567 - Will Community Emergency Providers Embrace Point-of-Care Ultrasounds?
Wednesday, May 13, 2020
Location: Majestic Ballroom: Majestic
Background and Objectives: Point of Care Ultrasound (POCUS) plays a vital role in many academic Emergency Departments (EDs). In smaller community hospitals, emergency providers may not be as familiar or comfortable performing POCUS. Furthermore, formal ultrasound may not be not available 24 hours a day leading to the delayed diagnosis, ordering of unnecessary CT scans and longer wait times. We sought to determine whether a mandatory educational program designed and administered by an US fellow would increase the number of POCUS performed in community hospitals.
Methods: Setting: Two community emergency departments with censuses of 36,500 and 24,500 patients annually. Subjects: Physicians and APPs with little to no ultrasound training were provided ultrasound education. Design: Physicians and APPs were given a mandatory US education course designed and administered by an US fellow. The fellow provided 16 hours of dedicated “skills days” in the first month during which the providers did hands-on training in the 12 core applications. In addition, quality assurance of all US studies was performed weekly with feedback to providers and brief US lectures were done at department meetings. The total number of scans and the level of provider (physician or APP) who performed the scan was calculated monthly. Differences between the first month of the program and the third month were calculated to assess the long-term impact of the program.
Results: A total of 23 providers, 12 (52%) physicians and 11 (48%) APPs participated in the program. 70% of the providers had no ultrasound experience and 65% of the providers have been practicing for more than 5 years. Over the course of three months, 349 ultrasound studies of billable quality were performed. Of those 349 studies, 156 (45%) of the studies were performed by physicians and 193 (55%) of the studies were performed by APPs. The number of studies performed increased each month with 81 studies performed in the first month and 160 studies performed in the third month (97.5% increase).
Conclusion: POCUS is a teachable skill to both physicians and APPs with little to no ultrasound experience. Providers are enthusiastic and eager to learn ultrasound. Even after the initial training, the number of billable US continued to increase monthly, suggesting the increase was not a passing phenomenon.