Healthcare Science Week | Implementing echo quality

At University Hospitals of Leicester NHS Trust we introduced echo quality (EQ) into the department by using the Echo Quality Framework¹ to guide key areas in need. The main aim was to provide more comprehensive EQ to every aspect of our service, with particular attention to echocardiography practise. A snapshot of some key methods we have utilised to incorporate and implement EQ include:

• Creating re-reporting tasks to assess echo practise amongst the team, results of which could be fed back to the team in our monthly departmental meetings, with follow-up educational presentations on the pathology of interest. This task alone has been a useful method at reducing our variability through scrutinising our local reporting protocols/habits. It has also led to increased engagement through continual conversations and idea generation amongst the team to find ways to better assess our accuracy and coherence.
• To assess the compliance, effectiveness and satisfaction of our service with patients and clinician expectations, we have made use of simple questionnaires.
• To advance our education and training for our wide variety of trainee cohorts, we have been created internal formal training and sign-off pathways utilising individualised local personal records and logs.

Ms Pooja Raithatha, Chief Cardiac Physiologist, University Hospitals of Leicester NHS Trust

At Great Western Hospital, Swindon, we were already implementing the Echo Quality Framework, which is essentially the breakdown of points you need to cover to gain EQA. Our main goal was to change the stigma of ‘echo audit’ in the department and to turn it into a positive experience in which everyone can learn from, rather than something everyone feared.

The first thing we did was send out anonymous surveys to all echocardiographers within the department to gain honest feedback and asked everyone to make suggestions on how to improve practice. Increasing engagement in EQ was our first step. The feedback in general was very negative, however there were lots of suggestions for improvement. This was a democratic process, so immediately increased engagement. The main change we implemented was the way our group EQ sessions were conducted. Initially, everyone in the room knew who had performed the scan and everyone feared their echo being pulled up. We now have reports that are completely anonymised and all scanner/ reporter details are removed. Moving to MS Forms for EQ has been innovative and further increased engagement. We generate a QR code for everyone to scan on their phones and anonymously complete their feedback whilst viewing the echo. We are constantly looking to improve the process of echo quality by regularly surveying staff to give everyone the chance to have their say.

Ms Sarah Wilson, Highly Specialised Cardiac Physiologist, Great Western Hospitals NHS Foundation Trust