PMID- 34791116
OWN - NLM
STAT- MEDLINE
DCOM- 20221121
LR  - 20221228
IS  - 2058-1742 (Electronic)
IS  - 2058-1742 (Linking)
VI  - 8
IP  - 8
DP  - 2022 Nov 17
TI  - Quality improvement initiative in paediatric echocardiography laboratory in a 
      low- to middle-income country.
PG  - 821-829
LID - 10.1093/ehjqcco/qcab084 [doi]
AB  - AIMS: To determine the impact of a quality improvement (QI) initiative in the 
      area of paediatric echocardiography (echo) in a low- to middle-income country 
      (LMIC).Care for patients with congenital heart disease is challenging, especially 
      in LMICs. Collaborative learning through QI projects is imperative to ensure 
      improvement in delivery processes leading to better patient outcomes. METHODS AND 
      RESULTS: This QI initiative was taken by a team consisting of physicians and 
      sonographers. Problems were identified, a key driver diagram (KDD) was created, 
      and simple process re-engineering was done using interventions based on the KDD. 
      Metrics (five process and one outcome) were assessed to determine the 
      effectiveness of the QI project. The process metrics assessed were 
      comprehensiveness of exam, timeliness of reporting, diagnostic accuracy and 
      error, and sedation adverse event rates of transthoracic echocardiograms, while a 
      novel comprehensive echo laboratory (lab) quality score was developed as an 
      outcome metric. Data were collected quarterly and analysed in the 
      post-implementation phase. Significant improvement was seen in comprehensive mean 
      score (20.4-29.7), timeliness (40-95%), and diagnostic accuracy rate (91-100%), 
      while a decrease was seen in the diagnostic error rate (7.5-3.5%) and the 
      sedation adverse event rate (6.8-0%), pre- vs. post-implementation. The overall 
      quality outcome score improved from 7 to 19 and the echo lab was able to achieve 
      adequate quality. CONCLUSION: This QI initiative produced improvement in all the 
      processes, and the overall quality of the echo lab without any substantial 
      increase in resources or cost.
CI  - (c) The Author(s) 2021. Published by Oxford University Press on behalf of the 
      European Society of Cardiology.
FAU - Mohsin, Shazia
AU  - Mohsin S
AUID- ORCID: 0000-0003-1003-4848
AD  - Section of Pediatric Cardiology, Department of Pediatric and Child Health, Aga 
      Khan University Hospital, Karachi, Pakistan.
FAU - Hasan, Babar
AU  - Hasan B
AD  - Section of Pediatric Cardiology, Department of Pediatric and Child Health, Aga 
      Khan University Hospital, Karachi, Pakistan.
FAU - Ather, Mishaal
AU  - Ather M
AD  - Section of Pediatric Cardiology, Department of Pediatric and Child Health, Aga 
      Khan University Hospital, Karachi, Pakistan.
FAU - Ali, Salima Ashiq
AU  - Ali SA
AD  - Section of Pediatric Cardiology, Department of Pediatric and Child Health, Aga 
      Khan University Hospital, Karachi, Pakistan.
FAU - Aslam, Nadeem
AU  - Aslam N
AD  - Section of Pediatric Cardiology, Department of Pediatric and Child Health, Aga 
      Khan University Hospital, Karachi, Pakistan.
FAU - Khalid, Farah
AU  - Khalid F
AD  - Section of Pediatric Cardiology, Department of Pediatric and Child Health, Aga 
      Khan University Hospital, Karachi, Pakistan.
FAU - Shabbir, Zain Adil
AU  - Shabbir ZA
AD  - Aga Khan University Hospital, Karachi, Pakistan.
FAU - Shabbir, Shaan Adil
AU  - Shabbir SA
AD  - Aga Khan University Hospital, Karachi, Pakistan.
FAU - Chowdhury, Devyani
AU  - Chowdhury D
AD  - Cardiology Care for Children, Lancaster, PA, USA.
AD  - Nemours Children's Hospital, Wilmington, DE, USA.
LA  - eng
PT  - Journal Article
PL  - England
TA  - Eur Heart J Qual Care Clin Outcomes
JT  - European heart journal. Quality of care & clinical outcomes
JID - 101677796
SB  - IM
MH  - Child
MH  - Humans
MH  - *Quality Improvement
MH  - Echocardiography
MH  - *Heart Defects, Congenital/diagnostic imaging/epidemiology
OTO - NOTNLM
OT  - ACPC QNET
OT  - Collaborative learning
OT  - Congenital heart disease
OT  - Echocardiogram
OT  - IAC
OT  - Key driver diagram
OT  - Low resource
OT  - Quality improvement
EDAT- 2021/11/19 06:00
MHDA- 2022/11/22 06:00
CRDT- 2021/11/18 07:17
PHST- 2021/10/04 00:00 [received]
PHST- 2021/11/06 00:00 [revised]
PHST- 2021/11/12 00:00 [accepted]
PHST- 2021/11/19 06:00 [pubmed]
PHST- 2022/11/22 06:00 [medline]
PHST- 2021/11/18 07:17 [entrez]
AID - 6429309 [pii]
AID - 10.1093/ehjqcco/qcab084 [doi]
PST - ppublish
SO  - Eur Heart J Qual Care Clin Outcomes. 2022 Nov 17;8(8):821-829. doi: 
      10.1093/ehjqcco/qcab084.