ACPC Quality Network Comprehensive Fetal Echocardiographic Examination Metric

ACPC Quality Network Comprehensive Fetal Echocardiographic Examination Metric - Process Map Chris Lindblade MD Fetal Cardiology Medical Director PCH

Process Map Goals • Collect 20 “normal” fetal echoes per quarter that meet inclusion/exclusion criteria • Exclusion criteria – – Incomplete or limited Abnormal structure, rhythm, or function Follow-up study Poor acoustic windows or otherwise technically limited

Process Map Goals • Randomize list if >20 studies/quarter • Select your Reviewer team – Physicians – Sonographers • Develop a reliable method of communicating worksheet data

Process Flow at PCH Fetal Nurse Coordinator pulls list of “normal” from internal database and enters it into Excel Fetal Medical Director reviews and randomizes first 20 cases for metric (e. g. random. org) Studies assigned to each reviewer ~ 4 -5 per quarter with 4 -5 reviewers.

Process Flow at PCH Reviewers complete worksheets and send back to FMD electronically for scoring/data entry FMD reviews the completed worksheets. Internal notes are made on deficiencies Numerator and denominator from worksheets is sent to QI staff and Qnet lead for submission

Metric Worksheet

Example of PCH Compiled Data

Pilot Data Form Submitted to ACPC

Key in Process Flow • Phoenix Children’s internal fetal echo database – Used for tracking diagnosis, referrals, deliveries, etc – Very helpful clinically and for program development • Alternative data sources: – – Fetal clinic schedule Echo reading database (Xcelera, Syngo, etc) Prospective case log of all normal studies Other?

Lessons Learned from Pilot Study • Review FE protocol with junior sonographers and fellows • Effective tool for internal QI review • Opportunity for education for local obstetrical community

Thank You!