X-ray reject analysis in Tikur Anbessa and Bethzatha Hospitals

Abstract

Abstract Background: It is not uncommon to encounter patients undergo repeat x-ray examinations after their initial x-rays are rejected for poor image quality thereby subjecting them to excess radiation exposure and avoidable extra cost. This creates a situation which necessitates the need to explore causes of reject and repeat of x-ray examinations. The employment of reject analysis as part of overall Quality Assurance (QA) programmes in clinical radiography and radiology services in the evaluation of image quality is a well established practice. The role of reject analysis in providing relevant information that would help achieve sound reduction in radiation exposure and cost as well as develop acceptable image quality was explored in this study. Objective: To assess the reject rate of x-ray films and obtain information for further recommendation on quality, cost, and radiation exposure in the two hospitals. Methods: Prospective and cross-sectional study approaches were employed. Reject rate was measured for two x-ray departments (one from public and the other from private) across all plain x-ray films examinations using a structured format on which relevant data for reject were recorded by investigators (radiologists and a medical physicist). Results were then collected and entered into a database for analysis. Results: Reject rate along with exposure rate was measured across all plain film exams for the hospitals. Analysis has shown that the overall reject rate was 4.94% in 4470 and 0.83% in 1870 exposed films for the public and private hospitals, respectively. Conclusion: The study has shown the highest reject to be that of chest x-ray in both adults and children with overexposure and patient motion, respectively being the major causes. Although the overall reject rate is well within the accepted range, individual causes of reject have given light into some of the most common problems of quality of radiography service and we recommend that regular and cyclic QA programmes should be instituted at all levels of the x-ray department and that of hospital management for effective and sustained service delivery, x-ray dose reduction to patients and personnel as well as economic management of scarce resource. [Ethiop.J.Health Dev. 2008;22