Quality improvement related to radiation safety chest radiography in the NICU.

Discussion includes radiation safety and radiographic quality management, continual quality improvement processes, and management review over a three year period. The results of radiation safety and radiographic quality audits conducted on random samples of chest radiographs are included. Specific measures and improvement strategies are presented as they relate to "babygrams" patient positioning, shielding, collimation, exposure technique, exposure index, and patient holding by NICU staff. Discussion of the change management process related to physician ordering, radiologic technologist training, and interdepartmental collaboration and team building.