Quality Improvement Implementation: Improving Reproducibility in the Echocardiography Laboratory

Daubert, Melissa A.; Yow, Eric; Barnhart, Huiman X.; Rabineau, Dawn; Crowley, Anna Lisa; Douglas, Pamela S.

doi:10.1016/j.echo.2015.03.004

Cited by 42 publications

(33 citation statements)

References 26 publications

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“…We offer our process for QI as an example for others who may wish to apply for IAC accreditation or reaccreditation. Our results also support the very recent publication from Duke Medical Center on their experience with QI reviews and show usefulness of similar approaches in the very large clinical practice …”

Section: Discussionsupporting

confidence: 89%

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Development and Implementation of a Quality Improvement Process for Echocardiographic Laboratory Accreditation

et al. 2016

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We describe our process for quality improvement (QI) for a 3-year accreditation cycle in echocardiography by the Intersocietal Accreditation Commission (IAC) for a large group practice. Echocardiographic laboratory accreditation by the IAC was introduced in 1996, which is not required but could impact reimbursement. To ensure high-quality patient care and community recognition as a facility committed to providing high-quality echocardiographic services, we applied for IAC accreditation in 2010. Currently, there is little published data regarding the IAC process to meet echocardiography standards. We describe our approach for developing a multicampus QI process for echocardiographic laboratory accreditation during the 3-year cycle of accreditation by the IAC. We developed a quarterly review assessing (1) the variability of the interpretations, (2) the quality of the examinations, (3) a correlation of echocardiographic studies with other imaging modalities, (4) the timely completion of reports, (5) procedure volume, (6) maintenance of Continuing Medical Education credits by faculty, and (7) meeting Appropriate Use Criteria. We developed and implemented a multicampus process for QI during the 3-year accreditation cycle by the IAC for Echocardiography. We documented both the process and the achievement of those metrics by the Echocardiography Laboratories at the Ochsner Medical Institutions. We found the QI process using IAC standards to be a continuous educational experience for our Echocardiography Laboratory physicians and staff. We offer our process as an example and guide for other echocardiography laboratories who wish to apply for such accreditation or reaccreditation.

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Section: Discussionsupporting

confidence: 89%

“…Our results also support the very recent publication from Duke Medical Center on their experience with QI reviews and show usefulness of similar approaches in the very large clinical practice. 23…”

Section: Discussionmentioning

confidence: 99%

Development and Implementation of a Quality Improvement Process for Echocardiographic Laboratory Accreditation

et al. 2016

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“…There has been little research into practice variation in image acquisition in pediatric echocardiography. More attention has been paid to differences in reporting, where quality improvement methodologies have been shown to decrease variation, especially with regard to quantitative reporting of function . While the variety of congenital heart disease means that image acquisition often needs to be individually tailored, standards have been developed for a complete structural diagnostic assessment as well as for some individual lesions .…”

Section: Resultsmentioning

confidence: 99%

A standardized imaging protocol improves quality and reduces practice variability in echocardiographic assessment of ventricular function by first‐year pediatric cardiology fellows

White

Rogers

et al. 2019

Echocardiography

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Background Echocardiography education for pediatric cardiology fellows has been a recent focus leading to the implementation of “boot camps.” Less is described about continuing education through fellowship and improving image quality. We noticed practice variation in echocardiograms assessing ventricular function performed on nights and weekends. Thus, we implemented a standardized protocol and assessed its impact on imaging and reporting completeness. Methods We created an imaging protocol for the assessment of ventricular function in the acute setting. The protocol included demographic information, a list of images to be obtained, and the methods to quantify ventricular function. The protocol was explained to first‐year fellows and distributed on an electronic quick reference card. Echocardiograms independently performed by first‐year fellows during their first 4 months of on‐call time were assessed pre‐ and postintervention using a standard rubric. Results Compliance with demographic reporting was high pre‐ and postintervention, but significantly improved after the standardized protocol (P < 0.001). Use of the protocol increased the median number of unique images obtained per echocardiogram from 13 to 17 (out of 23 required views, P < 0.001). Particularly improved was the performance of quantitative evaluations of function, including Simpson's method for left ventricular ejection fraction (four chamber: 40% vs 67%, P < 0.001; two chamber: 33% vs 67%, P < 0.001) and tricuspid annular plane systolic excursion (45% vs 80%, P < 0.001). Conclusions The introduction of a standardized imaging protocol and its distribution to first‐year fellows resulted in improvements in echocardiographic reporting completeness and increased the quality of information obtained by providing more quantitative assessments of ventricular function.

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“…54,55 Fanari et al 55 demonstrated that this intervention improved the correlation between echo-and catheter-based LVEF from 85% to 88% (P<0.001), although catheter-based LVEF has inherent limitations as a comparator. In summary, improved reproducibility of visually estimated LVEF can be achieved by teaching intervention, individual feedback, review of reasons for misclassification/errors coupled with review of reference images.…”

Section: Left and Right Ventricular Systolic Functionmentioning

confidence: 99%

Improving Appropriateness and Quality in Cardiovascular Imaging

Bhattacharyya

Lloyd

2015

Circ: Cardiovascular Imaging

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Abstract-High-quality cardiovascular imaging requires a structured process to ensure appropriate patient selection, accurate and reproducible data acquisition, and timely reporting which answers clinical questions and improves patient outcomes. Several guidelines provide frameworks to assess quality. This article reviews interventions to improve quality in cardiovascular imaging, including methods to reduce inappropriate testing, improve accuracy, reduce interobserver variability, and reduce diagnostic and reporting errors. (Circ Cardiovasc Imaging. 2015;8:e003988.

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Quality Improvement Implementation: Improving Reproducibility in the Echocardiography Laboratory

Cited by 42 publications

References 26 publications

Development and Implementation of a Quality Improvement Process for Echocardiographic Laboratory Accreditation

Development and Implementation of a Quality Improvement Process for Echocardiographic Laboratory Accreditation

A standardized imaging protocol improves quality and reduces practice variability in echocardiographic assessment of ventricular function by first‐year pediatric cardiology fellows

Improving Appropriateness and Quality in Cardiovascular Imaging

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