Radiographers/Radiological Technologists Role in Quality Assurance and Quality Control (QA-QC) as a Team Approach

POSITION STATEMENT

Revised2019

Radiographers/RadiologicalTechnologistsRoleinQualityAssuranceandQualityControl(QA-QC)asaTeamApproachTheISRRTpromoteswithinthescopeofpracticeforradiographers/radiologicaltechnologiststo

includecompetenceinqualityassuranceandqualitycontrolwithinaqualityassuranceframework.

Thisisessentialtoassurethedeliveryofsafe,cost-effectiveandhigh-qualitydiagnosticimaging

andradiotherapyservices.

TheISRRTconsidersqualityassuranceandqualitycontrolwithinthescopeofpracticefor

radiographers/radiologicaltechnologistsusinganintegratedteamapproach.Qualityassuranceand

qualitycontrolincludeseveryactivitywhichwillaffectthepatient’sjourneythroughtheclinical

imagingorradiotherapyserviceandincludesuseofionizingandnon-ionizingmodalities.For

DiagnosticImagingthiswillincludetheevaluationandmonitoringofpatientdosesreceivedfora

particularradiologicalexamination,protocolsandprocedureslinkedtospecificimaging

procedures,rejectanalysisandtheaccuracyofdiagnosticimagingreports.

Qualityassuranceembracesallaspectsofthediagnosticimagingprocessincludingavisualcheckof

theequipmentandconfirmationofcarefulpreparationpriortoeverypatientprocedureaswellas

establishingaroutinequalitycontroltesting(daily,weekly,monthly,quarterlyorannually)

programofequipment.

Qualitycontroltestingincludesthemonitoring,evaluationandmaintenanceofequipmentfor

optimalperformanceandstability.Itisessentialthatradiographers/radiologicaltechnologists

recognize,recordandreport,accordingtopolicy,whenasignificantincreaseorunderexposurein

radiationexposureoccurs.

Analyzingtheresultsofqualitycontroltestingtogetherwithinitiatingcorrectiveactionare

essentialintegralcomponentsofqualityassurance.Validatingqualityassurancetestingconditions

andresultsandreportingsignificanttolerancedeviationsfromqualitycontrolteststoappropriate

personnelisaprofessionalrequirement.

Theroleforradiographers/radiologicaltechnologistswillincludedocumentingandmaintaining

recordsforthequalitycontrolprograminaccordancewithapplicableregulations,legal

requirements,accreditingagenciesandrecommendationsfromequipmentmanufacturersusingan

integratedteamapproach.Thisroleissubjecttothedemonstrationofappropriateeducational

preparationleadingtoclinicalcompetencewithinthescopeofpracticefor

radiographers/radiologicaltechnologists.

Seniorandcompetentradiographers/radiologicaltechnologistsshouldberesponsiblefor

overseeingtheequipmentqualitycontroltestingprogrammeaswellasotherresponsiblerolesin

thequalityassuranceframeworkintheradiologydepartmentwhichembracesallimaging

modalitiesandqualityimprovementprojects.

Background:

Qualityassuranceformedicalexposures

TheBasicSafetyStandards(BSS)publishedbytheInternationalAtomicEnergyAgency(IAEA)as

GeneralSafetyRequirements-Part3,July2014supportthepositionstatement.TheBSScoversa

teamapproachdescribingactiveparticipationinqualityassuranceandqualitycontrolwith

responsibilitiesfortheentireteamincludingactiveparticipationofthemedicalradiation

technologists,radiologicmedicalpractitionersandmedicalphysicistsasstatedinsection3.170.

Registrantsandlicensees,inapplyingtherequirementsoftheseStandardsinrespectof

managementsystems,shallestablishacomprehensiveprogramofqualityassuranceformedical

exposureswiththeactiveparticipationofmedicalphysicists,radiologicalmedicalpractitioners,

medicalradiationtechnologistsand,forcomplexnuclearmedicinefacilities,radiopharmacistsand

radiochemists,andinconjunctionwithotherhealthprofessionalsasappropriate.Principles

establishedbytheWorldHealthOrganization,thePanAmericanHealthOrganizationandrelevant

professionalbodiesshallbetakenintoaccount.

