A 2-year comparative assessment of film reject analysis and economic implications at two hospitals in South-Western Nigeria

Abstract

Introduction: Quality assurance (QA) is indispensable to assure safety and quality in radiation medicine practices. This study performed an in-depth analysis of reject radiographic films to assess the contributory factors and the related implications as a form of audit. Materials and Methods: Data on radiographic films were obtained from the archives of two reputable hospitals in South-Western Nigeria. Information such as type of examination, reasons for rejection, film size and number of rejects were recorded on a purposely designed data collection form. The analysis of data was performed using Microsoft Excel 2016. Results: Reject analysis (RA) performed indicated 4.54% and 3.34% reject rates at Centre 1, and 8.94% and 5.55% reject rates at Centre 2 for 2016 and 2017, respectively. The major factors contributing to film reject at Centre 1 were found to be under-exposure, 21.13%; over-exposure, 20.07%; and fog, 21.30% in 2016 while in 2017, corresponding values were 20.87%, 16.69% and 16.86%. A similar trend was obtained at Centre 2 where the same factors accounted for reject rates at 20.60%, 25.13% and 18.59%, respectively, as above in 2016 and 24.29%, 26.91% and 17.07% in 2017. This study has shown a loss in yearly productive time of up to 150 working hours per machine. Conclusions: Repeating X-ray examinations engender wastage of time and finance as well as additional radiation exposures to the attendants. RA serves as a form of QA audit for monitoring and improving imaging services and the cost-effectiveness of diagnostic practice.