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A coaching model for sonographers: enhancing skill competency in transcranial Doppler examinations
Mohammad Jalloul1, Marcy L Hutchinson2, Cynthia F Norris3
1Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, 19104, USA. jalloulm@chop.edu.
Insights
A coaching model improved training for ultrasound technologists, increasing Transcranial Doppler (TCD) screening for children with sickle cell disease (SCD) and aiding stroke prevention efforts.
Area of Science:
- Pediatric Neurology
- Medical Imaging
- Quality Improvement
Background:
- Transcranial Doppler (TCD) is vital for stroke prevention in pediatric sickle cell disease (SCD).
- Low compliance with annual TCD screening is linked to limited access and insufficient technologist training.
- Addressing these barriers is crucial for effective SCD management.
Purpose of the Study:
- To enhance the number of ultrasound technologists proficient in TCD for SCD care.
- To improve adherence to recommended annual TCD screening protocols.
- To reduce reliance on a limited number of expert sonographers.
Main Methods:
- A quality improvement initiative at a children's hospital utilized a structured coaching model.
- Training involved one-on-one sessions, competency assessments, and hematology collaboration.
- Progress was tracked via surveys and control charts over 32 months.
Main Results:
- The percentage of TCD-competent sonographers increased from 21% to 58%.
- Reliance on a single expert technologist decreased from 42% to 3%.
- SCD patient TCD screening rates improved from 87% to 91%.
Conclusions:
- A coaching model effectively increased TCD-proficient technologists.
- The initiative significantly improved TCD screening rates for pediatric SCD patients.
- Enhanced technologist capacity supports better stroke risk management in SCD.
Background:
Transcranial Doppler (TCD) imaging is a key screening tool for stroke prevention in children with sickle cell disease (SCD). Despite clear guidelines recommending annual TCD screening, compliance remains low due to limited access and insufficient training among ultrasound technologists.
Methods:
A quality improvement initiative was implemented at a quaternary care children's hospital to increase the number of technologists proficient in TCD for SCD care. A structured coaching model was used, involving one-on-one training sessions, competency assessments, and collaboration with the hematology department to facilitate patient cases for practice. Progress was measured using surveys and control charts.
Results:
Over the 32-month period of this project, the percentage of TCD-competent sonographers increased from 21 to 58%, and reliance on a single expert technologist for TCD exams decreased from 42 to 3%. Additionally, the percentage of SCD patients receiving TCD screening rose from 87 to 91%.
Conclusion:
The implementation of a coaching model significantly improved the number of trained TCD technologists and enhanced screening rates for SCD patients.
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