A Real-World Experience: Retrospective Review of Point-of-Care Ultrasound Utilization and Quality in Community Emergency Departments
Introduction: Point-of-care ultrasound (POCUS) is commonly used in the emergency department (ED) as a rapid diagnostic tool. Emergency medicine (EM) has been an early adopter of POCUS with indications expanding over the last 10 years. While the literature describes widespread use among academic site...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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eScholarship Publishing, University of California
2023-06-01
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| Series: | Western Journal of Emergency Medicine |
| Online Access: | https://escholarship.org/uc/item/2069728b |
| _version_ | 1797766909622484992 |
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| author | Courtney M. Smalley Erin L. Simon McKinsey R. Muir Baruch S. Fertel |
| author_facet | Courtney M. Smalley Erin L. Simon McKinsey R. Muir Baruch S. Fertel |
| author_sort | Courtney M. Smalley |
| collection | DOAJ |
| description | Introduction: Point-of-care ultrasound (POCUS) is commonly used in the emergency department (ED) as a rapid diagnostic tool. Emergency medicine (EM) has been an early adopter of POCUS with indications expanding over the last 10 years. While the literature describes widespread use among academic sites, there is little data on clinical POCUS utilization at non-academic EDs. We sought to describe community emergency physician (EP) use of POCUS by quantifying the number and type of studies performed, characteristics of the performing physician, and quality metrics. Methods: Prior to the study period, all EPs underwent a standardized training and credentialing program. A retrospective review of all POCUS studies across 11 non-academic EDs from October 1, 2018–September 30, 2020 was performed by fellowship-trained physicians, who identified physician, exam type, and residency graduation year. The studies were then cross-referenced with quality review reports that assessed image acquisition, image interpretation, and image labeling. We performed descriptive statistics. Results: During the study period, 5,099 POCUS studies were performed by 170 EPs. Exams most frequently performed were cardiac (24%), focused assessment of sonography in trauma (21.7%), and pregnancy (16.2%). Recent EM residency graduates (<10 years) were higher utilizers of POCUS with a group mean of 1.3 exams per 100 patients. Of the studies done, 86% had no quality issues. Conclusion: Community POCUS demonstrates a heavy focus on core exams performed by recent EM residency graduates with minimal quality issues after a standardized training program. This study is the first to quantify actual community POCUS use in multiple EDs and may impact credentialing and skills maintenance requirements. |
| first_indexed | 2024-03-12T20:32:05Z |
| format | Article |
| id | doaj.art-3a22a2858ba340d49411d768fe66f812 |
| institution | Directory Open Access Journal |
| issn | 1936-9018 |
| language | English |
| last_indexed | 2024-03-12T20:32:05Z |
| publishDate | 2023-06-01 |
| publisher | eScholarship Publishing, University of California |
| record_format | Article |
| series | Western Journal of Emergency Medicine |
| spelling | doaj.art-3a22a2858ba340d49411d768fe66f8122023-08-01T21:19:03ZengeScholarship Publishing, University of CaliforniaWestern Journal of Emergency Medicine1936-90182023-06-0124410.5811/westjem.58965wjem-24-685A Real-World Experience: Retrospective Review of Point-of-Care Ultrasound Utilization and Quality in Community Emergency DepartmentsCourtney M. Smalley0Erin L. Simon1McKinsey R. Muir2Baruch S. Fertel3Cleveland Clinic Health System, Emergency Services Institute, Cleveland, OhioCleveland Clinic Akron General, Department of Emergency Medicine, Akron, OhioCleveland Clinic Health System, Emergency Services Institute, Cleveland, OhioColumbia University Vagelos College of Physicians and Surgeons, Department of Emergency Medicine, New York, New YorkIntroduction: Point-of-care ultrasound (POCUS) is commonly used in the emergency department (ED) as a rapid diagnostic tool. Emergency medicine (EM) has been an early adopter of POCUS with indications expanding over the last 10 years. While the literature describes widespread use among academic sites, there is little data on clinical POCUS utilization at non-academic EDs. We sought to describe community emergency physician (EP) use of POCUS by quantifying the number and type of studies performed, characteristics of the performing physician, and quality metrics. Methods: Prior to the study period, all EPs underwent a standardized training and credentialing program. A retrospective review of all POCUS studies across 11 non-academic EDs from October 1, 2018–September 30, 2020 was performed by fellowship-trained physicians, who identified physician, exam type, and residency graduation year. The studies were then cross-referenced with quality review reports that assessed image acquisition, image interpretation, and image labeling. We performed descriptive statistics. Results: During the study period, 5,099 POCUS studies were performed by 170 EPs. Exams most frequently performed were cardiac (24%), focused assessment of sonography in trauma (21.7%), and pregnancy (16.2%). Recent EM residency graduates (<10 years) were higher utilizers of POCUS with a group mean of 1.3 exams per 100 patients. Of the studies done, 86% had no quality issues. Conclusion: Community POCUS demonstrates a heavy focus on core exams performed by recent EM residency graduates with minimal quality issues after a standardized training program. This study is the first to quantify actual community POCUS use in multiple EDs and may impact credentialing and skills maintenance requirements.https://escholarship.org/uc/item/2069728b |
| spellingShingle | Courtney M. Smalley Erin L. Simon McKinsey R. Muir Baruch S. Fertel A Real-World Experience: Retrospective Review of Point-of-Care Ultrasound Utilization and Quality in Community Emergency Departments Western Journal of Emergency Medicine |
| title | A Real-World Experience: Retrospective Review of Point-of-Care Ultrasound Utilization and Quality in Community Emergency Departments |
| title_full | A Real-World Experience: Retrospective Review of Point-of-Care Ultrasound Utilization and Quality in Community Emergency Departments |
| title_fullStr | A Real-World Experience: Retrospective Review of Point-of-Care Ultrasound Utilization and Quality in Community Emergency Departments |
| title_full_unstemmed | A Real-World Experience: Retrospective Review of Point-of-Care Ultrasound Utilization and Quality in Community Emergency Departments |
| title_short | A Real-World Experience: Retrospective Review of Point-of-Care Ultrasound Utilization and Quality in Community Emergency Departments |
| title_sort | real world experience retrospective review of point of care ultrasound utilization and quality in community emergency departments |
| url | https://escholarship.org/uc/item/2069728b |
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