When a patient arrives in the hospitals with a health issue, it can take hours to establish, through tests, where the problem lies. However, this can be expedited if hospitalists can perform ultrasounds at a patient’s bedside. Using Point of Care Ultrasound (POCUS) as part of the clinical examination, much as they would use a stethoscope, further investigations could be better targeted.
Though POCUS is part of the standard of care for hospitalists in some regions, particularly with emergency physicians, it’s use in hospitalist medicine in Victoria is still novel. Hospitalist Dr. Rikus de Lange was trained on POCUS during his career in emergency medicine in Regina, and saw the value of being able to initiate treatment more rapidly once a diagnosis had been made. He received funding from the South Island Medical Staff Association to engage the hospitalists in Victoria to be trained in using bedside ultrasound.
A group of hospitalists met to discuss integrating POCUS into the hospitalists’ practices, a process that was essential for building consensus among the group for this service and training. Following this meeting, a survey was launched to assess the staff’s existing comfort and familiarity with the technology, as well as their knowledge of existing training pathways. The survey also assessed hospitalist interest and availability in receiving POCUS training.
After assessing existing availability of POCUS machines, the group quickly realized that more ultrasound machines were essential to learn, maintain skills and have access to POCUS on the wards. Hospitalists requested the purchase of more POCUS machines through Island Health. By engaging hospitalist physicians and setting up formal POCUS guidelines for the hospitalist, it facilitated discussions with Island Health that ultrasound machines should be purchased for both RJH and VGH hospitalist use. The group is currently navigating challenges to ensure that the IMIT Security and Privacy assessments can be operationalized in relation to this new technology.
In addition to the progress on purchasing the ultrasound machines, the group has established a pathway for Hospitalists to obtain ultrasound experience and proficiency through supervision within the hospitalist group. Point of Care Ultrasound privileging guidelines are now ready for implementation.
Speaking about the value of the funding, Dr. de Lange explained that it enabled them to embark upon this novel training. Without it, the hospitalist group may not have been trained in POCUS for years. There are other groups on the island who have since expressed interest in a POCUS program and the guidelines. Dr. de Lange says, “Formal POCUS training pathways and guidelines for hospitalists in Canada isn’t something that exists yet. In order for this type of training to come through, it requires physician engagement – someone will have to undertake it. South Island Hospitalists can be proud to lead with this technology in delivering high quality care.”