QUALITY IN RADIOLOGY

Quality in Radiology

Quality in Radiology

Introduction

Radiology is part of the service industry and as a service provider one needs to understand quality and delivery of service. This includes knowledge of customer service, customer satisfaction and all its related issues as well as quality assurance and improvement issues. Service quality and delivery in radiology are closely related but not the same. Nevertheless, both are required for customer satisfaction.

Academic and institutional radiology departments are now often considered as revenue centres in their hospitals. A cost centre is a unit or department in an organisation for which a manager is assigned responsibility for managing costs. Revenue generation is not the main concern of the department but cost control is of utmost importance. They are also often called support centres. With a revenue or profit centre, maximum revenues are generated and minimum expenses are incurred. The manager's role is to maximise profit while minimising losses. Salary packages of academics also often include a clinical component. Senior radiologists need to have an understanding of the financial aspects as well as service aspects of a radiology department(Power 2000 pp.111-9).

Quality in Radiology

Quality assurance in diagnostic radiology is a process to ensure that the image quality is optimal, so that the diagnostic interpretation by the radiologist can be done under the best possible conditions, including the assessment of radiation output, quality control of equipment, radiation protection of employees, public and patients. Quality assurance involves those planned and systematic actions necessary to provide adequate confidence that a product or service will satisfy any given requirement for quality [4]. Since quality assurance aims to prevent mistakes arising in any process, it is fundamentally different from quality control which concentrates on the elimination of faulty products or services after they have arisen. The official definition of quality is 'the totality of features and characteristics of a product or service that bear upon its ability to satisfy a given need' (Shaw 2000 pp.29-44). This may be described as 'fitness for purpose'. BRITISH STANDARD 5750 (BS 5750) BS 5750 is an internationally recognized quality management system, equivalent to the International quality standard (ISO 9000) and the European quality standard (EN 29000). BS 5750 was originally devised for manufac- Correspondence to: Dr J. M. E. Kirk, Department of Diagnostic Radiology, St George's Hospital, Blackshaw Road, London SWI7 OQT. turing industries but its use has been extended to include service industries. It provides a framework to control all aspects of a service to ensure total quality(Power 2000 pp.111-9).  Radiologists should try to ensure that the departments in which they work have a high quality of clinical care, images, image interpretation and results of interventions measured by outcome data(Cheek 2000). The quality of care in individual departments may be affected by the manpower and equipment resources available (25), but where possible radiologists should try to minimise waiting times and maximise the speed of the issue of a report (15). The development of standards of diagnostic accuracy and efficacy of most investigations is incomplete. Radiologists should, however, endeavour to identify the standards that are achievable in any particular area and attempt to ensure that they provide a quality of service, accuracy, effectiveness and efficacy, which falls within those ...