Quality assessment in radiology: value of a portable bar-code scanner integrated with a computer workstation

Radiographs are typically processed by several employees of a radiology department before being interpreted by a radiologist. A technologist acquires and labels the radiograph(s), and file room employees match the radiograph(s) with prior examinations and prepare them for interpretation by the radiologist. Every radiologist has encountered radiologic examinations in which the image quality, presentation, or associated clinical or technical information is suboptimal. In small departments, the process of immediately tracking the problem to its source and correcting it might be straightforward, albeit an annoying interruption to the radiologist's focus on clinical care. However, in larger departments, trends of human error or machine malfunction may be overlooked or untraceable because no effective method exists to track the quality of images and associated information. A feedback loop from radiologists to the department's ancillary personnel can result in a cycle of continuous quality improvement that enhances the quality of radiographic examinations and also decreases waste. To achieve this, we designed and implemented a computerized process that involves a portable bar-code scanner, a personal computer workstation, and our existing radiology information system.