Standards for Provision and Accreditation of Echocardiography in Ontario

Sanfilippo, Anthony J.; Chan, Kwan L.; Hughes, William; Kingsbury, Kori; Leong‐Poi, Howard; Sasson, Zion; Wald, Robert W.

doi:10.1016/j.cjca.2012.11.024

Cited by 6 publications

(7 citation statements)

References 2 publications

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“…The Cardiac Care Network of Ontario recently issued a statement on the standards for performance of echocardiography, which included recommendations that laboratories should have mechanisms to ensure that an indication is included with each referral and to educate physicians on appropriate indications for referral. (32) Therefore, a mechanism should be in development for recording an appropriate referral indication; tracking this information can be implemented with improvement of the system that records the diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Temporal Trends in the Utilization of Echocardiography in Ontario, 2001 to 2009

Blecker

Bhatia

You

et al. 2013

JACC: Cardiovascular Imaging

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The purpose of this study was to examine utilization and growth in echocardiography among the general population of Ontario between 2001 and 2009. The age- and sex-adjusted rates of echocardiography grew from 39.1 per 1,000 persons in 2001 to 59.9 per 1,000 persons in 2009, for an annual rate of increase of 5.5%. Repeat echocardiograms increased at a rate of 10.6% per year and accounted for 25.3% of all procedures in 2009 as compared to 18.5% in 2002. While significant increases in echocardiography utilization were observed, opportunities may exist to improve the clinical utility of the echocardiograms performed in Ontario.

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Section: Discussionmentioning

confidence: 99%

Temporal Trends in the Utilization of Echocardiography in Ontario, 2001 to 2009

Blecker

Bhatia

You

et al. 2013

JACC: Cardiovascular Imaging

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Section: Discussionmentioning

confidence: 99%

“…The ACCF AUC has been rapidly adopted in the United States as a useful tool to guide the appropriate use of echocardiography [ 15 – 24 ], and AUC are being integrated into the delivery of echocardiography services in other countries [ 10 – 13 ]. Demonstration of AUC adherence by echocardiography laboratories is already required for accreditation by government and international organizations (ICAEL) and this trend is expected to extend to other jurisdictions [ 12 , 13 ]. To date, published studies evaluating the appropriateness of echocardiography have employed an extensive review of the patient’s medical record, including diagnostic requisitions, written/electronic charts, electronic databases and contact with the referring physician [ 15 – 24 ].…”

Section: Discussionmentioning

confidence: 99%

“…There is no standard requisition for echocardiography and the results might differ in an echocardiography laboratory using a significantly different requisition format. However, the UOHI echocardiography laboratory requisition is similar in content to those widely used by echocardiography laboratories and contains all the elements recommended by accrediting echocardiography organizations such as ICAEL [ 12 , 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…While physicians are expected to use these criteria to guide their management decisions, the onus for the application of AUC has in part become the responsibility of the echocardiography laboratory. Demonstration of adherence to AUC is now required for accreditation of echocardiography laboratories by government insurers and international organizations, such as the Intersocietal Commission for the Accreditation of Echocardiography Laboratories (ICAEL) [ 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

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Limitations of free-form-text diagnostic requisitions as a tool for evaluating adherence to appropriate use criteria for transthoracic echocardiography

Banihashemi

Maftoon

Chow

et al. 2015

Cardiovasc Ultrasound

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BackgroundMonitoring the adherence to Appropriateness Use Criteria (AUC) has been identified as an important component for the accreditation of echocardiography laboratories. Referral requisitions are a logical tool to rapidly determine the appropriateness of transthoracic echocardiography (TTE) referrals, however data is lacking. We investigated whether standard free-form-text TTE referral requisitions can be used to evaluate AUC adherence.MethodsConsecutive TTE referral requisitions to the University of Ottawa Heart Institute echocardiography laboratory were reviewed over a four-week period. Indication on the requisition was matched with the relevant indication on the 2011 American College of Cardiology Foundation (ACCF) AUC. Requisitions that did not provide sufficient information to identify the relevant AUC indication were identified as inadequate. For inadequate requisitions, reason for the referral was clarified through medical records and referring physicians.ResultsOf the 1303 requisitions, 26.2% did not provide adequate information to determine adherence to AUC, despite a non-adherence (inappropriate) rate of only 6.1% in the referral population. Indication for referral, physician specialty, outpatient status, and prior echocardiogram were independent predictors of inadequate requisitions (p < 0.001, respectively). The most common reasons for inadequate requisitions were a failure to report: 1) change in clinical status, 2) date of a prior echocardiogram, and 3) type and/or severity of a valve lesion. Inclusion of this information would have decreased the inadequacy rate by 56%.ConclusionIn a large, academic echocardiography laboratory, over one quarter of free-form-text TTE requisitions are inadequate to evaluate AUC adherence. Structured requisition formats requiring AUC-relevant information are needed to facilitate the practical application of AUC in the echocardiography laboratory.Electronic supplementary materialThe online version of this article (doi:10.1186/1476-7120-13-4) contains supplementary material, which is available to authorized users.

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