Breast imaging boot camp: A mammography quality improvement initiative.

Abstract

138 Background: In mammography, compression, and positioning are key quality factors. ACR standards suggest that compression should ensure that a breast is taut (drawn tight with no slack). In environmental scans, semi-structured interviews with cross discipline providers from Chicago mammography facilities, we found wide variation in radiology technologist’s understanding of standard compression and views. Optimal compression was reported from 12-45 lbs and some sites reported that four views are taken regardless of breast size. This discovery led to a mammography technologist training program as a quality improvement intervention. Methods: The Chicago Breast Cancer Quality Consortium contracted with Louise Miller, AART, CRT, and RTRM to lead a Breast Imaging Boot Camp and partnered with 4 hospitals to carry out the training. There were three components of the boot camp: a 1-day seminar for all mammography technologists, 1 day of hands on training for a limited number of techs and a train the trainer component where selected techs went through a 3-day intensive program with the goal of preparing them to provide ongoing education to the Chicago mam-tech community. A preliminary tool was developed and used randomly by radiologists during the training to examine the amount of tissue in the image from one year to the next, the presence or absence of an Inter-mammary fold and cleavage. Results: More than 120 radiology technologists attended a day-long seminar, 10 received hands on training, 4 of the 10 were trained to be future trainers. Participants rated their overall impression of the day-long seminar between 4 and 5 on a 5-point scale. During the hands-on training, radiologists assessing the images commented on significant improvements in image quality from the previous year’s mammogram. A quantitative evaluation process has been developed to examine the efficacy of the training and measure impact on mammography quality. This evaluation involves a 3 month and 1-year assessment that will take place in September of 2012 and again in May of 2013. Results of first evaluation will be available for presentation. Conclusions: Results from the evaluation will help review effectiveness of technologists post-training techniques and identify areas to improve.