The Improvement of Patient Centering in Computed Tomography Through a Technologist-Focused Education Initiative

Proper patient centering is fundamental to the operation of CT. Misalignment of the patient is known to have a negative impact on image quality and dose. The purpose of this study was to improve patient centering in CT and examine the efficacy of several educational methods that could be implemented at any clinical site. The IRB determined the study was not human subjects research, and oversight was waived. Three interventions were examined. The first intervention involved a discussion on patient centering at a staff meeting. As the second intervention, an educational presentation was developed and delivered to CT technologists addressing the physics behind the importance of patient centering in CT. As the third intervention, individual technologist centering performance reviews were conducted by the modality supervisor. Clinical scan data was collected for each study period via a cloud-based software to examine the efficacy of each intervention in terms of lateral and vertical offset. The mean vertical offset of the baseline data was -1.97 cm. After the staff meeting, the mean vertical offset decreased to -1.60 cm (p < 0.001). Following the educational presentation, the mean vertical offset decreased to -1.14 cm (p < 0.001). After the technologist performance reviews, the mean vertical offset decreased to -0.86 cm (p < 0.001). This research examined a quality improvement initiative to improve patient centering at our institution which focused on communication and education. Through this initiative, the mean vertical positioning error decreased, the percentage of exams within 0-1 cm of isocenter increased, and the percentage of exams misaligned by greater than 3 cm decreased. This work has shown that patient centering can be improved with education.