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In an accessible location and shall be retained for as long a time as space permits or local ordinances may require. 2. All studies removed from the file shall be signed out by the responsible physician or other authorized person and a record of the transaction shall be kept until the study is returned. 3. No study shall be removed from the department until a t least a provisional interpretation has been rendered. 4. If images are removed from the department, it should be for a limited time period, and mechanisms of retrieval should be available.

4. Reports shall be delivered or mailed as soon as they are signed. 5. The time at which the completed report is dispatched from the facility and the method of delivery should be recorded. Comment: 1. The operation of this aspect of the imaging facility function is variable, and the same policies may not apply in all facilities. The intent is to perform each of the several steps in report preparation as quickly as possible after the completion of the previous step. 2. A major problem in this aspect of facility function is the tendency to "batch" the records, which defeats the objective of prompt report distribution.

EXAMPLE I Procedure: Patient positioning for an imaging study Objective: To ensure that the radiographs record the requested anatomy in'the requested projection. Comment: Poor positioning may exclude critical anatomic detail from the radiograph or, by projecting it in a nonstandard way, may make interpretations uncertain and comparison with previous radiographs difficult. This is one of the most common reasons for repeating a radiograph. Poor positioning, therefore, often results in unnecessary patient irradiation, and, in some instances, improper diagnosis.

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