Reject analysis : an analysis of rejected images in the medical imaging department of a general hospital in Malta.

Abstract

RESEARCH QUESTIONS Reject analysis may be defined as the critical evaluation of rejected images that have been deemed to be of insufficient quality in order for a radiological opinion to be produced. This was performed in the Medical Imaging Department of a general hospital in Malta, with the aim of establishing the reject rate in the Medical Imaging Department and to reveal the reasons for which radiographs are being rejected. The research questions for this study were the following: • What is the reject rate at the general hospital in Malta? • What are the main reasons that constitute to the rejected images? • How can the system be improved in order to diminish the reject rate? METHODOLOGY The research tool used was a datasheet that incorporated the acquisition of the reject rate of the department as well as the reasons for rejecting the radiographs. A section to document the dose and the DAP for every rejected image was also included. The reject analysis datasheet was developed from different reject analysis studies that were performed in other medical imaging departments in different countries. RESULTS The results obtained from the study demonstrated that the reject rate is of 6.3%. It was also found that radiographs were rejected primarily due to positioning errors (68.2%), followed by miscellaneous errors (13.4%), artefacts (9.5%), exposure errors ( 4. 7%) and patient movement ( 4.2% ). CONCLUSIONS On the basis of the results obtained, recommendations for having a continuous reject analysis as part of the quality assurance program of the department, with the aim of reducing the reject rate below the acceptable limit of 5% (IAEA, 2003), were proposed.