Rawle Marnie, Oliver Tanya, Pighills Alison, Lindsay Daniel
Medical Imaging Department, Mackay Base Hospital, Mackay, Queensland, Australia.
Medical Imaging Department, Redcliffe Hospital, Redcliffe, Queensland, Australia.
J Med Radiat Sci. 2017 Dec;64(4):244-250. doi: 10.1002/jmrs.229. Epub 2017 Apr 13.
X-ray Operator (XO) supervision in Queensland is performed by radiographers in a site removed from the XO site. This has historically been performed by telephone when the XO requires immediate help, as well as post-examination through radiographer review and the provision of written feedback on images produced. This project aimed to improve image quality through the provision of real-time support of XOs by the introduction of video conference (VC) supervision.
A 6-month pilot project compared image quality with and without VC supervision. VC equipment was installed in the X-ray room at two rural sites, as well as at the radiographer site, to enable visual and oral supervision. The VC unit enabled visualisation of the X-ray examination technique as it was being undertaken, as well as the images produced prior to transmission to the Picture Archiving and Communication System (PACS).
Statistically significant improvement in image quality criteria measures were seen for patient positioning (P = 0.008), image quality (P < 0.001) and diagnostic value (P < 0.001) of images taken during this project. No statistically significant differences were seen during case level assessment in the inclusion of only appropriate imaging (P = 0.06), and the inclusion of unacceptable imaging (P = 0.06), however improvements were seen in both of these criteria. The survey revealed 24.6% of examinations performed would normally have involved the XO contacting the radiographer for assistance, although, assistance was actually provided in 88.3% of examinations.
This project has demonstrated that significant improvement in image quality is achievable with VC supervision. A larger study with a control arm that did not receive direct supervision should be used to validate the findings of this study.
在昆士兰州，X射线操作员（XO）的监督工作由放射技师在远离XO工作地点的地方进行。从历史上看，当XO需要立即帮助时通过电话进行监督，并且在检查后通过放射技师审查以及对所生成图像提供书面反馈来进行监督。该项目旨在通过引入视频会议（VC）监督为XO提供实时支持，从而提高图像质量。
一个为期6个月的试点项目比较了有无VC监督时的图像质量。VC设备安装在两个农村地区的X射线室以及放射技师工作地点，以实现视觉和口头监督。VC设备能够在进行X射线检查技术操作时以及在图像传输到图像存档与通信系统（PACS）之前对所生成的图像进行可视化。
在该项目期间拍摄的图像中，患者体位（P = 0.008）、图像质量（P < 0.001）和诊断价值（P < 0.001）的图像质量标准测量有统计学上的显著改善。在病例水平评估中，仅纳入适当成像（P = 0.06）和纳入不可接受成像（P = 0.06）方面未发现统计学上的显著差异，不过在这两个标准方面都有改善。调查显示，所进行的检查中有24.6%通常会涉及XO联系放射技师寻求帮助，尽管实际上在88.3%的检查中提供了帮助。
该项目表明，通过VC监督可实现图像质量的显著改善。应该使用一个有未接受直接监督的对照组的更大规模研究来验证本研究的结果。
