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.