Open AccessDeveloping and Evaluating a Remote Quality Assurance System for Point-of-Care Ultrasound for an Internal Medicine Residency Global Health Track
Author(s) -
Steven Fox,
Mph Michelle Fleshner,
DO Collin Flanagan,
Thomas Robertson,
Ayako Fujita,
Divya Bhamidipati,
Abdulrahman Sindi,
Raghunandan Purushothaman,
Thuy Bui
Publication year - 2020
Publication title -
pocus journal
Language(s) - English
Resource type - Journals
ISSN - 2369-8543
DOI - 10.24908/pocus.v5i2.14433
Subject(s) - quality assurance , medicine , point of care ultrasound , medical physics , general partnership , quality (philosophy) , medical education , health care , ultrasound , radiology , business , philosophy , external quality assessment , finance , pathology , epistemology , economics , economic growth
Background: A quality assurance system is vital when using point-of-care ultrasound (POCUS) to ensure safe and effective ultrasound use. There are many barriers to implementing a quality assurance system including need for costly software, faculty time, and extra work to log images. Methods: With minimal funding or protected faculty time, we successfully developed an effective remote quality assurance system between residents rotating internationally and faculty in the US. Results: 270 total exams were logged using this system (41 per resident over a 7 week period). Over the course of the implementation period, a significant increase was seen in average image quality (p = 0.030) and percent agreement with reviewer (p = 0.021). No significant increase was seen for percent images with quality rating 5/5 (p = 0.068) or for studies per resident per week (p = 0.30). Discussion/Conclusions: A quality assurance system for remote review and feedback of POCUS exams was successfully developed with limited available funding, using consumer-level software and an educational collaboration. Residents used the system regularly and demonstrated improvement in reviewer-rated image acquisition and interpretation skills. A similar system can be applied for physicians in any geographic area looking to learn POCUS, in partnership with local or international POCUS mentors. We detail a step-by-step approach, challenges encountered, and lessons learned, to help guide others seeking to implement similar programs.