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1
Welcome
Medical Physicist Meeting
November 9, 20042:00 - 5:00 p.m.
2
Update on New Jersey’s Quality Assurance Program
• Bureau of Radiological Heatlh 25 Arctic Parkway Ewing, NJ
• Bureau Chief Paul G. Orlando (609) 984-5634 Office (609) 984-5811 Fax
3
QC Tests Performed by Medical Office Staff
Annual Medical Physicist QC Survey
State Inspections
Key Elements to Successful Program
4
Three Medical Studies Tracked for ESE & IQ
• PA Chest
• AP Lumbosacral Spine
• AP Foot
5
QA Program Timeline
Year 1 QA Year 2 QA Year 3 QA
4/01-9/02 9/02-9/03 9/03-9/04 9/04-9/05
Year 4 QAPre QA
6/00-4/01
6
PA Chest Data
7
All Facilities (PA Chest Study)
5.0
10.0
15.0
20.0
25.0
30.0
Baseline ESE Yr 1 Yr 2 Yr 3
ESE
(mR
)
40
45
50
55
60
65
IQ S
core
Chest ESE Chest IQ
NEXT Avg16.1 mR
8
3 Year Comparison of ESE & IQ by Discipline (PA Chest Study)
5.0
10.0
15.0
20.0
25.0
30.0
Baseline Yr 1 Yr 2 Yr 3
ES
E (
mR
)
40
45
50
55
60
65
IQ S
core
Medical ESE Hospital ESE Medical IQ Hospital IQ
NEXT Avg16.1 mR
9
AP Lumbar SpineData
10
All Facilities (AP Lumbar Spine Study)
300.0
350.0
400.0
450.0
500.0
550.0
Baseline ESE Yr 1 Yr 2 Yr 3
ESE
(mR
)
40
45
50
55
60
65
IQ S
core
Lumbar Spine ESE Lumbar Spine IQ
NEXT Average370 mR
11
3 Year Comparison of ESE & IQ Databy Facility Type (AP Lumbar Spine Study)
300
350
400
450
500
550
600
Baseline Yr 1 Yr 2 Yr 3
ES
E (
mR
)
30
35
40
45
50
55
60
65
70
IQ S
core
Medical ESE Chiropractor ESE Hospital ESE
Medical IQ Chiropractor IQ Hospital IQ
NEXT Avg 370 mR
12
AP Foot Data
13
All Facilities (AP Foot Study)
0.0
5.0
10.0
15.0
20.0
25.0
30.0
35.0
Baseline ESE Yr 1 Yr 2 Yr 3
ESE
(mR
)
40
45
50
55
60
65
70
75
IQ S
core
Foot ESE Foot IQ
14
3 Year Comparison of ESE & IQ Data by Discipline (AP Foot Study)
0
5
10
15
20
25
30
35
40
Baseline Yr 1 Yr 2 Yr 3
ES
E (
mR
)
40
45
50
55
60
65
70
75
IQ S
core
Medical ESE Podiatrist ESE Hospital ESE
Medical IQ Podiatrist IQ Hospital IQ
15
Reductions in ESE
Prior toQA (mR)
After Yr3QA (mR)
PercentReduction
ESEFoot 31.3 11.9 62.0%
Chest 22.2 12.9 41.9%
LumbarSpine
525.1 354.5 32.5%
16
All IQ Data
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
0-9 10-19 20-29 30-39 40-49 50-59 60-69 70-79 80-89 90-100
Yr 1 Yr 2 Yr 3
Year 1 Mean=51.3
Year 2Mean=60.6
Year 3 Mean= 62.0
POOR FAIR GOOD EXCELLENT
17
Image Quality Improvements
AverageScore
PoorImages
Good toExcellent
YR1 51.3 11% 53%
YR2 60.6 2% 83%
YR 3 62.0 2% 86%
18
Goals Established at the Onset of the Quality Assurance Program
• Reduce unnecessary radiation
– Set initial goal to reduce ESE 10% by 2005
– Achieved 32.5%-62.0% reductions in ESE
• Improved image quality resulting in better diagnosis and fewer repeat x-ray studies
– Set initial goal to increase IQ 15% by 2007
– Achieved 20.9% improvement in IQ
• More timely equipment repair, less down time
• Improved understanding of x-ray risks and benefits
• Closer ties with constituents
19
Violation History