title: Development of a National Echocardiography Quality Improvement Programme: insights into feasibility, uptake, and clinical utility.
abstract: OBJECTIVE
  There are minimal data on methods to measure and improve quality in image interpretation when reporting cardiovascular imaging studies. We sought to identify the feasibility and clinical utility of a nationally implemented quality assurance (QA) process.
  
  
  RESULTS
  A web-based platform was developed to administer a national QA module to 27 echocardiography departments within the UK. Three QA modules were delivered from 2011. The proportion of units using the QA module increased from 14 (52.2%) in the first module to 22 (81.5%) in the third module. There was no significant change in the proportion of correct answers between the first module (88.9%) and the third module (82.8%), P = 0.3. The number of echocardiographers with at least one incorrect answer increased from 16 (21.6%) in the first module to 54 (34%) in the third module, P = 0.03. Overall, in valvular heart disease cases there were 36 (10.6%) incorrect responses where qualitative assessment of the severity of valve dysfunction was tested compared with 4 (3.6%) incorrect responses where quantitative assessment of valve dysfunction was tested, P = 0.04. In chamber quantification cases, there were 36 (6.8%) incorrect responses where qualitative assessment of chamber function was tested compared with 3 (2.1%) incorrect responses where quantitative assessment of chamber function was tested, P = 0.04.
  
  
  CONCLUSIONS
  The incorporation of national QA programme is feasible with rapid uptake. The platform allows comparison of an individual's interpretation skills against a reference standard which can be used as a method to identify inter-observer variability and as a training tool.
authors.affiliation: Department of Cardiology, Hammersmith Hospital, Imperial College Healthcare NHS Trust, Du Cane Road, London W12 OHS, UK British Society of Echocardiography, London, UK sanjeev144@hotmail.com.
authors.forename: Sanjeev
authors.initials: S
authors.lastname: Bhattacharyya
authors.affiliation: British Society of Echocardiography, London, UK Sussex Cardiac Centre, Brighton & Sussex University Hospitals Trust, Brighton, UK.
authors.forename: Rachael
authors.initials: R
authors.lastname: James
authors.affiliation: British Society of Echocardiography, London, UK Department of Echocardiography, Guy's & St Thomas' NHS Trust, London, UK.
authors.forename: Helen
authors.initials: H
authors.lastname: Rimington
authors.affiliation: British Society of Echocardiography, London, UK Department of Echocardiography, York Teaching Hospitals NHS Trust, York, UK.
authors.forename: Jane
authors.initials: J
authors.lastname: Allen
authors.affiliation: Sussex Cardiac Centre, Brighton & Sussex University Hospitals Trust, Brighton, UK.
authors.forename: Lorraine
authors.initials: L
authors.lastname: Lee
authors.affiliation: Department of Cardiology, Hammersmith Hospital, Imperial College Healthcare NHS Trust, Du Cane Road, London W12 OHS, UK British Society of Echocardiography, London, UK.
authors.forename: Kevin
authors.initials: K
authors.lastname: Fox
authors.affiliation: British Society of Echocardiography, London, UK Department of Cardiology, University Hospital of UK, Cardiff, UK.
authors.forename: Navroz D
authors.initials: ND
authors.lastname: Masani
authors.affiliation: Department of Cardiology, East Sussex NHS Trust, Eastbourne, UK.
authors.forename: Guy
authors.initials: G
authors.lastname: Lloyd
mesh_terms: D016507:Cardiology Service, Hospital / Q000458:organization & administration; D016208:Databases, Factual; D004452:Echocardiography / Q000379:methods*; D005240:Feasibility Studies; D066275:Health Information Exchange; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D033181:Information Dissemination; D020407:Internet; D015588:Observer Variation; D016730:Program Development; D058996:Quality Improvement / Q000458:organization & administration*; D012015:Reference Standards; D006113:United Kingdom
keywords: cardiovascular imaging; echocardiography; quality