Mapping the Ultrasound Landscape to Define Point-of-Care Ultrasound and Diagnostic Ultrasound: A Proposal From the Society of Radiologists in Ultrasound and ACR Commission on Ultrasound

Patel, Maitray D.; Horrow, Mindy M.; Kamaya, Aya; Frates, Mary C.; Golding, Lauren Parks; Chong, Wui K.; Gerena, Marielia; Ghate, Sujata V.; Glanc, Phyllis; Goldbach, Alyssa; Gupta, Sonia; Hill, Paul; Johnson, Sarah; Kocher, Madison; Rubin, Eric; Sohaey, Roya; Waltz, Jeffrey; Wolfman, Darcy J.; Middleton, William D.

doi:10.1016/j.jacr.2020.09.013

Cited by 24 publications

(21 citation statements)

References 18 publications

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“…The findings on POCUS adoption by a health system and its clinicians captured in the present study mirror professional society conversations around this topic currently [ 8 , 15 ]. As the evidence for the utility of POCUS has grown with multiple studies demonstrating improved accuracy [ 34 ], expedited diagnoses [ 2 ], and an associated reduction in additional testing and overall costs [ 32 , 33 , 35 ], there is now an increasingly recognized need for guidelines in training standards and quality assurance to guide implementation [ 13 , 14 , 16 ].…”

Section: Discussionsupporting

confidence: 73%

“…The growing interest from clinicians across specialties and their ability to directly purchase personal handheld ultrasound devices has compelled hospitals to consider the need to develop local policies and invest in infrastructure to ensure the security of POCUS images as protected health information and quality assurance of these images. Accordingly, attention has now broadened to include determinants of adoption at the health system level, in order to ensure high-fidelity and sustainable POCUS use [ 12 , 13 , 14 , 15 ]. For instance, in January 2020, the Joint Commission endorsed a statement by the Emergency Care Research Institute (ECRI), a medical safety advisory group, that many healthcare facilities do not currently have adequate infrastructure, policies, and processes in place to ensure optimal and safe clinical use of POCUS [ 16 , 17 ].…”

Section: Introductionmentioning

confidence: 99%

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Multi-Level Stakeholder Perspectives on Determinants of Point of Care Ultrasound Implementation in a US Academic Medical Center

et al. 2021

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There is growing interest from multiple specialties, including internal medicine, to incorporate diagnostic point of care ultrasound (POCUS) into standard clinical care. However, few internists currently use POCUS. The objective of this study was to understand the current determinants of POCUS adoption at both the health system and clinician level at a U.S. academic medical center from the perspective of multi-level stakeholders. We performed semi-structured interviews of multi-level stakeholders including hospitalists, subspecialists, and hospital leaders at an academic medical center in the U.S. Questions regarding the determinants of POCUS adoption were asked of study participants. Using the framework method, team-based analysis of interview transcripts were guided by the contextual domains of the Practical Robust Implementation and Sustainability Model (PRISM). Thirty-one stakeholders with diverse roles in POCUS adoption were interviewed. Analysis of interviews revealed three overarching themes that stakeholders considered important to adoption by clinicians and health systems: clinical impact, efficiency and cost. Subthemes included two that were deemed essential to high-fidelity implementation: the development of credentialing policies and robust quality assurance processes. These findings identify potential determinants of system and clinician level adoption that may be leveraged to achieve high-fidelity implementation of POCUS applications that result in improved patient outcomes.

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Section: Discussionsupporting

confidence: 73%

Section: Introductionmentioning

confidence: 99%

Multi-Level Stakeholder Perspectives on Determinants of Point of Care Ultrasound Implementation in a US Academic Medical Center

et al. 2021

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“…The course teaches diagnostic US, defined as imaging performed in a radiology department with appropriate labeling, storage for later review, and stand‐alone reports. These elements distinguish diagnostic US from point of care US (POCUS), defined as US performed and reported in conjunction with a patient evaluation and management encounter, without image storage or a stand‐alone report 31 . The curriculum integrates these components over five continuous days, broken into morning and afternoon sessions.…”

Section: Curriculum Design and Planningmentioning

confidence: 99%

Ultrasound Simulation Training for Radiology Residents—Curriculum Design and Implementation

