A film reject analysis at two radiology departments in Nairobi

Abstract

Repeat films may be necessary if the preceding film is of poor quality or if the film does not provide the desired radiographic criteria for diagnosis. The rate of repeat films is variable in different institutions as reviewed in the study. It is desirable to reduce the repeat of film sand hence the exposure to unnecessary radiation and also the cost of the service. Between March and September 1992, a total of 4723 rejected films representing various types of radiologic examination were collected from Kenyatta National Hospital and the Agha Khan Hospital. The types of films and causes of repeats were analyzed. It was found that of all the films studied, the overall reject rate was 3.1% for the Agakhan hospital and 5.9% for Kerry at.t.a National hospital. The computer tomography film reject rate is 3.24% of all computer tomography films used and 1.79% for ultrasound films to number of films consumed. The chest radiographs were the most frequently repeated with 28.5% films from KNH and 18.6% from AKH. The reason for this may be due to the fact that chest radiographs are the most frequently performed examinations. The 18x24cm film size is the most frequently rejected at KNH with 27.8% while 24x30cm at AKH accounted for 34%. The exposure factors (42.2%) and positioning 23.3% were found to be the main reasons for retake radiographs. The overall repeat rates were 5.93% for Kenyatta National Hospital and 3.14% for Agha khan Hospital. Of the total number of films used the CT film and ultrasound film and 18x20cm film size were encountered only at the Agha khan hospital at the time of the study. The retake rates were within those reported in literature. The higher figures for Kenyatta National hospital as compared to that of Agha khan hospital may be explained by .- (1) Recirculating of processor chemicals and lack of good quality control program as evidenced by the low number of test films. (2) The hospital characteristics I Agha Khan hospital being a private hospital where cost is of utmost importance hence stringent measures to reduce wastage. (3) Number of employees. Time to time study of retakes to review constantly the patterns of retakes with an aim of reducing them I saving on the cost and subsequent reduction of radiation to the general population is recommended.