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Education Leads to Higher Compliance: Development and Implementation of New Neonatal Technique Charts for Digital Radiography

R Herrera

R Herrera*, D Vergara , L Johnson , UAB Medical Center, Birmingham, AL


MO-DE-201-5 (Monday, July 31, 2017) 1:45 PM - 3:45 PM Room: 201

Purpose: To verify if the combination of multi-step, continuous, and detailed education of technologists leads to higher-usage compliance for Digital Radiography (DR) technique charts of neonatal patients developed by the medical physicist.

Methods: A set of Lucite neonatal phantoms was constructed to investigate image quality, patient exposure, and appropriateness of techniques for a newly-acquired DR system, Carestream DRX-Revolution. A new set of technique charts was developed based on the pre-determined, optimal pediatric Carestream-Exposure Index (EI) to the detector plate of 1200 to 1600. Implementation of the new technique chart was a four-step process: 1) make lead technologists aware of the changes coming, 2) give detailed presentations to managing, lead, and staff technologists on the need for new techniques charts and how they were developed, 3) delete old protocols stored on the portable and implement new ones, and 4) place two laminated technique charts at the console – one taped to the support column of the x-ray tube and a second in an easily accessible slot on the console. Exposure data is downloaded from the machine on a monthly basis and analyzed for compliance.

Results: Implementing detailed educational meetings which include radiology staff of various levels led to a marked increase in compliance in the adoption of the new neonatal technique charts. As a consequence, the radiographic image quality for all neonatal patient sizes has improved, and sub-optimal exposures have decreased from 57% to 26%.

Conclusion: This work indicates the potential for significant improvements in technologist compliance rates when implementing new radiographic techniques. More effective educational sessions are achieved when including all levels of chain of command: managing, lead, and staff technologists. Effectiveness is further enhanced if discussion on the need for the new techniques is addressed as well as methods used and analysis of results leading to the new chart.

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