Call to Action: Creating Resources for Radiology Technologists to Capture Higher Quality Portable Chest X-rays.

Area of Science:

• Radiology
• Medical Imaging
• Quality Improvement

Background:

• Portable chest x-rays (PCXRs) are crucial but susceptible to quality failures like rotation and obstruction.
• The COVID-19 pandemic increased PCXR use, exacerbating quality issues and potential diagnostic errors.
• Preventable quality failures in PCXRs can significantly hinder accurate radiologist interpretation.

Purpose of the Study:

• To establish a baseline rate of quality failures in PCXR imaging at a university hospital.
• To identify key issues contributing to poor image quality through a technologist focus group.
• To propose targeted interventions for technologists to reduce PCXR quality failure rates.

Main Methods:

• Evaluation of 500 PCXRs for technical image quality failures by radiology residents.
• Categorization of images based on rotation, obstruction, and other quality metrics.
• Conducting a focus group with six technologist managers to identify barriers to quality imaging.

Main Results:

• A high baseline quality failure rate of 46.2% (231 out of 500 PCXRs) was observed.
• Technical quality problems impacted pathology detection in 43.5% of repeat PCXRs.
• Common issues included improper patient positioning, foreign objects, and inconsistent technologist training, with most failures occurring during night shifts.

Conclusions:

• The study highlights a significant rate of PCXR image quality errors, necessitating improvement.
• Poor image quality directly compromises radiologist interpretive accuracy, leading to potential misdiagnoses.
• Enhanced educational resources and support for technologists are vital for improving PCXR quality and diagnostic accuracy.