SCANZ3 Audit results Belinda Buckley on behalf of the SCANZ3 - - PDF document

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SCANZ3 Audit results

Belinda Buckley

• n behalf of the SCANZ3 Steering Group

Acknowledgements

 Steering group members Dr Alex Sasse and Dr Gillian Whalley and Dr Van Pelt as

the CSANZ Imaging group representative

 Dr Christien Fortune who performed the audit data entry  DHB site coordinators:

Michael Mooten Helen Walsh Renelle French Fiona Lean Margaret Oldfield Jackie Toy Leigh Lamont Mark Reyes Neil Silverwood Jenny Hardiman Tom Mortemore Laura Davidson Angela Morgan Timothy Hii Angela Geary Catherine Goggin Steve White Laura Perston David Yeoman Kerren Glasson

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SCANZ 3

 Method:

 Snapshot audit and survey  DHBs only  1 week in Dec 2015 – same week as 2005 and 2010  Retrospective – data collected in Feb/March 2016

 Aims:

 Regional disparity in echocardiogram provision  Workforce size and demographics - sonographers and Cardiologists  Additional resources - machines, rooms, clerical, patient transport  Proportion of normal scans  Audit data - comparison to 2005 data

Audit results

 Scan demographics volume, distribution, IP/OP  Patient demographics

age, gender

 Reporting practices

provider, physician reporting

 Wait times

referral to scan, scan to report

 Scan measurements

LV size, LV function

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Scan demographics

 20 DHB’s and 32 sites  25% of hospitals perform routine Saturday clinics

2005 2015 Change Scan volume 1180 1930 38%  TTE 94% 92% 2%  Stress 5.2% 3.2% 2%  OP 46% 61% ??

Patient demographics

50 100 150 200 250 300 350 400 450 0 to 9 10 to 19 20 to 29 30 to39 40 to 49 50 to 59 60 to 69 70 to 79 80 to 89 >90

Scan volume by age

Age 2005 2015 Male 56% 55% Median age 62 64 >18 years 83% 87% Largest age group 60-69 70-79

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Reporting practices

 92% sonographer scans  76% scans physician

reported

 Variation similar pattern

to 2005

100% reporting 0- 10% reporting

Proportion of DHB’s with % of echoes reported by a physician

6 DHB’s 11 DHB’s

Wait times

Referral received Scan performed Scan report

Patient echocardiogram journey

Referral to scan Scan to final report

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Referral to scan duration

Referral received Scan performed Scan report

Patient echocardiogram journey

Referral to scan Scan to final report

Referral to scan duration

 Excluded:

 5 DHB’s (29% of total

scan volume)

 Planned  Inpatients

 Total sample of 412  Average 65.9 days  Median 39.5 days

Wait to scan in 30 day groups

20 40 60 80 100 120 140

Volume of scans per 30 day wait duration

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Wait times

Referral received Scan performed Scan report

Patient echocardiogram journey

Referral to scan Scan to final report

 Excluded:

 non-physician reported

studies

 3 DHB’s  Inpatients

 Total sample of 877  Average 9.1 days  Median 0 days

Scan to final report duration

Wait duration in days

Volume of scans per wait duration

50 100 150 200 250 300 350 400 450 500 0-5 6-10 11-15 16-20 21-25 26-30 31-40 41-60 61-90 >90

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Limitations to wait time data

Referral received Scan performed Scan report

• Sample volume
• Scan type

Wait list date vs referral date Sonographer vs physician

Reported LV size and systolic function

10 20 30 40 50 60 70 80 90 100 2D/mmode volumes 3D FS volumes 3D

LV systolic function LV size

%

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Reported LV diastolic function

10 20 30 40 50 60 70 80 90 E/A Dec time TDI GLS area volumes dimension

LA Diastolic

%

Future analysis

 Clinical indications  Clinical findings  Proportion of normal scans  Referral to scan duration – scan specific  Reporting duration – relationship to physician workforce

size and DHB population

 Workforce to DHB population relationship

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Thank you