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