Start spreading the news: a deliberate approach to POCUS program development and implementation

Gaudreau-Simard, Mathilde; Kilabuk, Elaine; Halman, Samantha; Wooller, Krista; Woo, Michael Y.; Arntfield, Robert; Ma, Irene; Forster, Alan J.

doi:10.1186/s13089-023-00309-6

The Ultrasound Journal

Table 3 GIM-POCUS program logic model: resources, activities, and outputs

From: Start spreading the news: a deliberate approach to POCUS program development and implementation

Resources/Inputs	Activities	Outputs	Pillars
Early adopters¹ Infrastructure: 1. Ultrasound machines on wheels on medical wards 2. Hand held devices that allow for portability 3. Archiving capabilities Funding: 1. POCUS leads -Protected teaching, administrative and research time 2. Non-clinical partners -Biomedical engineering department -Information system department 3. Academic grants to support research, quality improvement and innovation	POCUS academic half days	Establish a POCUS curriculum imbedded within the GIM residency training program	Education
	POCUS rotation
	Asynchronous feedback on archived scans
	GIM POCUS rounds	Continuous professional development for practicing attendings
	POCUS course (interdepartmental)
	Bedside scanning sessions
	Optimize the physical location of US machines	Optimize the physical environment	Workflow
	Optimize the US to user ratio	Optimize the physical environment
	Integrate an archiving platform with US machines and the hospital information system	Onboard users to an archiving platform
	Training sessions on the use of the archiving platform	Onboard users to an archiving platform
	Establish a system failure reporting process for US machines and the archiving platform	Maintenance of infrastructure
	Establish standards for what constitutes an adequate scan²	Quality assurance of scans	Patient safety
	Establish and implement a credentialing process³
	Establish a mechanism by which a proportion of scans performed by credentialed users are reviewed
	Adopt patient safety policies⁴	POCUS quality improvement program
	Conduct morbidity and mortality rounds for POCUS-related adverse events
	Implement an adverse event reporting and reviewing process
	Develop questions and set up projects that are specific to the use of POCUS in GIM	Research program with a focus on quality improvement and implementation science	Research
	Develop an IM POCUS fellowship	Capacity building	Sustainability
	Recruit and retain credentialed users	Capacity building
	Interdepartmental rounds	Cross-departmental collaboration
	Interdepartmental delivery of teaching activities (course, academic half days)	Cross-departmental collaboration

US = ultrasound
¹Locally, the early adopter groups are POCUS-trained internists who have completed dedicated POCUS training (ranging from 3 to 6 months) as part of their GIM subspecialty residency training.
²Including standards for image acquisition, image interpretation, clinical integration, and documentation
³There is currently no standardized credentialing process for Internal Medicine POCUS in Canada. We, therefore, developed a dedicated POCUS Entrustrable Professional Activities (EPA) using consensus methodology. To be considered credentialed, learners must achieve entrustment on 50 EPAs, including a minimum attributed to each core application.
⁴Including learner policy, incidental findings policy, infection prevention policy

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