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Related Experiment Video

Updated: Sep 14, 2025

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Mammography Positioning Improvement Results and Unique Challenges in a Safety-Net Health System.

Firouzeh K Arjmandi1, Havisha Munjal2, Jody Hayes3

  • 1Assistant Quality Assurance Medical Director, Parkland Radiology, Dallas, Texas; Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas.

Journal of the American College of Radiology : JACR
|July 23, 2025
PubMed
Summary

Improving mammography positioning in safety-net practices is crucial for accurate cancer diagnosis. A structured program enhanced image quality by addressing technologist training and communication, increasing the percentage of well-positioned screening mammograms.

Keywords:
Mammography positioningdisparitiesquality improvementsafety-netscreening mammography

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Area of Science:

  • Radiology
  • Medical Imaging Quality Improvement
  • Health Disparities

Background:

  • Poor mammography positioning leads to diagnostic errors and can exacerbate health disparities.
  • A safety-net breast imaging practice observed increased technical repeats due to suboptimal screening mammography quality.

Purpose of the Study:

  • To share challenges encountered in a safety-net breast imaging practice.
  • To report on the outcomes of a structured improvement program aimed at enhancing mammography positioning.

Main Methods:

  • Participated in the ACR Mammography Positioning Improvement Collaborative (MPIC) using A3 thinking.
  • Conducted current-state analysis, process mapping, and root cause analysis.
  • Implemented targeted interventions and tracked positioning adherence across 1,639 screening mammograms.

Main Results:

  • Identified root causes: variable technologist skills, onboarding issues, high turnover, staffing shortages, language barriers, and patient factors.
  • Interventions included daily tips, one-on-one training, and a Spanish-language resource.
  • Significantly increased the percentage of screening mammograms meeting positioning criteria from 45% to 58% (P = .02).

Conclusions:

  • A structured improvement program effectively identified and addressed challenges in mammography positioning.
  • Interventions led to a significant improvement in overall screening mammography image quality in a safety-net setting.