Abstract

Background: Quality 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.Methods: The 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.Conclusion: The 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.

Highlights

  • Quality assurance (QA) of echocardiographic studies is vital to ensure that clinicians can act on findings of high quality to deliver excellent patient care

  • Studies have demonstrated that the intra-observer, inter-observer and inter-study variability of echocardiography is often significant [4]. This variation and the overall accuracy of studies and their accompanying reports can potentially be improved by a robust quality assurance (QA) process within echocardiographic departments

  • Despite this logical concept, there is a paucity of published documentation outlining a specific, practical, methodology of how a complete and holistic QA process can be setup

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Summary

Background

‘Quality involves the totality of a patient’s experience’ – Mayo Clinic, Rochester, MN, USA [1]. This variation and the overall accuracy of studies and their accompanying reports can potentially be improved by a robust quality assurance (QA) process within echocardiographic departments Despite this logical concept, there is a paucity of published documentation outlining a specific, practical, methodology of how a complete and holistic QA process can be setup. Published methodologies for echocardiography QA often focus on the blind re-reading of an arbitrary number of cases [8] This suggested toolbox borrows heavily from the field of clinical chemistry [9]; a discipline which crucially has stable control materials readily available to benchmark against. This list is deliberately prescriptive, and the numbers proposed are derived from an expert consensus of what would be reasonable and achievable for a department. An excellent QA process is one where feedback and reflective practice are embedded within to ensure that all lines of enquiry are intelligent and clinically relevant

Methods
Echo Quality
Findings
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