Congress:
EuroSafe Imaging 2021
Keywords:
Radioprotection / Radiation dose, Plain radiographic studies, Audit and standards, Quality assurance
Authors:
V. Tsapaki, M. Mikhail, O. PELLET, D. Paez, H. Delis
DOI:
10.26044/esi2021/ESI-14440
Methods or background
Clinical audit involves evaluation of data, documents and resources to check performance against standards. It is essentially a process of fact finding and interpretation and, as such, provides an efficient tool for improvement of quality (Figure 1). The QUAADRIL audit evaluates elements of diagnostic radiology practice related to staff, equipment, infrastructure, procedures, safety, overall facility performance, through comprehensive checklists and guidance on best practices (Figure 2). QUAADRIL refers to various applications of ionizing radiation in diagnostic radiology services, whether in public facilities or in private facilities. For the evaluation of other diagnostic modalities such as ultrasound or magnetic resonance imaging (MRI), the general audit structure and the principles, criteria and audit programmes for the various components of the clinical service can either be directly applied or be used as a basis for appropriate modification.
QUAADRIL is a voluntary audit which is not enforced by the IAEA but rather used for quality improvement by interested health institutions as an internal and external audit methodology. As a minimum, the audit team is at a minimum comprised by a radiologist, a diagnostic radiology medical physicist and a medical radiation technologist (radiographer). The IAEA trains auditors and encourages adoption of quality management through train-the-trainers courses. Recommendations generated by the audit team remain confidential to the health institution.
Therefore, QUAADRIL audits are not intended as:
(a) Regulatory inspections. The audit team must not assemble as an enforcing tool but exclusively as an independent source of advice on quality improvement.
(b) Investigation of accidents or reportable medical events. In the event of an investigation specifically into adverse events, a more focused audit is required.
(c) Assessment for entry into cooperative clinical research studies. These assessments are conducted by peers within the group involved in the study and are focused on the strict adherence of an institute to a single specified clinical protocol in a selected group of patients.
Finally, QUAADRIL does NOT provide accreditation but rather encourages adoption of a quality culture and constant improvement.