Impact Evaluation After Implementing a Co-Designed Point-Of-Care Ultrasound Program at a Veterans Affairs Emergency...

Area of Science:

• Emergency Medicine
• Medical Ultrasound
• Implementation Science

Background:

• Point-of-care ultrasound (POCUS) is a vital bedside diagnostic tool in Emergency Departments (EDs).
• A persistent gap exists between implementing POCUS programs and achieving sustained usage and provider retention.
• This study addresses the need for effective strategies to enhance POCUS integration and long-term application in ED settings.

Purpose of the Study:

• To evaluate the impact of a co-designed, multifaceted intervention aimed at improving the usability and sustainability of POCUS in a Veterans Affairs ED.
• To assess the acceptability, appropriateness, and feasibility of the implemented POCUS program among primary ED providers.

Main Methods:

• A mixed-methods cohort study was conducted in a single Veterans Affairs ED from November 2021 to October 2022.
• A co-designed intervention incorporating provider education, image review, and archival was implemented.
• Data collection included pre/post-course surveys, interviews, and health record analysis using the AIM-IAM-FIM validated tool.

Main Results:

• Emergency Department POCUS scans significantly increased by over 270% (from 72 to 267) six months post-intervention (p < 0.001).
• No significant changes were observed in radiology ultrasound orders or ED length-of-stay.
• Commonly performed ED POCUS included cardiac, deep vein thrombosis (DVT), soft tissue, musculoskeletal, and biliary scans. Provider comfort levels showed minimal change, but all participants found the program acceptable, appropriate, and feasible.

Conclusions:

• The co-designed intervention successfully increased the utilization of POCUS within the Emergency Department.
• Future research should focus on evaluating program sustainability and developing methods to potentially reduce reliance on radiology ultrasounds while improving patient-centered outcomes.