Before the Mammography Quality Standard Act was set up, there were many problems in the quality control process of mammographic equipment. Additionally, it was difficult to train mammography technologists to perform quality mammograms on patients, and inconsistencies in the system led to technicians performing suboptimal mammograms.
Therefore, to improve early breast cancer diagnosis, it was important to work on image resolution. Hence, the MQSA standards were set, and proper documentation was formed for everyone working in the mammography facility, including:
- requirements for equipment
- quality control
- CE credits in both education and experience for mammography technologists, etc.
Certainly, these requirements are inspected by the MQSA inspector, and as a result, the facility is certified for providing quality mammography services to citizens. In this article, we will discuss the MQSA inspection checklist in detail to help you prepare for the evaluation day.
The Mammography Quality Standards Act (MQSA) was passed in 1992 by congress in order to achieve standard mammography quality across the nation. The decision was made to:
- implement quality mammography services for patients
- help in early breast cancer detection
The MQSA has been amended twice, taking into consideration the impact of setting up the requirement standards. Currently, the final amendment has detailed requirements for:
- Employees: For example, the people who interpret mammograms, mammography techs, radio techs, physicists, etc. concerning their education, experience, and CE credits
- Medical Audits: It is important for mammography facilities to have a system in order to follow up the obtained biopsy results
- Quality Control and Recordkeeping: Facilities should always keep a record of their activities; certain records are required at the time of inspection
Above all, it is mandatory for facilities to get their MQSA certification in order to offer any mammography service to citizens. The facilities get certification only if they are able to comply with the MQSA requirements. If the facility fails to qualify the inspection, it has to stop providing all mammography services. Moreover, they have to regain their certificate by implementing the changes suggested by the inspector. Additionally, it is compulsory for facilities to display the valid certificate copy from the MQSA, and it must be easily visible to customers.
Who gets MQSA certified?
There is a general confusion that stays with radiologic and mammography technologists. You, as a mammography technologist or a radiologic technologist, do not get certified under the Mammography Quality Standard Act. The facility that you work in gets the certification to offer mammography services. Moreover, it is illegal to perform mammograms on people without a valid Mammography Quality Standard Act accreditation; however, it is mandatory for you as a tech to comply with the requirements set for you. You are responsible for the image resolution and comprehension of the mammograms; therefore, you will need to comply with the CE credits and the experience credits. Failure to fulfil these requirements will impact the certification for the facility.
The Inspection Checklist
The MQSA inspector informs the facility well in advance about the inspection date and time. The facility needs to prepare in such a way as to still be able to provide services to patients. The inspector will need approximately 20 minutes in each mammography unit to evaluate the mammogram. The following is a checklist for you to crosscheck your preparations for the inspection day.
- Keep records of every activity that you perform
- Document all the information
- Keep ample space ready for the inspector to view the documents undisrupted
- All other inspection reports that are conducted by the state within the last and the current MQSA inspection period
- Safety Survey Reports of the equipment
- Record retention policy
- State registration documents upholding the present name, contact, and owner details
- Availability of all the required protective shields for employees and equipment
- Display all records; the inspector will select any 5 of his choice
- Keep a medical record log that will help track positive results
- Have letter samples to depict the use of easy language in result demonstration
- Documentation to ensure that the physicians review all the reposts
- EQUIP reports
- Ensure that all the monitors and QC manuals are updated to the latest versions
- Put forward all the QC manuals and QC tests of all the monitors (on-site and off-site) used since the last inspections
- Ensure that the information is the same in the QC forms as it is in the one filed in the monitor software
- Provide Medical Equipment Evaluation reports about all the units, new and old
- Provide reports about the evaluation of the mamo unit after the replacement of any part.
Plan of Action Manual
- Display the technique chart
- Provide detailed information on the responsibilities associated with the role of every employee
- Keep records of service and operator manuals of all mamo units
- Keep physicist reports
- Keep meeting minutes of the quality assurance meetings held at the facility to improve the service quality
Credential Requirements for Employees
On-site and Off-site Medical Physicists
- Degree certificate, 20 hours per semester in physics, 20 contact hours in mammography surveys
- Should have survey 1 facility and 10 units or an FDA approval letter
- Unexpired State Approval / License
- 2-D and 3-D initial training – 8 CEU’s (only applicable if your facility uses the same)
Continuing Education / Experience Requirements
- 15 CEUs in 3 years
- Should have maintained a record of surveying at least 2 facilities and 6 units in 24 months
- Copy of the 40 hours of training and the ARRT R card
- Have supervised 25 mammograms
- 8 CE units of the 2-D and 3-D training (if used in your facility)
Continuing Education / Experience
- Copy of a valid MD license and ABR
- 3 months of training and 60 CMEs (if qualified after 4/28/99)
- 40 CMEs and 2 months of training
- Should have supervised 240 readings within a period of 6 months
- 8 CEUs in 2-D and 3-D initial training (only applicable if your facility uses them)
Continuing Education / Experience
- Should have given readings of at least 960 mammograms in 2 years
- Should have earned 15 Continuing Education Units in 3 years
- Additionally, the CEUs must be in category 1
MQSA inspection is an annual affair, which aims to maintain a standard quality of mammography services around the country. The evaluation is complete only with the exit interview that the inspector gives. The inspector might inform you about the deficiencies during the exit interview or you may receive an email containing the result of the inspection.