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

21/07/2017 SCANZ3 Audit results Belinda Buckley on 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 1

21/07/2017 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 2

21/07/2017 Scan demographics  20 DHB’s and 32 sites 2005 2015 Change 38%  Scan volume 1180 1930 2%  TTE 94% 92% 2%  Stress 5.2% 3.2% OP 46% 61% ??  25% of hospitals perform routine Saturday clinics Patient demographics 450 Scan volume by age 400 2005 2015 350 300 Male 56% 55% 250 Median age 62 64 200 >18 years 83% 87% 150 100 Largest age 60-69 70-79 50 group 0 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 Age 3

21/07/2017 Reporting practices 11 DHB’s  92% sonographer scans 6 DHB’s  76% scans physician reported 0- 10% reporting 100%  Variation similar pattern reporting to 2005 Proportion of DHB’s with % of echoes reported by a physician Wait times Patient echocardiogram journey Referral to scan Scan to final report Referral Scan Scan report received performed 4

21/07/2017 Referral to scan duration Patient echocardiogram journey Referral to scan Scan to final report Referral Scan Scan report received performed Referral to scan duration  Excluded: 140 Volume of scans per 30 day wait duration 120  5 DHB’s (29% of total scan volume) 100 80  Planned 60  Inpatients 40  Total sample of 412 20  Average 65.9 days 0  Median 39.5 days Wait to scan in 30 day groups 5

21/07/2017 Wait times Patient echocardiogram journey Referral to scan Scan to final report Referral Scan Scan report received performed Scan to final report duration 500  Excluded: Volume of scans per wait duration 450  non-physician reported 400 studies 350 300  3 DHB’s 250  Inpatients 200  Total sample of 877 150 100  Average 9.1 days 50  Median 0 days 0 0-5 6-10 11-15 16-20 21-25 26-30 31-40 41-60 61-90 >90 Wait duration in days 6

21/07/2017 Limitations to wait time data • Sample volume • Scan type Sonographer Wait list date vs vs physician referral date Referral Scan Scan report received performed Reported LV size and systolic function % 100 LV systolic 90 80 function 70 LV size 60 50 40 30 20 10 0 2D/mmode volumes 3D FS volumes 3D 7

21/07/2017 Reported LV diastolic function % 90 LA 80 70 Diastolic 60 50 40 30 20 10 0 E/A Dec time TDI GLS area volumes dimension 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 8

21/07/2017 Thank you 9