Implementation of a quality control program in a radiology department

Transcrição

1 Implementation of a quality control program in a radiology department Poster No.: B-0602 Congress: ECR 2013 Type: Scientific Paper Authors: M. Leão, L. P. V. Ribeiro, A. F. Abrantes, J. Pinheiro, R. P. P. A. Almeida, K. B. Azevedo, S. Rodrigues; Faro/PT Keywords: DOI: Professional issues, Management, Conventional radiography, Audit and standards, Education, Radiation safety /ecr2013/B-0602 Any information contained in this pdf file is automatically generated from digital material submitted to EPOS by third parties in the form of scientific presentations. References to any names, marks, products, or services of third parties or hypertext links to thirdparty sites or information are provided solely as a convenience to you and do not in any way constitute or imply ECR's endorsement, sponsorship or recommendation of the third party, information, product or service. ECR is not responsible for the content of these pages and does not make any representations regarding the content or accuracy of material in this file. As per copyright regulations, any unauthorised use of the material or parts thereof as well as commercial reproduction or multiple distribution by any traditional or electronically based reproduction/publication method ist strictly prohibited. You agree to defend, indemnify, and hold ECR harmless from and against any and all claims, damages, costs, and expenses, including attorneys' fees, arising from or related to your use of these pages. Please note: Links to movies, ppt slideshows and any other multimedia files are not available in the pdf version of presentations. Page 1 of 17

2 Purpose In a healthcare increasingly demanding, where quality is very important, it is expected that professionals and institutions meet the patients' needs. Health Quality is understood as the systematization of all processes, in all areas of the management world, and the ISO (International Organisation for Standardisation) 9001/2008 standards, which ensure the certification of many health organizations, report that there are eight principles for a quality management system. On health, in general, and on radiology, in particular, it is expected the same levels of quality in all locations, and it is recommended that the Radiology departments come to develop from quality control programs to total quality management programs (Vidigal, 2010). The main goal of this research was to evaluate the importance that radiographers give to the implementation of a quality control system programs in their radiology departments, since many of them are still not certified by quality standards. It was intended to understand the importance of implementation of the quality system; if radiographers know in what consists a system of quality control; and to investigate the importance that they give to Radiological Protection criteria. Methods and Materials This research was a quantitative, descriptive and transversal study. Sample and Data Collection The data collection for this study was take place in the District of Évora and Beja (Portugal), more specifically on public hospitals and healthcare centers with radiology department. The study sample was consisted of 47 radiographers who works in the institutions mentioned above (in a total of 62 radiographers; response rate of 75.8%). For the statistical analysis we considered two sub-samples (31 radiographers from public hospitals and 16 radiographers from healthcare centers). Instrument Page 2 of 17

3 The instrument applied in this study was a 30-item questionnaire which is divided into 5 parts: Part 1-5 sociodemographic questions Part 2-8 items in order to situate the radiographers in relation to the quality control programs. Part 3 - composed by a scale of quality assessment importance (7 items on a 5 point Likert scale) Part 4 - composed by a scale of radiological protection importance (5 items on a 5 point Likert scale) Part 5-5 questions to check for radiological protection materials in the institutions concerned. The original instrument was developed at the University of Trás-os-Montes e Alto Douro in 2008 by the authors Helga Macedo e Vitor Rodrigues. The use of the questionnaire was authorized by the authors; and in accordance to institutional guidelines, the approval of this study was obtained from the review board. Variables In this study, the independent variables were the importance given to quality control and the importance given to radiological protection. The dependent variables evaluated were the gender, age, professional experience, academic degree, training in the quality area, institution/radiology department with or without accreditation/certification, existence of quality control programs. Statistical analysis Statistical analysis was made using descriptive statistics, Mann-Whitney and Kruskal- Wallis tests in order to verify correlation between items. Results Page 3 of 17

4 Fig. 2: Sample distribution regarding radiological protection equipment References: Department of Radiology, Health School - University of Algarve Sociodemographic Characterization Gender: The data collected shows that the majority of the sample was male, 13 (27.7%) of radiographers are female and 34 (72.3%) were male. Age: In relation to age was verified that most of Radiographers is between 40 to 49 years (31%). The mean, maximum and minimum, can be viewed in figure 1. Page 4 of 17

5 Fig. 1: Sample distribution according to age at Healthcare Centres and Public Hospitals References: Department of Radiology, Health School - University of Algarve Professional Experience: We have found that most radiographers has between 10 and 19 years of professional experience, in this case 15 (31.9%) radiographers. Academic Degree: it was found that more than half of the sample (53,2%) are graduated radiographers. 9 (19,1%) have the bachelor's and the others are post-graduated radiographers. Quality Control Institution/Radiology department with or withoutt accreditation / certification: The majority of radiographers (n=45; 95.7%) responded that the institution where they works is not currently in the process of accreditation/certification. Only 2 (4.3%) answered Page 5 of 17

