Written by Chris Thom
Spoon Feed
In this single institution study, the move to an “encounter-based” POCUS workflow improved provider satisfaction and reduced data entry errors.
Reducing steps improves POCUS compliance
This was a single emergency department analysis of a quality improvement project pertaining to POCUS workflow. Prior to this change, POCUS scans required manual entry of a patients’ medical record number (MRN) and the operator ID. This was then transitioned to an “encounter-based” workflow, wherein the ultrasound machine worklist was automatically populated by all of the patients who had been registered in the ED on that date. The user would select the patient, perform the exam, and then document the interpretation of the scan in an Epic procedure note. This institution used only Epic and PACS, no middleware products.
50 out of 69 (72.5%) clinicians completed the survey. 46% of respondents were residents and 30% were attending physicians. 94.7% found it to be more convenient to use than the old workflow, and 97.4% expressed preference for the new workflow. MRN data entry errors fell from 141 in the 138 days prior to the workflow change to 90 in the 138 days following workflow change. Based on this reduction in error, an estimated $7,000 in additional POCUS charges could be made.
How will this change my practice?
The topic of POCUS workflow is often overlooked, yet it is critical to POCUS success. Too many steps for the physician user will invariably suffer poor compliance. The “encounter-based” process saves a step and allows users to focus on ultrasound image acquisition instead of manual data entry. This is particularly important for critical or emergent studies. Third party middleware products often facilitate this, though the current study managed to succeed with Epic and PACS only. I am curious whether different POCUS exam types (e.g. – biliary, cardiac, etc.) are clearly separated in their Epic procedure notes and PACS system for easy sorting and management.
Source
Impact of worklist selection on point-of-care ultrasound workflow – a quality improvement project. BMC Health Serv Res. 2025 Jan 14;25(1):76. doi: 10.1186/s12913-025-12234-6. PMID: 39810260