Alexander

McComb

Bowman

et al. 2022

J of Ultrasound Medicine

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Medical simulation training can be used to improve clinician performance, teach communication and professionalism skills, and enhance team training. Radiology residents can benefit from simulation training in diagnostic ultrasound, procedural ultrasound, and communication skills prior to direct patient care experiences. This paper details a weeklong ultrasound simulation training curriculum for radiology residents during the PGY-1 clinical internship. The organization of established teaching methods into a dedicated course early in radiology residency training with the benefit of a multi-disciplinary approach makes this method unique. This framework can be adapted to fit learners at different skill levels or with specific procedural needs. Key Words-curriculum; internship and residency; radiology; simulation training; ultrasonography U ltrasound (US) examinations are highly operator dependent and require a complex skill set including anatomic knowledge, hand-eye coordination, and image optimization. In the United States, the US examination is primarily performed by sonographers, with interpretation by radiologists; however, residents are expected to demonstrate competency in US image generation as well as interpretation. 1,2 Accurately performing US is also particularly important for US-guided interventions, which span nearly all subspecialties in radiology.Medical education training has long been taught by an apprenticeship model, but changes in regulations, quality and safety initiatives, and societal expectations of medical care have led to a decrease in hands-on training opportunities. 3 Simulation training in undergraduate and graduate medical education has been growing in use over the last two decades, particularly in surgical specialties and in technical skills, 4 and provides an effective and safe environment in which to practice a procedure or symptom scenario before encountering a patient in the clinical setting. [5][6][7][8] Trainees can perform deliberate practice in a low stress environment, essential for skill acquisition. 3,9 In radiology education, simulation-based training methods often focus on specific procedural skills, 10-20 call preparation, 5,21,22 and contrast reaction scenarios, [23][24][25][26] but are likely underutilized in diagnostic radiology (DR) and interventional radiology (IR) training. 27,28 Simulation training offers opportunity for instruction in communication skills as well as physical clinical skills. Communication workshops can be particularly beneficial to radiologists as their

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“…El PoCUS es una herramienta impulsada por la Medicina de Urgencias junto a otras especialidades afines. Por ello, la mayoría de los cursos de entrenamiento y competencia son impartidos por médicos especialistas no radiólogos, como los dictados en territorio norteamericano por The American College of Emergency Physicians (ACEP), American Institute of Ultrasound in Medicine, The Society for Academic Emergency Medicine, The Canadian Association of Emergency Physicians, entre otros (5,(15)(16)(17).…”

Section: Metodologíaunclassified

“…Solo se incluyeron resultados en español o en inglés. Los autores discriminaron los artículos por título y resúmenes por conveniencia, basados en su relación con el objetivo del presente manuscrito y su nivel de relevancia.DESARROLLO ¿Cuáles son los alcances del uso del PoCUS dentro y fuera de los SU?Es importante recalcar las diferencias entre el ultrasonido convencional y el PoCUS, tal como lo afirma The American College of Radiology(5). El PoCUS es una herramienta de naturaleza finita, que se reduce a contextos específicos tanto en el paciente urgente como en…”

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PoCUS: luces y sombras

Quintero-Vanegas

Gómez-Duque

2022

Iatreia

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Introducción: el ultrasonido junto a la cama del paciente (PoCUS) es una herramienta clínica que se emplea en los servicios de urgencias desde hace tres décadas. Sin embargo, actualmente persisten interrogantes relacionados con los riesgos de error diagnóstico por parte del médico no radiólogo y la certificación de competencias para su incorporación. Objetivo: describir y analizar el marco conceptual sobre el uso de PoCUS en las especialidades medicoquirúrgicas en Colombia. Resultados: la implementación del PoCUS mejora la sensibilidad de la exploración física en el contexto oportuno y orienta la formación médica en áreas como anatomía, fisiología y evaluación clínica. Además, permite a diferentes especialistas complementar su quehacer cotidiano, pues facilita la adquisición de habilidades y el reconocimiento de las limitaciones de la herramienta, según la certificación de competencias y la reglamentación vigente. Conclusiones: el PoCUS es una herramienta efectiva (y con mínimos eventos adversos) para la toma de decisiones clínicas en el servicio de urgencias, e incluso en otros contextos de la práctica clínica. El entrenamiento requerido para la adquisición de las habilidades técnicas necesarias para su manejo está al alcance de cualquier médico.

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Mapping the Ultrasound Landscape to Define Point-of-Care Ultrasound and Diagnostic Ultrasound: A Proposal From the Society of Radiologists in Ultrasound and ACR Commission on Ultrasound

Cited by 24 publications

References 18 publications

Multi-Level Stakeholder Perspectives on Determinants of Point of Care Ultrasound Implementation in a US Academic Medical Center

Multi-Level Stakeholder Perspectives on Determinants of Point of Care Ultrasound Implementation in a US Academic Medical Center

Ultrasound Simulation Training for Radiology Residents—Curriculum Design and Implementation

PoCUS: luces y sombras

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