Title : Quality improvement project Improving the quality of radiographs taken in OMFS at Musgrove Park hospital Somerset NHS foundation trust
Abstract:
Aims: This quality improvement project aims to study aims to systematically improve the quality of intraoral and extra oral radiographs from June 2025 at Musgrove park hospital OMFS department for third molar surgery, localization of maxillary canines, supernumerary teeth and impacted teeth.
Methodology: In June 2025 using Plan, Do, Study, Act (PDSA) cycles and QI improvement methodology, we audited the quality of CBCTs, upper/lower standard occlusals, periapicals and lateral cephalograms taken in the OMFS outpatients department at Musgrove Park Hospital.
Over a 4 week period by reviewing radiographs taken and clinical notes taken from our electronic patient record PACs imaging software.
Two PDSA cycles were implemented in July and August 2025 respectively (1) Design of posters for the correct positioning of OPGs and display of educational posters, (2) Teaching sessions to dental nurses in the department hands on demonstrations were carried out including correct patient positioning when taking CBCTs, OPGs, upper standard occlusal radiographs and periapical radiographs. (3) Video tutorials and reading materials sent to nurses and clinicians in the department by email Data collection cycles followed each improvement cycle.
Results: PDSA 1: 80% of radiographs were diagnostically acceptable and 20% diagnostically unacceptable. 50% of CBCTs had radiographic faults of poor contrast or artefacts. Contrast problems emerged as the most prevalent issue, accounting for 90% of the cases. Other common problems included incorrect film positioning in 20% of OPGs and upper standard occlusal radiographs. Contrast problems emerged as the most prevalent issue, accounting for 90% of the cases. Other common problems included incorrect film positioning in 20% of OPGs and upper standard occlusal radiographs.
PDSA 2: 98% of radiographs taken were taken diagnostically acceptable and 2% were diagnostically unacceptable.
Conclusion: Contrast issues was shown to be the predominant concern affecting image quality. These findings highlight the critical importance of continuous quality improvement initiatives in radiographic practices to enhance diagnostic precision and ensure optimal patient care in oral and maxillofacial surgery.
