Digital radiography reject analysis of examinations with multiple rejects: an Australian emergency imaging department clinical audit

Abstract Introduction The largest source of manmade ionising radiation exposure to the public stems from diagnostic medical imaging examinations. Reject analysis, a form of quality assurance, was introduced to minimise repeat exposures. The purpose of this study was to analyse projection‐specific re...

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Main Authors: Brittany Stephenson‐Smith, Michael J Neep, Pamela Rowntree
Format: Article
Language:English
Published: Wiley 2021-09-01
Series:Journal of Medical Radiation Sciences
Subjects:
Online Access:https://doi.org/10.1002/jmrs.468
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author Brittany Stephenson‐Smith
Michael J Neep
Pamela Rowntree
author_facet Brittany Stephenson‐Smith
Michael J Neep
Pamela Rowntree
author_sort Brittany Stephenson‐Smith
collection DOAJ
description Abstract Introduction The largest source of manmade ionising radiation exposure to the public stems from diagnostic medical imaging examinations. Reject analysis, a form of quality assurance, was introduced to minimise repeat exposures. The purpose of this study was to analyse projection‐specific reject rates and radiographic examinations with multiple rejects. Methods A retrospective audit of rejected radiographs was undertaken in a busy Australian metropolitan emergency digital X‐ray room from March to June 2018. The data were collected by reject analysis software embedded within the X‐ray unit. Reject rates, and reasons for rejection for each X‐ray projection were analysed. Results Data from 11, 596 images showed overall reject rate was 10.3% and the overall multiple reject rate was 1.3%. The projections with both a high number and high percentage of rejects were antero‐posterior (AP) chest (175, 18.1%), AP pelvis (78, 22.5%), horizontal beam hip (61, 33.5%) and horizontal beam knee (116, 30.5%). The projections with both a high frequency and multiple reject rate were horizontal beam knee (32, 8.4%) and horizontal beam hip (17, 9.3%). The top reasons for multiple rejects were positioning (67.1%) and anatomy cut‐off (8.4%). Conclusions The findings of this study demonstrated that projection‐specific reject and multiple reject analysis in digital radiography is necessary in identifying areas for quality improvement which will reduce radiation exposure to patients. Projections that were frequently repeated in this study were horizontal beam knee and horizontal beam hip. Future research could involve re‐auditing the department following the implementation of improvement strategies to reduce unnecessary radiation exposure.
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spelling doaj.art-e528bbc5831b45308223830ce5785bf72022-12-21T22:35:54ZengWileyJournal of Medical Radiation Sciences2051-38952051-39092021-09-0168324525210.1002/jmrs.468Digital radiography reject analysis of examinations with multiple rejects: an Australian emergency imaging department clinical auditBrittany Stephenson‐Smith0Michael J Neep1Pamela Rowntree2Department of Medical Imaging The Prince Charles Hospital Chermside Queensland AustraliaDepartment of Medical Imaging Logan Hospital Meadowbrook Queensland AustraliaMedical Radiation Sciences School of Clinical Sciences Faculty of Health Queensland University of Technology (QUT) Queensland AustraliaAbstract Introduction The largest source of manmade ionising radiation exposure to the public stems from diagnostic medical imaging examinations. Reject analysis, a form of quality assurance, was introduced to minimise repeat exposures. The purpose of this study was to analyse projection‐specific reject rates and radiographic examinations with multiple rejects. Methods A retrospective audit of rejected radiographs was undertaken in a busy Australian metropolitan emergency digital X‐ray room from March to June 2018. The data were collected by reject analysis software embedded within the X‐ray unit. Reject rates, and reasons for rejection for each X‐ray projection were analysed. Results Data from 11, 596 images showed overall reject rate was 10.3% and the overall multiple reject rate was 1.3%. The projections with both a high number and high percentage of rejects were antero‐posterior (AP) chest (175, 18.1%), AP pelvis (78, 22.5%), horizontal beam hip (61, 33.5%) and horizontal beam knee (116, 30.5%). The projections with both a high frequency and multiple reject rate were horizontal beam knee (32, 8.4%) and horizontal beam hip (17, 9.3%). The top reasons for multiple rejects were positioning (67.1%) and anatomy cut‐off (8.4%). Conclusions The findings of this study demonstrated that projection‐specific reject and multiple reject analysis in digital radiography is necessary in identifying areas for quality improvement which will reduce radiation exposure to patients. Projections that were frequently repeated in this study were horizontal beam knee and horizontal beam hip. Future research could involve re‐auditing the department following the implementation of improvement strategies to reduce unnecessary radiation exposure.https://doi.org/10.1002/jmrs.468digital radiographymultiple repeatsreject analysisreject rateX‐rays
spellingShingle Brittany Stephenson‐Smith
Michael J Neep
Pamela Rowntree
Digital radiography reject analysis of examinations with multiple rejects: an Australian emergency imaging department clinical audit
Journal of Medical Radiation Sciences
digital radiography
multiple repeats
reject analysis
reject rate
X‐rays
title Digital radiography reject analysis of examinations with multiple rejects: an Australian emergency imaging department clinical audit
title_full Digital radiography reject analysis of examinations with multiple rejects: an Australian emergency imaging department clinical audit
title_fullStr Digital radiography reject analysis of examinations with multiple rejects: an Australian emergency imaging department clinical audit
title_full_unstemmed Digital radiography reject analysis of examinations with multiple rejects: an Australian emergency imaging department clinical audit
title_short Digital radiography reject analysis of examinations with multiple rejects: an Australian emergency imaging department clinical audit
title_sort digital radiography reject analysis of examinations with multiple rejects an australian emergency imaging department clinical audit
topic digital radiography
multiple repeats
reject analysis
reject rate
X‐rays
url https://doi.org/10.1002/jmrs.468
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AT pamelarowntree digitalradiographyrejectanalysisofexaminationswithmultiplerejectsanaustralianemergencyimagingdepartmentclinicalaudit