Quality Improvement in Noninvasive Imaging: Present and Future Initiatives

Indicators of quality services in pediatric and congenital echocardiography include structural, process, and outcome factors. Structural indicators involve the available resources related to the facility, the equipment, and the staff. Process indicators relate primarily to the activities and tasks associated with echocardiography, and these include patient selection as well as study performance, interpretation, and reporting. Outcome indicators involve the results of quality services and are intimately related to quality improvement activities as well as quality metrics. Current quality improvement activities in the field of pediatric and congenital echocardiography include development of the accreditation process for sonographers, physicians, and echocardiography laboratories; evaluation of productivity standards within echocardiography laboratories; identification of appropriate use criteria specific to pediatric and congenital echocardiography; and establishment of a robust database of normal reference values for cardiovascular measurements in children. Candidate quality metrics currently in development involve reporting of critical results, adverse events with sedated studies, variability of echocardiographic measurements, diagnostic errors, study completeness, and image quality.