Echocardiography service provision in New Zealand: Capacity modelling the cardiac sonographer workforce

Abstract

Background: Increasing utilisation of echocardiography places pressure on hospital services in NZ. Regional disparity in both utilisation and the cardiac sonographer workforce has previously been identified. We sought to model the capacity of the cardiac sonographer workforce at a national and district health board (DHB) level to better understand the regional differences seen. Methods: In 2013, surveys were completed by 18 hospitals employing cardiac sonographers (return rate 100%). Questions related to cardiac sonographer demographics, echo utilisation and workflow. Actual clinical capacity was calculated for each scan type from scan duration and 2012 annual scan volumes. The NZ national actual capacity was compared to the capacity predicted from three international models. Potential clinical capacity was calculated from the workforce size in full time equivalent (FTE) and clinical availability (working hours minus leave provision) with an inefficiency factor from a United Kingdom (UK) planning model. Results: Scan duration and population based clinical capacity varies between centres, with no clear relationship to centre type (surgical/regional). NZ capacity is similar to the United Kingdom 30:70 model, and consistently less than the United States of America (USA) model for all scan types. There are marked regional differences in actual versus potential capacity with 6/16 DHBs demonstrating excess actual capacity (performing more scans than predicted). Conclusions: There is regional disparity in the capacity of the cardiac sonographer workforce which appears to be strongly related to scan duration. Workforce capacity modelling should be used with need and demand modelling to plan adequate levels of service provision.