Improving sonographic visualisation of the appendix in a regional referral hospital
Ultrasound is a first-line and often preferred imaging modality in the diagnosis of acute appendicitis. When the appendix is not visualised during a dedicated appendix ultrasound study, patients may require a CT study, which uses ionising radiation, or undergo conservative clinical observation with...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2025-01-01
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| Series: | BMJ Open Quality |
| Online Access: | https://bmjopenquality.bmj.com/content/14/1/e002865.full |
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| author | Shyr Chui Carly Phinney Karina Hansen Deanna Danskin |
| author_facet | Shyr Chui Carly Phinney Karina Hansen Deanna Danskin |
| author_sort | Shyr Chui |
| collection | DOAJ |
| description | Ultrasound is a first-line and often preferred imaging modality in the diagnosis of acute appendicitis. When the appendix is not visualised during a dedicated appendix ultrasound study, patients may require a CT study, which uses ionising radiation, or undergo conservative clinical observation with the inherent risk of clinical deterioration, perforation and sepsis. Median baseline data, at our hospital imaging department, revealed a rate of combined normal and abnormal appendix visualisation of 34.5% which is below the reported visualisation rates in the North American literature and well below the rates reported in the global literature. We embarked on a formal quality improvement (QI) project to improve the rates of appendix visualisation in our hospital ultrasound department. Using the Model of Improvement framework and a team approach, we generated and trialled multiple plan-do-study-act interventions over a project term of 12 months. In the second half of the project term, we saw a sustained rise in appendix visualisation exceeding our original stretch goal of 75% visualisation which was sustained 6 months after the formal project end (p<0.001). This rise was accompanied by a commensurate increase in sonographer confidence in appendix visualisation. In our case, the Model of Improvement methodology proved successful in solving our complex problem of sonographic appendix under-visualisation. The learnings of this QI project have been widely shared and spread according to the ethos of QI. |
| format | Article |
| id | doaj-art-1787f91a212c44f6b8cd27d962ca5ea9 |
| institution | Kabale University |
| issn | 2399-6641 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open Quality |
| spelling | doaj-art-1787f91a212c44f6b8cd27d962ca5ea92025-02-03T18:55:09ZengBMJ Publishing GroupBMJ Open Quality2399-66412025-01-0114110.1136/bmjoq-2024-002865Improving sonographic visualisation of the appendix in a regional referral hospitalShyr Chui0Carly Phinney1Karina Hansen2Deanna Danskin3Medical Imaging, University Hospital of Northern British Columbia, Prince George, British Columbia, CanadaUniversity Hospital of Northern British Columbia, Prince George, British Columbia, CanadaUltrasound Department Supervisor, University Hospital of Northern British Columbia, Prince George, British Columbia, CanadaQuality Improvement Coach, University Hospital of Northern British Columbia, Prince George, British Columbia, CanadaUltrasound is a first-line and often preferred imaging modality in the diagnosis of acute appendicitis. When the appendix is not visualised during a dedicated appendix ultrasound study, patients may require a CT study, which uses ionising radiation, or undergo conservative clinical observation with the inherent risk of clinical deterioration, perforation and sepsis. Median baseline data, at our hospital imaging department, revealed a rate of combined normal and abnormal appendix visualisation of 34.5% which is below the reported visualisation rates in the North American literature and well below the rates reported in the global literature. We embarked on a formal quality improvement (QI) project to improve the rates of appendix visualisation in our hospital ultrasound department. Using the Model of Improvement framework and a team approach, we generated and trialled multiple plan-do-study-act interventions over a project term of 12 months. In the second half of the project term, we saw a sustained rise in appendix visualisation exceeding our original stretch goal of 75% visualisation which was sustained 6 months after the formal project end (p<0.001). This rise was accompanied by a commensurate increase in sonographer confidence in appendix visualisation. In our case, the Model of Improvement methodology proved successful in solving our complex problem of sonographic appendix under-visualisation. The learnings of this QI project have been widely shared and spread according to the ethos of QI.https://bmjopenquality.bmj.com/content/14/1/e002865.full |
| spellingShingle | Shyr Chui Carly Phinney Karina Hansen Deanna Danskin Improving sonographic visualisation of the appendix in a regional referral hospital BMJ Open Quality |
| title | Improving sonographic visualisation of the appendix in a regional referral hospital |
| title_full | Improving sonographic visualisation of the appendix in a regional referral hospital |
| title_fullStr | Improving sonographic visualisation of the appendix in a regional referral hospital |
| title_full_unstemmed | Improving sonographic visualisation of the appendix in a regional referral hospital |
| title_short | Improving sonographic visualisation of the appendix in a regional referral hospital |
| title_sort | improving sonographic visualisation of the appendix in a regional referral hospital |
| url | https://bmjopenquality.bmj.com/content/14/1/e002865.full |
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