James R. Halama PhD, Medical Physicist David A. Urani MBA, CNMT, Manager

1. A Program for Paperless Recording of Routine Nuclear Medicine Equipment Quality Control Results James R. Halama PhD, Medical Physicist David A. Urani MBA, CNMT, Manager Rebecca A. Sajdak BA, CNMT, Sr. Technologist Robert H. Wagner MD

2. Project Purpose and Aim To Eliminate the use of Paper Logs and Ensure the Timely Completion of QC Tests The AIM of this project is to develop a database program to store the results from many routine tests into a single on-line database eliminating the use of paper logs. Integrating results into a single Microsoft Access Programhas the advantage that supervisors and physicists may systematically review and track test results to ensure proper camera performance and that those tests are completed in a timely manner. "Confidential: Quality Improvement Material"

3. Background Statement A Nuclear Medicine Gamma Camera quality control program has many routine tests, regularly assessing gamma camera uniformity, spatial resolution and linearity, SPECT uniformity and Center of Rotation (COR), spatial and contrast resolution. A Microsoft Access program was developed to store all test results from all camera systems into a single online database eliminating the use of paper logs. Recording camera operating problems and downtime has also been added. Because proper camera performance is so important to a successful Nuclear Medicine Department. "Confidential: Quality Improvement Material"

4. Solutions Implemented The Microsoft Access Program Improves Our Ability: • To Audit Test Frequency • To Review Prior Test Results & Specifications • To Quickly Access the QC Procedure Manual • To Record Equipment Operating Problems & Downtime • To Ensure Proper Equipment Performance and Tests are Completed According to Schedule "Confidential: Quality Improvement Material"

5. Results • Our SPECT QC Compliance has greatly improved and it also has greatly organized the Quality Control Protocols for our busy department. • The comprehensive review function allows the technologist to easily determine whether a less frequently performed test needs to be completed. • This is also very convenient for review by outside accreditations and inspections by the Joint Commission.  • "Confidential: Quality Improvement Material"

6. Gamma Camera QC Main Screen

7. Daily QC Example

8. Hyperlinks to Procedure Manual

9. Center-of-Rotation Example

10. SPECT Phantom Review Screen

11. Monitoring Camera Performance • IU Index – Camera sensitivity variation to radiation across the imaging detector. • Uniformity test is performed every day before the gamma camera is used for patient imaging begins. • If the IU Index exceeds the warning level for two consecutive days, further evaluation is required before patients can be imaged.

12. SPECT QA Testing Compliance • SPECT – Gamma camera tomographic acquisition. • Center-of-rotation validation acquired monthly on five gamma cameras. • SPECT phantom acquisition acquired quarterly on five gamma cameras.

13. Analysis • We have already reached our goal of “going green” paperless program. • We can easily track equipment downtime operating problems. Being able to report downtime is very important when making decisions on major equipment purchases, buying service contract, and • We have improved compliance to 100% on SPECT QC testing and have identified tasks where we were over performing. Our records for Quality Control are up to date. "Confidential: Quality Improvement Material"

14. Next Steps • The program has been well received by the Nuclear Medicine Staff so a next step might be to incorporate clinical protocols onto an electronic database. • Further study actions would be to expand the program to the other modalities in the Radiology Departments. "Confidential: Quality Improvement Material"