Gambaran pemakaian film pada computed radiography sebagai upaya efisiensi dan meningkatkan layanan kesehatan

Abstract

Background: Radiology services play a crucial role in providing accurate diagnostic information, and the quality of radiographic images is fundamental to a successful diagnosis. One indicator of service quality is the film rejection rate, which is the rate of images that must be redone due to inadequate quality. Although advances in Computed Radiography (CR) technology offer advantages over conventional systems, rejections continue to occur, primarily due to human error, technical factors, mechanical errors, and administrative errors. Ministry of Health standards stipulate a tolerance of ≤ 2%, therefore, analyzing the factors causing film rejection is crucial to maintaining the quality of radiology services, reducing excessive radiation exposure, and improving patient safety through the implementation of Quality Assurance and Quality Control.

Purpose: To identify and describe the use of radiographic film in Computed Radiography (CR) systems as an efficiency measure to improve healthcare services.

Method: The study was conducted from January to March 2025 at the Radiology Department of Siloam Sriwijaya Hospital in Palembang, with a sample size of 165 rejected films. The study used a quantitative descriptive design, with data obtained through documentation of reject film logs, observations of the radiographic examination process, and questionnaires distributed to radiographers. Descriptive analysis was conducted by calculating the percentage of rejects and categorizing the contributing factors.

Results: During January–March 2025, there were 9,127 film uses, with a total of 165 reject cases (average 1.80%). The breakdown was 39 cases (1.27%) in January, 62 cases (1.68%) in February, and 64 cases (2.68%) in March.

Conclusion: Film usage during the January–March 2025 period showed that the film rejection rate remained within the average tolerance limit of ≤ 2%, as per the Ministry of Health standards. The dominant factors causing rejection were human error in the form of incorrect patient positioning, inappropriate exposure factor selection, patient movement, and double exposure cases, along with administrative errors in the form of duplicate printing for BPJS patients. Other technical factors, such as artifacts and mechanical errors, were found at a lower frequency but still impacted the quality of radiology services.

Suggestion: Improve the competence of radiographers through ongoing training and strengthened patient communication, routine maintenance of Computed Radiography (CR) equipment, and administrative oversight, particularly to prevent duplicate printing for BPJS patients, with the support of a digital system and the implementation of Quality Assurance and Quality Control. Furthermore, routine reject analysis should be conducted to ensure the film rejection rate remains within standard limits.

Keywords: Computed radiography; Human error; Healthcare; Radiograph film rejection

Pendahuluan: Pelayanan radiologi berperan penting dalam menyediakan informasi diagnostik yang akurat, kualitas citra radiografi menjadi faktor fundamental bagi keberhasilan diagnosis. Salah satu indikator mutu pelayanan adalah angka reject film, yaitu citra yang harus diulang akibat kualitas tidak memadai. Meskipun perkembangan teknologi Computed Radiography (CR) memberikan keunggulan dibanding sistem konvensional, kasus reject tetap ditemukan, terutama akibat human error, disertai faktor teknis, mechanical error, serta kesalahan administratif. Standar Kementerian Kesehatan menetapkan toleransi ≤2%, sehingga analisis terhadap faktor penyebab reject film menjadi penting untuk menjaga mutu pelayanan radiologi, menekan paparan radiasi berlebih, dan meningkatkan keselamatan pasien melalui penerapan Quality Assurance dan Quality Control.

Tujuan: Mengidentifikasi dan memberikan gambaran pemakaian film radiograf pada sistem Computed Radiography (CR) sebagai upaya efisiensi dalam meningkatkan pelayanan kesehatan.

Metode: Kegiatan dilaksanakan pada periode Januari–Maret 2025 di Instalasi Radiologi Rumah Sakit Siloam Sriwijaya Palembang dengan jumlah sampel 165 reject film. Penelitian menggunakan desain deskriptif kuantitatif, data diperoleh melalui dokumentasi log reject film, observasi proses pemeriksaan radiografi, serta penyebaran kuisioner kepada radiografer. Analisis dilakukan secara deskriptif dengan menghitung persentase reject dan mengkategorikan faktor penyebabnya.

Hasil: Selama Januari–Maret 2025 terdapat 9,127 pemakaian film dengan total 165 kasus reject film (rata-rata 1.80%). Rinciannya adalah 39 kasus (1.27%) pada Januari, 62 kasus (1.68%) pada Februari, dan 64 kasus (2.68%) pada Maret.

Simpulan: Pemakaian film selama periode Januari–Maret 2025 menunjukkan bahwa angka reject film masih berada dalam batas toleransi rata-rata ≤ 2% sesuai standar Kementerian Kesehatan. Faktor dominan penyebab reject adalah human error berupa kesalahan pemosisian pasien, pemilihan faktor eksposi yang tidak tepat, pergerakan pasien, serta kasus double exposure, disertai kontribusi kesalahan administratif berupa pencetakan ganda pada pasien BPJS. Faktor teknis lain seperti artefak dan mechanical error ditemukan dengan frekuensi lebih rendah, namun tetap berpengaruh terhadap mutu pelayanan radiologi.

Saran: Perlunya peningkatan kompetensi radiografer melalui pelatihan berkelanjutan dan penguatan komunikasi dengan pasien, pemeliharaan rutin peralatan Computed Radiography (CR), serta pengawasan administratif khususnya pencegahan pencetakan ganda pasien BPJS, dengan dukungan sistem digital dan penerapan Quality Assurance serta Quality Control. Selain itu lakukan reject analysis rutin agar angka reject film tetap dalam batas standar.