Use of Echocardiograms

Background

Echocardiograms are important modalities with which to diagnose heart abnormalities children. There is room for improvement when selecting patients for initial transthoracic echocardiograms in outpatient pediatric cardiology.

This quality improvement initiative is based on comparing guidelines for use of initial transthoracic echocardiograms and our actual use of the test in outpatient pediatric cardiology. Here is the Appropriate Use Criteria guideline we have utilized:
"Appropriate Use Criteria for Initial Transthoracic Echocardiography in Outpatient Pediatric Cardiology"; Journal of the American Society of Echocardiography; Volume 27, Issue 12, pp. 1247-1266, December 2014.

Assessment

We reviewed the medical records of 50 pediatric patients who underwent echocardiogram at GCH in 2023. We found that we could increase the percentage of echocardiograms in the "Appropriate Use Category" based on the national guidelines by 10%. We are currently at 87%. Our goal is to achieve a 10% increase in the appropriate use category the end of 2024. We found we could decrease the percentage of echocardiograms in "Rarely Appropriate Use Category" based on national guideline by 10% by the end of 2024. Our goal is to decrease rarely appropriate use by 10%. We are currently at 48%.

Recommendation

The goal of this QI Project is to more closely follow the algorithms from the national guidelines for transthoracic echocardiogram. See guideline algorithms below for chest pain, arrhythmias, palpitations, syncope, and murmur. Click on images to enlarge.