6 yes, and one of them mentioned the joint commission on accreditation of healthcare organizations. It was also observed that 45 radiographers (95,7%) claim there is no quality control program in their departments. Quality Training In relation to training activities in the quality area, 7 (23.3%) of radiographers in healthcare centers have reported training activities at the institution where they work. 2 of them say that these formations are not periodic. In hospitals only 1 (6.3%) radiographer said attend to training activities in the quality area. Quality control area - What is it? About this question, 19 radiographers claim to know what a quality control program is. Of all these, the aspects more often mentioned were image quality control, equipment calibration, radiation protection and equipment quality control. Training and education in quality? 25,5% of radiographers have training in quality programs and 72,3% don't have any kind of training. Importance of Quality Control Promotion of quality training and implementation of quality control program 80,9% of radiographers claim it is important the need of promoting quality training and 70,2% consider necessary the implementation of a quality control program, while only 4,3% say it is of little importance. 40,4% would like to collaborate in the implementation of a quality control program. Implementation of quality control program as a motivational factor 38,3% of radiographers consider quality control programs as a motivational factor and 12,8% say it is a moderate motivational factor. Implementation of quality control program as a patient satisfaction factor Page 6 of 17

7 When asked if the implementation of a quality control program would promote patient satisfaction 42,6% say it would have a moderate impact, 34% claim it is very important, and 14,9% refer that is it low importance. Importance of Radiological Protection Dose assessment in the radiology department When asked about dose assessment in the exam rooms, 38,3% say that measurements are rarely done, 27,7% refer that they are never done. Regarding individual dose assessment of radiographers, 85,1% say that these are always made, equipment consistency tests are rare (36,2%) or never done (12,8%), but 34% are always calibrated. Radiological Protection Existence and condition of radiological protection equipment Concerning the existence of radiological protection equipment, the radiographers refer that all institutions have this equipment (figure 2) and all of these have physical protection barriers. Regarding ionizing radiation signage, almost all institutions (96,% in the hospitals and 93,8% in healthcare centers) have this warning in their departments, but only half (48,4%) have signage for pregnant women. Page 7 of 17

8 Fig. 2: Sample distribution regarding radiological protection equipment References: Department of Radiology, Health School - University of Algarve Mann-Whitney and Kruskal-Wallis tests We verified, through Kruskal Wallis test, that there is significant statistical differences between age groups and importance of quality control (p=0.027) (figure 3), between academic degree and importance of quality control (p=0.003) (figure 4). For all other variables considered there were no significant statistical differences. Page 8 of 17

9 Fig. 3: Kruskal wallis test for the importance of quality control and age group References: Department of Radiology, Health School - University of Algarve Page 9 of 17

10 Fig. 4: Kruskal wallis test for the importance of quality control and academic degree References: Department of Radiology, Health School - University of Algarve Images for this section: Page 10 of 17

11 Fig. 1: Sample distribution according to age at Healthcare Centres and Public Hospitals Page 11 of 17

12 Conclusion More than half of radiographers don't know what a quality control program is, nor they have any kind of training in quality, however almost all radiographers considers this topic to be very important. Some of institutions analyzed don't have a quality control program implemented; therefore we weren't able to verity the existence or not of the relation between the importance of a quality control program and radiological protection. Quality control programs are essential to the radiology department and radiation safety guidelines must be implemented. Despite that some radiology departments have radiological protection equipment often applied by radiographers, their effectiveness and condition must be checked regularly. References Bittar, O. J. (1999). Gestão de processos e certificação para qualidade em saúde. Instituto Dante Pazzanese de Cardiologia,, São Paulo. Cardoso, J. F. (novembro de 1996 ). Os mestres da Qualidade. Obtido em 29 de dezembro de 2011, de Exame Executive Digest: ed25cap1.html Carvalho, C. O. (2004). Qualidade em Saúde: Conceitos, Desafios e Perspetivas. Tese de Mestrado, Universidade Federal de São Paulo, São Paulo. Couto, R. C., & Pedrosa, T. M. (2007). Hospital - Acreditação e Gestão em Saúde (2ªEdição ed.). Rio de Janeiro: Guanabara Koogam. Diário da República - I Série - A. (8 de agosto de 2002). Obtido em 18 de janeiro de 2012, de Diário da República Electronico: Diário da República - I Série - A N.o 163. (17 de julho de 2002). Obtido em 16 de janeiro de 2012, de Diário da República: Page 12 of 17

