TY - JOUR
T1 - The Effect of Image Review before Patient Discharge on Study Completeness and Sonographer Job Satisfaction in a Pediatric Echocardiographic Laboratory
AU - Johnson, J
AU - Robinson, J
AU - Young, L
AU - Camarda, J
PY - 2016/10/1
Y1 - 2016/10/1
N2 - Background Incomplete echocardiographic assessment accounts for approximately 10% of preventable diagnostic errors and may place children at risk for adverse outcomes or increased testing. The aim of this study was to determine if physician review of images improves study completeness. Methods A prospective quality improvement (QI) study initiated physician review of first-time echocardiographic studies for completeness before patient discharge. Studies were incomplete if not all anatomic structures were diagnostically demonstrated. QI examinations were compared with controls obtained before study initiation. Demographic and clinical information and duration of scan were collected during the control and QI periods. An anonymous survey was administered to the sonographers to assess perceptions of the intervention. Results There were no differences between the QI (n = 63) and control (n = 63) groups in age, height, weight, and technical barriers. After study completion, 35% of control scans versus 5% of QI scans were incomplete (P < .001). In the QI group, the sonographer, physician, or both returned to scan in 12 (19%), nine (14%), and two (3%) studies, respectively. QI studies were longer than control studies (44 vs 36 min, P = .003) before review. Physician review added a median of 6 min (range, 1–28 min). The majority of sonographers believed that immediate review improved communication, and 50% believed that it improved their job satisfaction. Conclusions Review of initial outpatient echocardiographic examinations before patient discharge significantly improves study completeness. Review adds a nominal amount of time to total study duration, improves sonographer-physician communication, and may prevent unnecessary testing, potentially reducing the cost of care.
AB - Background Incomplete echocardiographic assessment accounts for approximately 10% of preventable diagnostic errors and may place children at risk for adverse outcomes or increased testing. The aim of this study was to determine if physician review of images improves study completeness. Methods A prospective quality improvement (QI) study initiated physician review of first-time echocardiographic studies for completeness before patient discharge. Studies were incomplete if not all anatomic structures were diagnostically demonstrated. QI examinations were compared with controls obtained before study initiation. Demographic and clinical information and duration of scan were collected during the control and QI periods. An anonymous survey was administered to the sonographers to assess perceptions of the intervention. Results There were no differences between the QI (n = 63) and control (n = 63) groups in age, height, weight, and technical barriers. After study completion, 35% of control scans versus 5% of QI scans were incomplete (P < .001). In the QI group, the sonographer, physician, or both returned to scan in 12 (19%), nine (14%), and two (3%) studies, respectively. QI studies were longer than control studies (44 vs 36 min, P = .003) before review. Physician review added a median of 6 min (range, 1–28 min). The majority of sonographers believed that immediate review improved communication, and 50% believed that it improved their job satisfaction. Conclusions Review of initial outpatient echocardiographic examinations before patient discharge significantly improves study completeness. Review adds a nominal amount of time to total study duration, improves sonographer-physician communication, and may prevent unnecessary testing, potentially reducing the cost of care.
KW - Echocardiography
KW - Job satisfaction
KW - Pediatric
KW - Quality improvement
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U2 - 10.1016/j.echo.2016.07.005
DO - 10.1016/j.echo.2016.07.005
M3 - Article
C2 - 27544871
AN - SCOPUS:84994067407
VL - 29
SP - 1000
EP - 1005
JO - Journal of the American Society of Echocardiography
JF - Journal of the American Society of Echocardiography
SN - 0894-7317
IS - 10
ER -