[Analysis of reject x-ray films as a quality assurance element in diagnostic radiology].
OBJECTIVE
Analysis of reject films from a large radiological department under the following aspects: How big is the waste of films? Where are the sources of error? What are the possible means of quality assurance?


METHODS
During a total period of 9 months, separated into three quarters, 14,570 reject films were analysed and assigned to 4 categories ("positioning", "exposure", "reject films due to patients" and "others"). In addition they were classified according to the respective parts of the body. The influence of a "study effect" was quantified by the analysis before and after information of staff.


RESULTS
The reject film rate in relation to all performed x-rays, was 9.0-13.2% of all the films taken during that period: of these, the failure rate (x-rays useless for diagnosis because of their bad quality) was between 54.2 and 57.5%. In this category, the main sources of error were positioning (55%) and exposure (34%). Surprisingly, the technical film waste amounted to 42.5-45.8% (not developed or preexposed films, x-rays of phantoms etc.).


CONCLUSIONS
Wasted films due to errors occurring during taking, as well as technical film waste, are unavoidable. Their proportion in relation to the total number of films should not exceed 8%. The main approach to reducing cost must be to cut down technical film waste.
Lewentat
G
G
Klinik für Diagnostische Radiologie und Neuroradiologie, Zentralklinikum Augsburg.
Bohndorf
K
K
D006801:Humans; D008029:Lighting; D011187:Posture; D011785:Quality Assurance, Health Care; D011859:Radiography / Q000379:methods / Q000592:standards*; D014962:X-Ray Film