A quantitative needs assessment for a tele-ultrasound consult program in a tertiary care Emergency Department.

Abstract

Point-of-care ultrasound (POCUS) has been shown to be beneficial in facilitating patient care, but its adoption is variable among emergency medicine (EM) clinicians. We identified the patterns of POCUS use and gaps in POCUS integration in a tertiary care emergency department (ED). These data provide a user-centered platform for subsequent development of a tele-ultrasound (tele-US) consultation program. We developed a 25-item needs assessment survey and used a 5-point Likert scale to assess current patterns of POCUS use and potential needs for POCUS among EM clinicians. Data were analyzed descriptively, and a chi-square analysis was used to assess for differences in POCUS use and comfort levels among clinicians. Overall, 48% (91/190) of eligible providers responded to the survey. Clinician responders included 38% (35/91) attendings (including fellows), 29% (26/91) residents, and 33% (30/91) advance practice providers (APPs). In assessing needs, 70% (58/83) of clinicians noted they would use POCUS more if they had more training. 76% (63/83) of clinicians felt comfortable with image acquisition and 68% (56/83) with image interpretation. APPs were less comfortable with POCUS image interpretation and clinical integration of POCUS findings compared to residents (χ2: 16.3, p < 0.0001 and χ2: 5.1, p = 0.02, respectively). 65% (54/83) of clinicians would use POCUS more if real-time supervision via tele-US was available for image acquisition and image interpretation. EM clinicians indicated a substantial need for further real-time POCUS training and supervision, especially for image interpretation. A clinician-centered strategy, such as tele-US, has potential to increase proficient use of POCUS.