Geographic variation in point of care ultrasound provision: results from a national audit.

Acute medicine Point-of-care systems Training Ultrasonography

Journal

The ultrasound journal
ISSN: 2524-8987
Titre abrégé: Ultrasound J
Pays: Italy
ID NLM: 101742146

Informations de publication

Date de publication:
21 Mar 2023
Historique:
received: 03 09 2022
accepted: 04 03 2023
entrez: 21 3 2023
pubmed: 22 3 2023
medline: 22 3 2023
Statut: epublish

Résumé

There is an emerging consensus that point-of-care ultrasound is an essential skill in acute care. This is reflected in recent changes to the Acute Internal Medicine curriculum in the UK. The need to develop and maintain specific ultrasound competencies is now a mandatory component of training. There is a degree of uncertainty as to how existing training infrastructure can best accommodate these changes. Data were obtained from the latest annual Society for Acute Medicine Benchmarking Audit 2021. All Acute Medical Units in the UK are eligible to participate. Data pertaining to the number of ultrasound machines and number of clinicians that regularly use point of care ultrasound were collected. This was used to develop a series of maps demonstrating variation in provision at the national level. In total, 123 AMUs responded to the questions related to ultrasound prevalence and numbers of trained clinicians. Of these, 78.9% (97/123) reported having access to at least one ultrasound machine. There was at least one clinician that regularly used ultrasound in 81 responding hospitals (65.9%). There was significant geographic heterogeneity in the use of ultrasound and availability of accredited supervisors. At a regional level, ultrasound expertise is typically concentrated within a relatively small number of hospitals. Geographic variation in the use of ultrasound and availability of registered supervisors represents a significant challenge to ultrasound training provision at the national level. Targeted interventions in areas with less developed training infrastructure, such as regional training hubs may be required to ensure more equitable access to training opportunities.

Sections du résumé

BACKGROUND BACKGROUND
There is an emerging consensus that point-of-care ultrasound is an essential skill in acute care. This is reflected in recent changes to the Acute Internal Medicine curriculum in the UK. The need to develop and maintain specific ultrasound competencies is now a mandatory component of training. There is a degree of uncertainty as to how existing training infrastructure can best accommodate these changes.
METHODS METHODS
Data were obtained from the latest annual Society for Acute Medicine Benchmarking Audit 2021. All Acute Medical Units in the UK are eligible to participate. Data pertaining to the number of ultrasound machines and number of clinicians that regularly use point of care ultrasound were collected. This was used to develop a series of maps demonstrating variation in provision at the national level.
RESULTS RESULTS
In total, 123 AMUs responded to the questions related to ultrasound prevalence and numbers of trained clinicians. Of these, 78.9% (97/123) reported having access to at least one ultrasound machine. There was at least one clinician that regularly used ultrasound in 81 responding hospitals (65.9%). There was significant geographic heterogeneity in the use of ultrasound and availability of accredited supervisors. At a regional level, ultrasound expertise is typically concentrated within a relatively small number of hospitals.
CONCLUSION CONCLUSIONS
Geographic variation in the use of ultrasound and availability of registered supervisors represents a significant challenge to ultrasound training provision at the national level. Targeted interventions in areas with less developed training infrastructure, such as regional training hubs may be required to ensure more equitable access to training opportunities.

Identifiants

pubmed: 36943576
doi: 10.1186/s13089-023-00314-9
pii: 10.1186/s13089-023-00314-9
pmc: PMC10030694
doi:

Types de publication

Journal Article

Langues

eng

Pagination

16

Informations de copyright

© 2023. The Author(s).

Références

Smallwood N, Dachsel M (2018) Point-of-care ultrasound (POCUS): unnecessary gadgetry or evidence-based medicine. Clin Med (Lond) 18(3):219–224
doi: 10.7861/clinmedicine.18-3-219 pubmed: 29858431
Royal College of Physicians. Acute Medicine Task Force, editor. Acute medical care: the right person, in the right setting-first time 2007. Royal College of Physicians.
Smallwood N, Lane N (2015) A career in acute internal medicine. BMJ 350:h2704
doi: 10.1136/bmj.h2704
Joint Royal Colleges of Physicians Training Broard. Acute Internal Medicine. https://www.jrcptb.org.uk/specialities/acute-medicine .
Joint Royal Colleges of Physicians Training Broard. Curriculum for Acute Internal Medicine 2022. https://www.jrcptb.org.uk/sites/default/files/AIM%202022%20curriculum%20FINAL%20July%202022_0.pdf .
Russell J, Dachsel M, Gilmore A, Matsa R, Smallwood N (2021) Focused Acute Medicine Ultrasound (FAMUS): uptake, completion and barriers to accreditation after two years. Acute Med 20(3):187–192
doi: 10.52964/AMJA.0863 pubmed: 34679136
Russell FM, Zakeri B, Herbert A, Ferre RM, Leiser A, Wallach PM (2022) The State of Point-of-Care ultrasound training in undergraduate medical education: findings from a national survey. Acad Med 97(5):723–727
doi: 10.1097/ACM.0000000000004512 pubmed: 34789665
Knight T, Clare S, Smallwood N, Lasserson D (2020) Gaps in point of care ultrasound provision and the cost of ultrasound equipment provision: results of a nationwide audit of acute medical units. Acute Med 19(2):64–68
doi: 10.52964/AMJA.0803 pubmed: 32840255
Society for Acute Medicine. SAMBA 2021 study protocol 2021. https://www.acutemedicine.org.uk/download/samba-2021-protocol/ .
Atkin C, Knight T, Cooksley T, Holland M, Subbe C, Kennedy A et al (2022) Society for Acute Medicine Benchmarking Audit 2021 (SAMBA21): assessing national performance of acute medicine services. Acute Med 21(1):19–26
doi: 10.52964/AMJA.0888 pubmed: 35342906
Wilkinson JN, Saxhaug LM (2020) Handheld ultrasound in training—the future is getting smaller! J Intensive Care Soc 22(3):220–229
doi: 10.1177/1751143720914216 pubmed: 34422105 pmcid: 8373282
Soni NJ, Boyd JS, Mints G, Proud KC, Jensen TP, Liu G et al (2021) Comparison of in-person versus tele-ultrasound point-of-care ultrasound training during the COVID-19 pandemic. Ultrasound J 13(1):39
doi: 10.1186/s13089-021-00242-6 pubmed: 34487262 pmcid: 8419826

Auteurs

Sunil Aggarwal (S)

University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK. sunil.aggarwal3@nhs.net.

Reshma Shanmugam (R)

University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.

Thomas Knight (T)

Sandwell and West Birmingham Hospitals NHS Foundation Trust, Birmingham, UK.
Birmingham Acute Care Research Group, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK.

Catherine Atkin (C)

University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
Birmingham Acute Care Research Group, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK.

Sarbjit Clare (S)

Sandwell and West Birmingham Hospitals NHS Foundation Trust, Birmingham, UK.

Nicholas Smallwood (N)

Hampshire Hospitals NHS Foundation Trust, Hampshire, UK.

Daniel Lasserson (D)

School of Medicine, University of Warwick, Coventry, UK.
Oxford University Hospitals NHS Foundation Trust, Oxford, UK.

Classifications MeSH