Evolution of Clinical Quality Activities within a National Echocardiography Database: Seven-Year Trends from the GenesisCare Outcomes Registry

Abstract

Introduction: Despite rapid technologic advances and growth, less attention has been focused on quality in imaging than in other areas of cardiovascular medicine. Therefore the ACC proposed additional areas of effort such as data standardisation, structured reporting identifying key data elements and imaging registries. We explored these changes within a large multi-centre Australian registry. Methods: From 2010–2014 we introduced direct online entry of echocardiographic studies into an electronic database, selection and auditing of key data elements and quality improvement pathways to maximise completeness of data acquisition and reporting across 4 states. We compared data completeness (AV peak velocity, EF, E/E”, LA area, rhythm, RVSP) by time and state using de-identified data. Results: 464,688 echocardiographic procedures were captured from 2011 to 2018. Data completeness improved significantly from 2011–2018 (72.0 ± 26.8 vs 88.2 ± 13.5% p = 0.02). while Inter-practice variability fell for both EF and E/E’ (p < 0.002). Conclusion Identification, systematic capture and auditing of key echo data elements can significantly improve the quality and reduce inter-practice variability of echo data. Developing a national database allows rapid adoption of local quality improvements.