Section3.171.Registrantsandlicenseesshallensurethatprogramsofqualityassuranceformedical

exposureinclude,asappropriatetothemedicalradiationfacility:

a)Measurementsofthephysicalparametersofmedicalradiologicalequipmentmadeby,orunder

thesupervisionof,amedicalphysicist:

(i)Atthetimeofacceptanceandcommissioningoftheequipmentpriortoitsclinicaluseon

patients;

(ii)Periodicallythereafter;

(iii)Afteranymajormaintenanceprocedurethatcouldaffectprotectionandsafetyof

patients;

(iv)Afteranyinstallationofnewsoftwareormodificationofexistingsoftwarethatcould

affectprotectionandsafetyofpatients.

(b)Implementationofcorrectiveactionsifmeasuredvaluesofthephysicalparametersmentioned

in(a)aboveareoutsideestablishedtolerancelimits.

(c)Verificationoftheappropriatephysicalandclinicalfactorsusedinradiologicalprocedures.

(d)Maintainingrecordsofrelevantproceduresandresults.

(e)Periodicchecksofthecalibrationandconditionsofoperationofdosimetryequipmentand

monitoringequipment.

Radiographers/radiologicaltechnologistsfollowingtheireducationandtrainingwillobtaina

thoroughunderstandingandknowledgeperformingqualitycontroltestingofequipment,which

theyperformdailybeforethestartofanyprocedure.

Radiographers/radiologicaltechnologistswillalsoobtaincompetenceperformingqualitycontrol

forfilmprocessingchemicalswhereappropriateorprocessorsensitometryandgeneralsystem

conditionsforcomputedradiography(CR)anddirectreadout(DR)equipmentwhenappropriate.

Theradiographer/radiologicaltechnologististhepersonoperatingtheequipment.

Theradiographer/radiologicaltechnologistwillalsobeperformingthequalitycontroltesting,

evaluatingtheresultsandreportinganydeviationstotheserviceteamorphysicistsaccordingto

protocols.

Thiseducationaltrainingwillalsoincludeperformingqualityassuranceactivitiesandparticipation

insafetyandriskmanagementactivities.Atthecompletionofeducation,

radiographers/radiologicaltechnologistsshouldbecompetenttoassesstheoutcomeofthequality

managementactionplanforequipmentandprocessesinadiagnosticimagingorradiotherapy

center.

Theeducationincludesreviewingandevaluatingqualityassuranceprocessesandtoolsfor

effectiveness.Radiographers/radiologicaltechnologistslearnhowtoevaluateperformanceof

equipment,materialsandprocessesinaqualityassuranceactivitybasedonestablishedguidelines.

Allhealthcarefacilitiesirrespectiveofsettingandincludingbothhospitalandcommunity-based

servicesmusthaverobustprocessesforqualityassuranceandqualitycontrolwithwritten

processesandcompetentradiographers/radiologicaltechnologists.

TheeffectivenessoftheQualityAssuranceprogrammeandQualitycontroltestingshouldbesubject

toindependentscrutinyandaudit.

References:www.iaea.org,InternationalBasicSafetyStandards(BSS),InternationalAtomicEnergyAgency(IAEA),GeneralSafetyRequirementsPart3,July2014.ThePracticeStandardsforMedicalImagingandRadiationTherapy,RadiographyPracticeStandards,2017https://www.asrt.org/docs/default-source/practice-standards-published/ps...NuclearMedicineTechnologistScopeofPracticeandPerformanceStandards,SocietyofNuclearMedicineandMolecularImagingTechnologistSectionApproved:June2016,http://www.snmmi.org/ClinicalPractice/content.aspx?ItemNumber=5532DiagnosticX-RayImagingQualityAssurance:AnOverviewhttps://www.canada.ca/en/health-canada/services/environmental-workplace-...Breastscreening:guidanceforbreastscreeningmammographershttps://www.gov.uk/government/publications/breast-screening-quality-assu...iNote:Linkstoexternalwebsitesmaychangewithoutnotice

iRevised2019