What is it about?
Our study implemented a co-designed multifaceted intervention at a single Veterans Affairs ED to enhance POCUS usability and sustainability, including education, equipment knowledge, quality review process, and image archiving in the health record. The primary outcome was to identify the facilitators and barriers to optimize our program implementation using the consolidated framework for implementation research (CFIR) and to serve as a reproducible model for future dissemination at other clinical sites. We evaluated the preliminary impact of our POCUS program by collecting data via provider surveys and interviews.
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Why is it important?
One major clinical tool that is being incorporated into clinical practice at hospitals and medical sites nationwide with potential for high impact on patient care is point-of-care ultrasound (POCUS). Emergency ultrasound program leaders nationwide recognize that POCUS knowledge retention and utilization are difficult to achieve, and implementation of a sustainable program is not well understood in prior literature. Identifying and addressing barriers to sustainable POCUS implementation remain important to increase POCUS use, reduce radiology ultrasound, and improve emergency department (ED) and hospital patient outcomes.
Perspectives
Through semi-structured interviews, we identified major POCUS barriers including time constraints, alternative radiology imaging availability, comfort with POCUS knowledge and skills, and eliminating unnecessary and cumbersome steps for image acquisition and documentation/storage. Major facilitators to POCUS use were ultrasound machine availability, ease of POCUS documentation, resident teaching, POCUS use for ED procedures, hands-on POCUS group training, contagiousness and enthusiasm among colleagues, and ultrasound faculty support and guidance. Additionally, ED and hospital leadership support and hospital-wide POCUS collaboration were cited as essential for success. Additional identified needs, including POCUS quality assurance and feedback, faculty credentialing, establishing a POCUS archiving system, and continuity of care with shared POCUS image viewing across the hospital, require development locally to improve provider knowledge and skills and eliminate unnecessary duplicate radiology studies.
Dr Rebecca G Theophanous
Duke University
Read the Original
This page is a summary of: A qualitative study of perceived barriers and facilitators to point-of-care ultrasound use among Veterans Affairs Emergency Department providers, PLoS ONE, November 2024, PLOS,
DOI: 10.1371/journal.pone.0310404.
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