A patient-centred model to quality assure outputs from an echocardiography department: consensus guidance from the British Society of Echocardiography

Abstract

BackgroundQuality assurance (QA) of echocardiographic studies is vital to ensure that clinicians can act on findings of high quality to deliver excellent patient care. To date, there is a paucity of published guidance on how to perform this QA. The British Society of Echocardiography (BSE) has previously produced an Echocardiography Quality Framework (EQF) to assist departments with their QA processes. This article expands on the EQF with a structured yet versatile approach on how to analyse echocardiographic departments to ensure high-quality standards are met. In addition, a process is detailed for departments that are seeking to demonstrate to external bodies adherence to a robust QA process.MethodsThe EQF consists of four domains. These include assessment of Echo Quality (including study acquisition and report generation); Reproducibility & Consistency (including analysis of individual variability when compared to the group and focused clinical audit), Education & Training (for all providers and service users) and Customer & Staff Satisfaction (of both service users and patients/their carers). Examples of what could be done in each of these areas are presented. Furthermore, evidence of participation in each domain is categorised against a red, amber or green rating: with an amber or green rating signifying that a quantifiable level of engagement in that aspect of QA has been achieved.ConclusionThe proposed EQF is a powerful tool that focuses the limited time available for departmental QA on areas of practice where a change in patient experience or outcome is most likely to occur.

The Echocardiography Quality Framework: a comprehensive, patient-centered approach to quality assurance and continuous service improvement

“…This is described in detail by Ingram et al . ( 1 ). The framework provides the philosophy and structure of the program (effectively, the contents page of the EQF ‘instruction manual’), with each domain being underpinned by examples of practice that can be used or adapted by others (effectively, the chapters of the instruction manual).…”

“…Each EQF quadrant and domain is described below along with the principles of assessment and delivery. A program of implementation, including sample protocols and score sheets has been developed and are presented elsewhere ( 1 ).…”

“…With local modifications or improvements where required, it should be possible to implement it in any hospital-based echocardiography department, regardless of size. Guidance on the frequency of EQF activity and linkage to the BSE Departmental Accreditation process has been developed by the BSE Clinical Standards Committee and are described in detail elsewhere (in this issue) ( 1 ).…”

“…A framework outlining the recommended frequency and duration of each domain has been developed by BSE and is described in detail by Ingram et al . ( 1 ).…”

British Society of Echocardiography Departmental Accreditation Standards 2019 with input from the Intensive Care Society

“…Although accredited departments will need to demonstrate a high-quality service through adherence to these standards, the departmental accreditation application is intended to be supportive and non-judgemental. The departmental accreditation process is separate but linked with the British Society of Echocardiography (BSE) echo quality framework (EQF), in that departments seeking accreditation are expected to participate in the EQF (1). For the first time, the BSE has also incorporated departmental accreditation standards for emergency echocardiography which have been developed in association with the Intensive Care Society (ICS).…”