title: The Effect of a Quality Improvement Intervention on Variability of Measurements of Left Ventricular Dimensions in a Pediatric Echocardiography Laboratory.
abstract: OBJECTIVE
  To assess the effect of a multifaceted quality improvement intervention on variability of left ventricular dimensions as measured on pediatric echocardiograms.
  
  
  METHODS
  Variability of measurements of left ventricular dimensions was assessed using percent error before a multifaceted educational intervention. Sonographers attended group sessions, used visual prompts and received individual feedback regarding the proper technique for measuring the left ventricle. Variability was reassessed following the intervention.
  
  
  RESULTS
  Sonographers were more likely to use proper measurement technique (38% vs. 62%, P = .017) after the educational intervention. The percent error of the left ventricular end systolic measurement decreased significantly (12.4% to 8.8%, P = .002). The percent error of the left ventricular end diastolic measurement showed a trend toward a decrease (7.7% to 5.8%, P = .067). There was no significant improvement in percent error for other measurements. Use of correct technique and sonographer experience of less than 5 years predicted decreased percent error.
  
  
  CONCLUSIONS
  A multifaceted educational intervention can be used to improve measurement variability in pediatric echocardiography laboratories.
authors: Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Md, USA.
authors: Alicia H
authors: AH
authors: Chaves
authors: University of Maryland Medical Center, Baltimore, Md, USA.
authors: Jennifer
authors: J
authors: Sebastian
authors: Children's National Medical Center, Washington, DC, USA.
authors: Susan
authors: S
authors: Hoopes
authors: Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Md, USA.
authors: Geoffrey L
authors: GL
authors: Rosenthal
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002983:Clinical Competence / Q000592:standards; D004452:Echocardiography / Q000592:standards; D004502:Education, Medical, Continuing; D000068156:Formative Feedback; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007318:Inservice Training; D010372:Pediatrics / Q000193:education* / Q000592:standards; D011237:Predictive Value of Tests; D015397:Program Evaluation; D058996:Quality Improvement / Q000592:standards; D019984:Quality Indicators, Health Care / Q000592:standards; D015203:Reproducibility of Results
keywords: Measurement Variability; Pediatric Echocardiography; Quality Improvement