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Diagnostics (Basel). 2019 Oct 18;9(4). pii: E153. doi: 10.3390/diagnostics9040153.

Stakeholder Perceptions of Point-of-Care Ultrasound Implementation in Resource-Limited Settings.

Author information

1
Division of Hospital Medicine, University of Colorado, Aurora, CO 80045, USA. anna.maw@cuanschutz.edu.
2
Alma Mater Hospital, Gros Morne 4210, Haiti. galvibr@gmail.com.
3
Alma Mater Hospital, Gros Morne 4210, Haiti. ricardsh93@yahoo.fr.
4
Division of Engineering and Applied Science, California Institute of Technology, Pasadena, CA 91125, USA. michael.yao@atriaconnect.org.
5
Alma Mater Hospital, Gros Morne 4210, Haiti. brunoexame@gmail.com.
6
Division of General Internal Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA 15260, USA. fleshnerm@upmc.edu.
7
Department of Health Systems, Management and Policy, Centers for American Indian and Alaska Native Health, Colorado School of Public Health, Aurora, CO 80045, USA. meredith.fort@cuanschutz.edu.
8
Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado School of Medicine, Aurora, CO 80045, USA. megan.a.morris@cuanschutz.edu.

Abstract

BACKGROUND:

Nearly half of the world lacks access to diagnostic imaging. Point of care ultrasound (POCUS) is a versatile and relatively affordable imaging modality that offers promise as a means of bridging the radiology gap and improving care in low resource settings.

METHODS:

We performed semi-structured interviews of key stakeholders at two diverse hospitals where POCUS implementation programs had recently been conducted: one in a rural private hospital in Haiti and the other in a public referral hospital in Malawi. Questions regarding the clinical utility of POCUS, as well as barriers and facilitators of its implementation, were asked of study participants. Using the Framework Method, analysis of interview transcripts was guided by the WHO ASSURED criteria for point of care diagnostics.

RESULTS:

Fifteen stakeholders with diverse roles in POCUS implementation were interviewed. Interviewees from both sites considered POCUS a valuable diagnostic tool that improved clinical decisions. They perceived barriers to adequate training as one of the most important remaining barriers to POCUS implementation.

CONCLUSIONS:

In spite of the increasing affordability and portability of ultrasounds devices, there are still important barriers to the implementation of POCUS in resource-limited settings.

KEYWORDS:

implementation; point-of-care-ultrasound; ultrasound

PMID:
31635219
DOI:
10.3390/diagnostics9040153
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