MEASUREMENT OF C a,100
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REFERENCE TO ANNEX IV [IV-1] INTERN
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CONTRIBUTORS TO DRAFTING AND REVIEW
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Korea, Republic of KINS Inc., Infor
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SErIES IAEA HumAn HEAltH SErIES IAEA Hum

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