Reviewing processes with a view to maximising workflow efficiency is a good idea once in a while. Vanessa Knivett, communications specialist for RTI, explains how the company’s innovative software and all-in-one meters can help improve the quality of your quality assurance.

Improving patient and staff safety, and ensuring healthcare excellence are the primary goals of every quality assurance (QA) programme for X-ray devices. However, advances in imaging technology and a growing, aging population means that the number of scans performed is increasing. These factors ensure that whenever QA processes are discussed, efficiency is a key watchword from a cost and test-time perspective.

A basic QA programme to control diagnostic image quality consists of a series of routine, standardised tests to detect changes in X-ray equipment function, using original performance as the baseline. QA measurement efficiency is determined by two factors: appropriate processes to test, evaluate and record data; and equipment performance.

Hit me with your best shot

While there are differences in hardware sold for X-ray QA programmes in terms of accuracy, precision, sensitivity and range, these are not as great as they used to be, thanks to improvements in semiconductor technology. Many X-ray meters boast ‘one-shot’ operation, requiring just one exposure to capture all the relevant beam parameters. Similarly, all-in-one devices combining radiography, fluoroscopy, mammography, dental and CT capabilities are now commonplace. Arguably, selecting an all-in-one multimeter capable of one-shot measurement is a first step towards ensuring workflow efficiency.

Potentially the greatest workflow efficiency improvements can be realised by refining the measurement-gathering process, and access to the latest software is key in this. With appropriate set-up, contemporary test software can semi-automate test procedures by directing users through a prescribed set of test protocols. By applying an appropriate test workflow, errors can be minimised and, ultimately, test times decreased.

Henrik Bertilsson is medical physicist for the Kronoberg region of Sweden and in charge of the QA of X-ray equipment for two hospitals. He explains: "I am currently responsible for more than 30 X-ray units, including four CT scanners, three interventional systems, six conventional radiographic systems, four mobile units, nine surgical C-arms and six panoramic systems, plus a CBCT machine for dental radiology. In addition, I am in charge of acceptance-testing over a hundred intra-oral units for dental applications throughout our region."

As with any standard QA programme, all imaging equipment in Kronoberg undergoes an initial acceptance test prior to routine service, plus a comprehensive annual check-up. This process examines all the usual performance parameters, such as radiation dose and image quality, with a view to detecting performance deviations so that corrective action can be taken. The medical physicist checks all imaging equipment after service, and operating staff calibrate CT equipment on a daily basis.

The Kronoberg hospitals use RTI’s Piranha all-in-one X-ray meter, Cobia Smart, for measuring radiography and fluoroscopy parameters, as well as the firm’s Ocean diagnostic software. Bertilsson says: "Ocean allows me to set up measurement templates for many different types of equipment. It is convenient, as it collects all the data at once and performs automatic analysis."

Time for a check-up

With time in the X-ray room often limited, speed is essential with these processes. Ocean 2014 has a ‘quick check’ mode that detects the instrument and detectors connected, allowing users to start measuring immediately. It displays all measured parameters on one screen and saves them in Ocean for later review outside of the X-ray room.

While one-shot measurement accelerates data gathering, Bertilsson confirms that the reporting capabilities of RTI’s Ocean deliver the greatest improvements to workflow, stating that "annual QA test time has been cut to between two and four hours per unit on average, and down to just one hour for some systems".

Other customers have reported cuts in more-routine measurements from two hours to as low as 20 minutes, delivering real cost savings and greatly reducing downtime.

Crucially, a medical physicist’s time and expertise is best employed in many other ways than taking measurements and performing repetitive data entry. Contemporary test software in no way eliminates the need for highly skilled medical physicists in the X-ray QA process, but it can certainly optimise workflow and drive measurable efficiency improvements.

Based on the customer’s needs we develop, manufacture, calibrate and provide the market with systems used in radiology QA. We aim to be a responsive and helpful colleague and partner for our users, setting up and providing good solutions to problems they may encounter.

Our products are created by and for people. We will work together to achieve an open, vibrant and inspirational environment where ideas and energy can grow with the mission to minimise risks and optimise processes in radiology QA. We do this in a modern, easy and enjoyable way without compromising on performance.

RTI provides complete quality assurance solutions for X-ray modalities and facilities

We have ‘click & go’ solutions for X-ray quality assurance of X-ray modalities and facilities, everything from basic service to specialists.

Our multimeters can ‘do it all in one shot’ – kV, time, dose, dose rate, HVL, pulsed fluoroscopy and total filtration – and together with our powerful software we can offer you an extraordinary X-ray QA solution.

We also provide simple-to-use instrument for daily checks of the output from an X-ray tube. You simply place it beneath the X-ray tube, make an X-ray exposure, and rapidly get an accurate reading.

Two-year calibration cycle

RTI Electronics products have such a high measurement performance that the recommended calibration interval is as long as 24 months. This, together with the extended warranty programme (up to ten years), reassures you to trust your instrument and offers you a low lifetime cost.

Each product comes with a 24-month factory warranty. By joining the RTI Extended Warranty Program, you will have the opportunity to increase your warranty two years at a time up to ten years.

RTI X-ray QC control solutions

Black Piranha
Simply plug ‘n’ play. The new RTI Black Piranha brings a quickness and power to your X-ray QA workflow. The Black Piranha includes what you would expect in a multifunction meter. Connection to various accessories, tablet and PC is automatic – just plug ‘n’ play. The Quick Check feature identifies the probes you insert and selects the optimum Piranha settings for your measurements. You can even easily programme your own default start-up screen. The Black Piranha can measure on Rad, Fluoro, Dent, Mammo and CT.

Ocean 2014
Ocean is RTI’s versatile software for X-ray quality assurance. By using Ocean you will speed up your total working process and minimise your time in X-ray room. With Ocean you can plan your measurements at your desk in advance, create checklists, add information as a pop-up window for a specific exposure, and include instructions to simplify the work for you and your co-workers. After that you perform your measurements and, if needed, print out the report. Then you can return to your office and, at your own pace, continue with trend and more detailed waveform analysis, and upload your measurements to a central storage (if requested).

Cobia Smart
Cobia Smart is a straightforward and simple-to-use instrument for checking that the output from an X-ray tube is correct. Place it beneath the X-ray tube, make an X-ray exposure and rapidly get an accurate reading. The measured values can be read directly from Cobia Smart’s large and clear display, even from a distance. No adjustments are required, making it exceptionally easy to use.

Cobia Flex
Cobia Flex belongs to the straightforward and simple-to-use instrument from RTI. It has all the same smart design and easiness as the Cobia Smart, but will also give you the possibility to connect to external dose probes and extra gadgets.

RTI Ocean QA Software was updated in June 2014 to be able to interact with the Cobia Flex.