<title>Quality Assurance: A Fundamental Whose Time Has Come</title>

Abstract

IntroductionWe live in an era of consumerism, in which people are demanding that the products and services they receive be of uniform high quality. This attitude increasingly prevails in the area of health care services, where the patient-consumer expects to receive the highest quality medical care which a facility can provide.In diagnostic radiology, the issue of quality involves three separate assumptions: first, that a necessary and appropriate examination was ordered for the patient; secondly, that the image on the radiograph or fluoroscopic viewing system is of such quality that an accurate diagnosis can be made; and thirdly, that the image is interpreted correctly by a qualified individual.We will focus on the second of these three factors, addressing the problem of what is being done and what can be done in the future to assure that facilities can produce radiographs of consistently high quality.The importance of this facet of quality assurance is twofold: good quality increases the probability of accurate diagnoses and at the same time tends to reduce the patient's exposure to radiation. The subject of our discussion, then, will be those actions which can be taken to provide adequate confidence that a facility will consistently produce optimum diagnostic radiographs, at minimum cost and with minimum patient exposure. The ProblemThe need for quality assurance (QA) in diagnostic radiology becomes evident when the published data relating to the performance of diagnostic x -ray equipment are examined.While no single piece of data is conclusive in itself, the message that emerges from the overall picture is convincing. Further indication of the need for QA is demonstrated by the fact that several professional organizations and some x -rayrelated companies are moving to alleviate the problem. The Bureau of Radiological Health, FDA also recognizes the need and plans to be actively involved in identifying major items of concern and then participating in the development of programs to satisfy both the educational and performance aspects of the problem.