BACKGROUND: The aim of this study was to demonstrate improvement in the characterization of diastolic function in the routine practice of a clinical echocardiography laboratory after the implementation of a quality improvement initiative. The echocardiographic analysis of left ventricular (LV) diastolic dysfunction is an inherently complex process involving the integration of multiple indices for accurate assessment. METHODS: A baseline survey of 50 randomly chosen echocardiographic studies was reviewed for the accuracy of diastolic function assessment. A four-step quality improvement protocol was then initiated: (1) sonographer and physician education; (2) the implementation of data acquisition protocol changes using LV inflow, tissue Doppler velocity of the mitral annulus in early diastole (e'), flow propagation velocity of LV inflow (Vp), and left atrial volume index (LAVI), along with the establishment of uniform criteria for diagnostic interpretation; (3) peer review of performance; and (4) focused interactive case review sessions. RESULTS: At baseline, measurements of LV inflow were most often correct (100% accurate), while measurements of e' (82% accurate), Vp (12% accurate), and LAVI (12% accurate) and the proper classification of diastolic function (44% accurate) were significantly limited. After the quality improvement initiative, there were significant increases in the accuracy of all recorded measurements, with e' 92% accurate (a 10% improvement; P < .10), Vp 67% accurate (a 55% improvement; P < .001), LAVI 80% accurate (a 68% improvement, P < .001), and proper characterization of diastolic function 76% accurate (a 32% improvement, P < .001). CONCLUSIONS: A multifaceted quality improvement protocol including staff education, systematic support with enhanced infrastructure, and peer review with feedback can be effective for improving the clinical performance of a nonacademic echocardiography laboratory in the characterization of diastolic function.
BACKGROUND: The aim of this study was to demonstrate improvement in the characterization of diastolic function in the routine practice of a clinical echocardiography laboratory after the implementation of a quality improvement initiative. The echocardiographic analysis of left ventricular (LV) diastolic dysfunction is an inherently complex process involving the integration of multiple indices for accurate assessment. METHODS: A baseline survey of 50 randomly chosen echocardiographic studies was reviewed for the accuracy of diastolic function assessment. A four-step quality improvement protocol was then initiated: (1) sonographer and physician education; (2) the implementation of data acquisition protocol changes using LV inflow, tissue Doppler velocity of the mitral annulus in early diastole (e'), flow propagation velocity of LV inflow (Vp), and left atrial volume index (LAVI), along with the establishment of uniform criteria for diagnostic interpretation; (3) peer review of performance; and (4) focused interactive case review sessions. RESULTS: At baseline, measurements of LV inflow were most often correct (100% accurate), while measurements of e' (82% accurate), Vp (12% accurate), and LAVI (12% accurate) and the proper classification of diastolic function (44% accurate) were significantly limited. After the quality improvement initiative, there were significant increases in the accuracy of all recorded measurements, with e' 92% accurate (a 10% improvement; P < .10), Vp 67% accurate (a 55% improvement; P < .001), LAVI 80% accurate (a 68% improvement, P < .001), and proper characterization of diastolic function 76% accurate (a 32% improvement, P < .001). CONCLUSIONS: A multifaceted quality improvement protocol including staff education, systematic support with enhanced infrastructure, and peer review with feedback can be effective for improving the clinical performance of a nonacademic echocardiography laboratory in the characterization of diastolic function.
Authors: Shelby Kutty; David Russell; Ling Li; Rimsha Hasan; Qinghai Peng; Peter C Frommelt; David A Danford Journal: Int J Cardiovasc Imaging Date: 2013-12-10 Impact factor: 2.357
Authors: Zaher Fanari; Usman I Choudhry; Vivek K Reddy; Chete Eze-Nliam; Sumaya Hammami; Paul Kolm; William S Weintraub; Erik S Marshall Journal: Echocardiography Date: 2015-06-01 Impact factor: 1.724
Authors: Stephanie Minter; Alicia Armour; Amanda Tinnemore; Karen Strub; Anna Lisa Crowley; Gerald S Bloomfield; John H Alexander; Pamela S Douglas; Joseph A Kisslo; Eric J Velazquez; Zainab Samad Journal: Int J Cardiovasc Imaging Date: 2018-08-20 Impact factor: 2.357
Authors: Richard V Williams; Renee Margossian; Minmin Lu; Andrew M Atz; Timothy J Bradley; Michael Jay Campbell; Steven D Colan; Dianne Gallagher; Wyman W Lai; Gail D Pearson; Ashwin Prakash; Girish Shirali; Meryl S Cohen Journal: Echocardiography Date: 2013-04-25 Impact factor: 1.724
Authors: José Maria Gonçalves Fernandes; Benício de Oliveira Romão; Ivan Romero Rivera; Maria Alayde Mendonça; Francisco de Assis Costa; Margareth de Souza Lira Handro; Orlando Campos; Ângelo Amato V De Paola; Valdir Ambrósio Moisés Journal: Cardiovasc Ultrasound Date: 2019-08-13 Impact factor: 2.062
Authors: Anitha Parthiban; Ashley Warta; Jennifer A Marshall; Kimberly J Reid; Keith Mann; Girish Shirali; Tara Swanson Journal: Pediatr Qual Saf Date: 2018-06-06