13 Diário da República - I série A. (18 de julho de 2002). Obtido em 18 de janeiro de 2012, de Direção Geral das Instalações e Equipamentos da Saúde: Diário da República - I Série A. (17 de julho de 2002). Obtido em 18 de janeiro de 2012, de Diário da República: Diário da República. (17 de novembro de 2008). Obtido em 18 de janeiro de 2012, de Instituto Português da Qualidade: Fortin, M. F. (2006). Fundamentos e Etapas do Processo de Investigação. Canada: Lusodidacta. Furquim, T. A., & Costa, P. R. (2009). Garantia de Qualidade em Radiologia Diagnóstica. Revista Brasileira de Física Médica, pp Ganhão, F. N., & Pereira, A. M. (1992). A Gestão da Qualidade - Como implementá-la na empresa. Lisboa: Editorial Presença. Gil, A. C. (1991). Como elaborar projetos de pesquisa. São Paulo : Atlas. Guia Interpretativo ISO 9001:2000. (dezembro de 2003). Obtido em 30 de dezembro de 2011, de Associação Portuguesa de Certificação: src_cdroms/sistemas_qualidade/links/guia_interpr.pdf Instituto Português da Qualidade. (setembro de 2009). Obtido em 29 de dezembro de 2011, de Instituto Português da Qualidade: modid=0&pagid=3&faqid=141 Juran, J. (1989). Juran on leadership of quality. New York: Free Press. Lima, J. J. (2005). Técnicas de Diagnóstico com raios X. Coimbra: Imprensa da Universidade de Coimbra. Macedo, H. A., & Rodrigues, V. M. (2009). Programa de controle de qualidade: a visão do técnico de radiologia. Tese de Mestrado, Universidade de Tràs-os-Montes e Alto Douro, Vila Real. Page 13 of 17

14 Maroco, J. (2010). Análise Estatística com o PASW Statistics. ReportNumber. Martin, V., & Henderson, E. (2004). Gestão de Unidades de Saúde e de Serviços Sociais. Monitor. Mezomo, J. C. (2001). Gestão da Qualidade na Saúde. Brasil: Manole. Perereira, A. (2008). Guia prático de utilização do SPSS : análise de dados para ciências sociais e psicologia (7ªEdição ed.). Silabo. Pires, A. R. (2004). Qualidade - Sistemas de Gestão da Qualidade (3º Edição ed.). Lisboa: Edições Sílabo. Quality service in radiology. (julho de 2007). Biomedical Imaging and Intervention Journal, pp Rosa, J. R., Queiroz, F. C., Viegas, Q., Hekis, H. R., & Pereira, F. B. (2011). Gestão da Qualidade em um setor de Radiologia Hospitalar. Santa Catarina. Serapioni, M. (junho de 2009). Avaliação da qualidade em saúde.reflexões teóricometodológicas para uma abordagem multidimensional. Revista Crítica de Ciências Sociais, pp Sousa, C. (s.d.). SPQ- Sistema Português da Qualidade. Obtido em 15 de janeiro de 2012, de Stabhope, M., & Lancaster, J. (1999). Enfermagem Comunitária - Promoção da Saúde de Grupos, Famílias e Indivíduos (4ª Edição ed.). Lisboa: Lusociência. Stevens, A. (1 de dezembro de 2007). Establishing Quality Indicators for Medical Imaging and the Basic Quality Management Toolbox. pp Tratado que institui a Comunidade Europeia da Energia Atómica (Euratom). (19 de outubro de 2007). Obtido em 18 de janeiro de 2012, de Europa - EU: legislation_summaries/institutional_affairs/treaties/treaties_euratom_pt.htm Page 14 of 17

15 Vidigal, R. R. (2010). Contributo para a Gestão da Qualidade Clínica num Serviço de Radiologia. Universidade Nova de Lisboa, Lisboa. Personal Information M. Leão, Department of Radiology, Health School - University of Algarve, Portugal. mariliableao@gmail.com L. P. V. Ribeiro, PhD, Department of Radiology, Health School - University of Algarve, Member of Cdaf (Research Center of Sports and Physical Activity), Portugal. lpribeiro@ualg.pt A. F. Abrantes, PhD, Department of Radiology, Health School - University of Algarve, Member of CESNOVA (Sociology Studies Center of New University of Lisbon), Portugal. aabrantes@ualg.pt J. Pinheiro, Department of Radiology, Health School - University of Algarve. joao.pinheiro88@gmail.com R. P. P. Almeida, Department of Radiology, Health School - University of Algarve, PhD student at Faculty of Health Sciences - University of Beira Interior, Portugal. rpalmeida@ualg.pt K. B. Azevedo, Department of Radiology, Health School - University of Algarve, Portugal; PhD student at Cranfield University, UK. kbazevedo@ualg.pt S. Rodrigues, Master, Department of Radiology, Health School - University of Algarve. srodrigues@ualg.pt Page 15 of 17

16 Fig. 5 References: Department of Radiology, Health School - University of Algarve Images for this section: Fig. 5 Page 16 of 17

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