運用品管圈手法提升骨質密度分析正確率

Improved Accuracy Analysis of Bone Mineral Density Examination by the Use of Quality Control Circle Technique

杜家宏(Chia-Hung Tu) ； 吳文峯(Wen-Feng Wu) ； 趙敏(Max M. Chao)

《中華放射線技術學雜誌》 37卷1期 (2013/03) Pp. 22-30

摘要

骨質密度檢查（bone mineral density, BMD）是一種預防性的檢查與治療骨質疏鬆症的基礎。骨質密度檢查造成的分析錯誤主要來自於錯誤的操作方式與設備的故障，而本文的目的是利用品管圈（quality control circle, QCC）手法來提升骨質密度檢查分析的正確率。在品管圈活動前，從2011年3月至4月止共收集了786件骨質密度檢查，產生分析錯誤共有43 件。依品管圈手法分析前三項錯誤原因，一、分析錯誤（analysis error，2.3%），二、未知因素的影像傳輸錯誤（unspecified error，1.0%），三、骨密度數值比較影像錯誤（trend images error，0.8%）。經由品管圈成員討論後提出三項改善對策，包括：一、影像上傳之前由具經驗的操作放射師再進行影像品管，二、修訂操作流程及分析說明的提示衛教單，三、在職繼續教育及骨質密度執照考試。根據提出的三項對策施行並分成改善中及改善後兩階段進行數據收集。改善中數據收集從2011年7月至8月止，共630件骨質密度查，發生分析錯誤有21件。改善後數據收集從2011年9月至10月止，共778件骨質密度檢查，發生分析錯誤有17件。數據結果表示，analysis error 由改善前2.3%，下降至改善中1.4%及改善後1.3%。Unspecified error 由改善前1.0%，下降至改善中0.6%及改善後0.4%。Trend images error由改善前0.8%，下降至改善中0.5%及改善後0.1%。品管圈手法對於發現錯誤及提高正確率是一項很有用的工具。本文的結果表示，運用品管圈手法確實能夠降低骨質密度檢查的分析錯誤率。然而，放射師本身的技術與知識對於骨質密度檢查結果的表現也很重要，放射師可循參加繼續教育及證照考試的方式來提升操作儀器品質並作為證明。

關鍵字

品管圈 ； 骨質密度檢查 ； 骨質疏鬆症

並列摘要

Bone mineral density (BMD) is a preventive examination and the base of treatment of osteoporosis. BMD analysis errors produced are from operations and equipments. The purpose of this study is to examine the effect of quality control circle (QCC) technique on the accuracy analysis of BMD. Before QCC technique stated to use, there were 786 patients in BMD examination from March to April in 2011. Analysis errors occurred in 43 patients. According to QCC technique, 1) Data analysis error (2.3%), 2) Unspecified error (1.0%), 3) Trending image errors (0.8%). Three strategies were proposed after team discussion: 1) Double check of analysis data by the second Radiographer before uploading, 2) Updating of operating instruction, 3) Continuing medical education and license examination. Three of previously mentioned strategies were used in subsequent improving and improved stages. 630 patients in BMD examination were gathered at improved stage from July to August in 2011. Analysis errors occurred in 21 patients. 778 patients in BMD examination were gathered at improved stage from September to October in 2011. Analysis errors occurred in 17 patients. They were, according to QCC technique, 1) analysis errors (1.4% to 1.3%), 2) unspecified error (0.6% to 0.4%), 3) trend images error (0.5% to 0.1%). QCC technique was an useful tool to discover errors and improve the accuracy. This study showed QCC technique can actually decrease analysis errors. Moreover, Radiographer's technique and knowledge are crucial to the performance of BMD examination. Continuing medical education and licensure examination can be used as references for Radiographer's evaluation in the future.

並列關鍵字

Bone mineral density ； Quality control circle ； Osteoporosis