Imaging Center Daily Operations Checklist

An outpatient imaging center is a scheduling business built around equipment that cannot be rushed. A single MRI suite might run twenty patients a day in fixed slots, and one scan that runs twenty minutes long pushes every patient after it.

It is also a facility with a genuine safety hazard that most healthcare settings do not have. The MRI magnet is always on, including overnight, including during a power failure, and a ferromagnetic object brought into zone four becomes a projectile.

The routine here serves three purposes at once: patient safety, image quality, and a schedule that holds.

Opening

• Unlock and disarm the alarm
• Confirm the facility is at temperature and humidity within equipment specification
• Confirm all modalities powered and completed their startup
• Confirm PACS and RIS systems are online and communicating
• Confirm the scheduling system reflects today's list
• Confirm the interface to referring providers is functional
• Review today's schedule for contrast studies, sedation, and complex cases
• Confirm staffing against the schedule including technologist coverage
• Confirm the radiologist's coverage and read turnaround expectations

The system check is the one that stops a whole day when skipped. A PACS connection down at 7 a.m. means images that cannot be read, and it is much easier to solve before the first patient than after six.

Equipment Quality Control

Each modality has manufacturer and accreditation-required daily checks.

• Perform the daily quality control on each modality
• Confirm the phantom images meet the acceptance criteria
• Record all quality control results
• Confirm calibration status is current
• Confirm no error codes or faults are present
• Confirm coil and detector function
• Report any failed quality control before scanning patients
• Do not scan on a modality that failed quality control

Quality control failures are a stop, not a note. An accreditation body reviewing records will look at whether scanning continued after a failed check.

MRI Safety Zones

This is the discipline that defines an MRI facility.

• Confirm zone boundaries are marked and doors are secured
• Confirm zone three and four access is restricted and controlled
• Confirm the ferromagnetic detection system is functional
• Confirm no unscreened person can reach zone four
• Confirm the emergency quench procedure is posted and understood
• Confirm the oxygen monitor is functional
• Confirm no ferrous equipment has entered the magnet room
• Confirm cleaning and maintenance staff have been screened and escorted

Everyone entering zone four is screened, including staff, including the person who has worked there for six years, including facilities and cleaning personnel. The incidents in this field almost always involve someone who was not screened because they were not a patient.

Patient Screening

• Verify patient identity with two identifiers
• Confirm the order matches the study to be performed
• Confirm the correct body part and laterality
• Complete the MRI safety screening questionnaire
• Screen for implants, devices, and prior surgeries
• Verify implant conditions and MR compatibility documentation
• Screen for metal fragments in occupational or injury history
• Confirm pregnancy screening per policy
• Confirm the patient has removed all metal and personal items
• Confirm the patient understands the procedure and duration

Implant screening is the item that requires actual verification, not a patient's recollection. Device cards, operative reports, and manufacturer conditions are checked, not assumed.

Contrast Studies

• Confirm the order specifies contrast and the agent
• Confirm allergy history and prior contrast reactions
• Confirm renal function values are within protocol where required
• Confirm the patient meets the screening criteria
• Confirm informed consent per policy
• Confirm IV access is established and patent
• Confirm the injector is loaded correctly and purged of air
• Confirm the emergency response supplies and medications are available
• Monitor the patient during and after injection
• Document the agent, dose, lot, and site

Contrast reaction supplies are checked daily, and the crash cart is checked and logged. The one time it is needed, it is needed immediately.

Scanning

• Confirm the correct protocol for the indication
• Position the patient correctly and comfortably
• Confirm coil placement and selection
• Provide hearing protection for MRI
• Provide the call bell and confirm the patient can use it
• Maintain visual and audio contact throughout
• Confirm image quality on each sequence before moving on
• Repeat any sequence with motion or artifact before the patient leaves
• Confirm all required sequences and views are complete

Checking image quality before the patient gets off the table is the difference between a repeat sequence and a recalled patient. Recalls cost a slot, an apology, and the referring provider's confidence.

Radiation Safety

For modalities using ionizing radiation.

• Confirm the technique is appropriate to the patient's size
• Apply the lowest dose consistent with diagnostic quality
• Confirm shielding is used where appropriate
• Confirm dose is recorded per requirement
• Confirm personnel dosimeters are worn and exchanged on schedule
• Confirm no one remains in the room during exposure without protection
• Confirm the pregnancy screening was completed

Image Handling

• Confirm images transfer to PACS completely
• Confirm patient demographics are correct on every study
• Confirm the study is associated with the correct order
• Confirm prior studies are available for comparison
• Confirm the study is routed to the correct reading queue
• Flag urgent findings per the critical results policy
• Confirm the technologist's notes are attached

A study filed under the wrong patient is a serious patient safety event and it is entirely preventable with two identifiers at every step.

Between Patients

• Clean and disinfect the table and all contact surfaces
• Change linens
• Clean and disinfect coils and positioning devices
• Confirm the room is reset for the next protocol
• Confirm the schedule is on time and communicate any delay
• Update the waiting patient about a delay before they ask

Telling a waiting patient about a fifteen-minute delay before they notice it is the difference between a small inconvenience and a complaint.

Front Desk

• Verify insurance and authorization before the study
• Confirm the order and referring provider information
• Collect and document consent forms
• Collect payment or copay per policy
• Confirm the patient's contact information for results
• Confirm patients are informed of preparation requirements before arrival
• Manage the waiting area and communicate delays

Authorization verified after a scan is performed is a scan that may not be paid for. It happens in front, before, or the center absorbs the cost.

Closing

• Confirm all studies are complete, transferred, and routed
• Confirm all critical findings were communicated and documented
• Confirm no patient is left unaccounted for
• Complete the end-of-day quality control where required
• Clean and disinfect all rooms
• Restock supplies, contrast, and linens
• Confirm the crash cart is sealed and in date
• Confirm all patient records are secured
• Confirm zone access is secured
• Confirm the magnet room is locked and access is restricted overnight
• Set the alarm

The magnet room stays locked overnight because the magnet stays on overnight. Cleaning crews and contractors are the most common cause of a projectile incident.

Weekly and Monthly

• Perform the weekly and monthly quality control per modality
• Confirm accreditation requirements are documented and current
• Confirm all technologist certifications and licenses are current
• Confirm all staff have completed MRI safety training
• Review repeat and reject rates by technologist and modality
• Review report turnaround times
• Review schedule adherence and slot utilization
• Confirm preventive maintenance is on schedule
• Confirm dosimetry reports are reviewed
• Review any safety event or near miss

Repeat rate is the technical quality metric that matters. A technologist with a repeat rate well above the group is either positioning inconsistently or working with equipment that needs attention, and both are fixable once seen.

How MyTeamTasks Helps

A center with three modalities and multiple technologists cannot verify from the front office that daily quality control was completed on every unit before the first patient. A shared task system assigns the quality control, screening, and cleaning routines per modality with timestamps and required entries, and blocks a modality from being marked ready until its checks pass. When an accreditation survey asks for the daily record, it exists as a continuous history with names attached rather than as a binder filled in the week before.