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Minor finding Major finding Patient or study not entered correctly into electronic medical record (EMR) Patient name misspelled Incorrect examination type or number selected Wrong patient name printed on labels Patient date of birth missing Patient identification number (ID) missing or incorrect Order incorrect but not reordered or reentered Patient date of birth incorrect Order aborted but not cancelled in EMR Study entered on wrong date Dual study but second order not generated Multiple patients’ information in one record CT order not entered correctly in EMR Consent form missing or incomplete Patient history form incomplete Paperwork not scanned into PACS and not available for scanning Study forms or worksheets incomplete Wrong patient ID number entered in glucose meter Paperwork not scanned into PACS but still available for scanning Failure of on-call tech to notify on-call NM physician Minor finding Major finding Patient ID incorrect, name misspelled, or date of birth incorrect Radiopharmaceutical dose not within specified parameters Pharmacy labels not present, not initialed Resident/fellow radiopharmaceutical order not countersigned by staff physician/authorized user Wrong procedure code used Altered biodistribution due to incorrect radiopharmaceutical dosing Prescription for pharmacologic agent missing (furosemide, regadenoson, cholecystokinin) Altered biodistribution due to radiopharmaceutical quality control failure Pregnancy form incomplete Quality-management-program worksheet missing or incomplete Pediatric dose not verified Pregnancy test not performed Pregnancy form missing or incorrect Minor finding Major finding Missing labels: directional, study, view, image Patient identification missing or incorrect Study-specific parameters missing (e.g., time or % of gastric-emptying meal consumed) Dynamic study acquired incorrectly; flow study not done, missed, early, or late Processing forms or worksheets missing or incomplete Wrong collimator used; study not interpretable Date of study missing or incorrect Incorrect isotope window used; study not interpretable Region of interest too large, too small, or mislocated but does not cause incorrect interpretation Area of interest out of camera field of view (poor positioning) Generated data missing or not labeled correctly Region of interest too large, too small, or mislocated and causes incorrect interpretation Type of camera system not recorded on images Study processed incorrectly, with incorrect data or results Technologist initials missing from images Data incorrectly calculated (wrong formula used) Camera failure; patient moved to other system Incorrect notations: directional, study, view, image labels, if they contribute to incorrect study interpretation Restarting of camera or computer required Furosemide or cholecystokinin not administered at correct time Study modification not recorded (e.g., patient inability to comply) Equipment failure; study cannot be performed for patient who has been dosed Images acquired in wrong projection Minor finding Major finding Processing forms or worksheets missing or incomplete Patient fasting time inadequate Date of study missing or incorrect Patient glucose level too high (>200 mg/dL) Camera system used not recorded on images Acquisition incorrect: not imaged at 60 ± 10 min after radiopharmaceutical injection Technologist initials missing from images Wrong injection time, wrong dose, or wrong patient weight entered into SUV program Pharmacy label, or pharmacist or technologist initials, missing Contrast dose missing, incomplete, or incorrect Checklists missing or incomplete CT processed incorrectly or incompletely (field of view) Camera failure; patient moved to other system Maximum-intensity projection missing or not done Calendar year Studies reviewed (n) Findings identified (n) Frequency 2012 3,899 1,584 41% 2013 4,013 1,360 34% 2014 4,134 1,087 26% 2015 3,932 1,238 31% 2016 3,710 1,151 31% Month Cases reviewed (n) Unacceptable studies (≥1 major finding or >3 minor findings) Unacceptable studies Major findings Minor findings January 260 10 3.8% 10 66 February 335 18 5.3% 18 102 March 378 21 5.6% 19 126 April 336 27 8.0% 25 100 May 315 24 7.6% 24 84 June 286 29 10.1% 29 111 July 253 14 5.5% 13 69 August 395 29 7.3% 29 117 September 306 26 8.5% 26 104 October 326 21 6.4% 21 123 November 276 30 10.9% 31 68 December 244 28 11.5% 33 81 Annual 3,710 277 7.5% 278 1,151 Frequency of findings by year NM staff (n) 2012 2013 2014 2015 2016 New 1 NA NA NA 21.7% 20.4% 2 NA NA NA NA 30.1% 3 NA NA NA 30.4% 23.8% 4 NA NA NA 11.5% 10.5% 5 NA 30.6% 16.1% 7.9% 12.8% 6 NA 32.2% 16.9% 8.0% 12.8% 7 NA NA NA NA 32.9% 8 NA NA NA NA 18.2% Senior 9 22.1% 11.8% 9% 8.8% 9.7% 10 4.1% 0% 3.9% 2.8% 5.6% 11 32.2% 17.3% 14.4% 15.2% 11.7% 12 3.3% 1.8% 4.8% 4.9% 0% 13 32.5% 28.2% 15.7% 16.8% 18.2% 14 17.9% 14.8% 11.2% 10.5% 11.3% 15 38.7% 26.5% 21.3% 19.5% 27.1% 16 7.2% 4.1% 5% 9.2% 7.5% Mean 19.8% 13.1% 10.7% 11.0% 11.4% SD 13.9% 10.8% 6.2% 5.8% 8.2% NA = not applicable.
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