Increasing Point-of-care Ultrasound Scanning by Pediatric Emergency Medicine Fellows: A Quality Improvement Initiative

Introduction: During the past 20 years, there has been an increased integration of point-of-care ultrasound (POCUS) curricula in pediatric emergency medicine (PEM) fellowships. Locally, our fellows were not achieving the recommended 150 scans target we set for graduation. We undertook this quality improvement initiative to increase POCUS scanning in our PEM fellowship. Methods: We implemented a quality improvement project from July 2020 to June 2021. Our primary aim was to increase the number of scans performed monthly by the fellows from 3 to 5 scans per fellow per month. After querying the fellows and identifying barriers to POCUS scanning, we implemented interventions targeted at increasing longitudinal scanning, transparency, and accountability in the achievement of target scan numbers. Results: The number of scans per fellow per month increased from a baseline of 3 to 7.6 scans per fellow per month. All graduating fellows met the target of 150 scans by graduation. The impact was sustained 5 years later. Conclusions: The most effective interventions included required quarterly supervised scanning, maintaining a transparent scan-count dashboard, and encouraging scanning with co-fellows when working clinically. These strategies can be incorporated by other PEM training programs.