Assessment Aids Used to Improve Efficiency of Portable X-Ray

Portable x-ray is a photographic examination performed with a mobile x-ray machine. It offers convenience for patients who have difficulty moving or cannot cooperate during procedure, such as intensive care unit (ICU) patients, and patients in emergency room. When facing a patient who cannot cooperate or needs assistance during the examination, a radiographer usually need help from others or need to use auxiliary equipment. Under this kind of situation, the chance of getting an imperfect image is much higher, compared with the ideal situation when a patient would cooperate voluntarily. This project aims to lower portable x- ray retake rates and improve safety for patients under the procedure by analyzing reasons and types of retakes. We made use of quality control (QC) software system of digital radiography (DR) portable machine, counted and analyzed all retakes and categorized their reasons from January through December 2012. We found retake rates was 6.99% and half of reason is cutting to image edge, thus improving this factor to reduce retaking rate will help significantly. To overcome the problem of cutting to image edge, we came up with three improvement measures: (1) continued education program for radiographers, (2) review of previous images, (3) improving imaging plate (IP) for image receiving fixture by affixing 3mm double-sided adhesive foam around the edge of it. We collected data of monthly retake rates from January through December 2013, and analyzed the data with Chi-Square. The result shows that retake rate had dropped from 6.99% to 3.04%, with cause of cutting to image edge dropped from 3.75% to 1.86%. Based on the statistical analysis, the p value was found to be 0.002 (lower than 0.05) when comparing retake rates before and after improvement measures. It shows significant improvement on reducing retake rates. And the p value was 0.049 (lower than 0.05) when comparing retake rates with the cause of cut to image edge before and after improvement measures. The statistic results also indicate that the three improvements measures all contribute to the improvement on retake rates in general. The results confirm that our counter measures have taken effect in lowering portable x-ray retake rates significantly. And it achieves our goal of improving patient safety and providing better health care quality.