Quality assurance in repeat films

The Quality Assurance Program of Walter Reed Army Medical Center is described. This program has been in effect since January 1, 1978 and is ongoing. The logical derivation of the use of the repeat film analysis as the focus of the Quality Assurance Program is described in detail. This repeat analysis procedure includes (1) the collection of all repeat and discarded film; (2) the separation of all repeat and discarded film into types according to the etiology leading to their being discarded; and (3) evaluation of radiographic artifacts to analyzed the types of artifacts, the mistakes which lead to these artifacts, and the means of eliminating the causes of these artifacts. Artifacts are categorized according to patient error, physician error, radiographer error, machine error, film screen processor error, etc. Statistics of this analysis are presented from January 1, 1978 through July 1, 1979. Pertinent examples of different types of errors are illustrated and the logical step-by-step process leading to the elimination of causes is explained in detail.