Quality Improvement

Quality Improvement (QI) in echocardiography isn’t just about compliance. it’s about delivering more accurate, consistent, and reproducible results for better patient outcomes.

Every day, echocardiography guides life-changing decisions: Should this patient get surgery? Is their heart failure medication working? Can they safely undergo major surgery? Yet behind these critical choices lies an uncomfortable truth—the same patient, scanned by different sonographers or interpreted by different cardiologists, can receive significantly different measurements and, ultimately, different care paths.

This isn't about incompetence or carelessness. It's about the inherent complexity of echocardiography and the urgent need for systematic quality improvement (QI) in cardiac imaging.

The good news? QI doesn’t have to be complicated. With a simple, well-planned activity, you can start making meaningful improvements in your echo lab today.

Why Quality Improvement is Necessary in Echocardiography

Echocardiography is one of the most operator-dependent imaging modalities in medicine.

Quality Improvement (QI) in echocardiography isn’t just about compliance—it’s about delivering more accurate, consistent, and reproducible results for better patient outcomes.

Variability between operators can occur due to differences in measurement technique, interpretation, or image acquisition. Over time, these differences can lead to inconsistent patient assessments.

By regularly reviewing and aligning our methods, we can:

Reduce measurement variability
Improve diagnostic confidence
Build trust in our results among referring clinicians
Support better clinical decision-making

A Simple, Real-World Example of QI in Action

To show how straightforward QI can be, we ran a simple activity at a conference using just a Google Form linked to a Google Sheet.

It might sound complex, but honestly, the process took only minutes to set up and produced valuable insights.

What We Did:

Designed a Google Form

Participants entered three key echo measurements:

LVOT Diameter (mm)
LVOT VTI (cm)
Mitral Regurgitation severity (categorical variable)

Linked it to Google Sheets

Responses automatically flowed into a central spreadsheet.

Built an automated results dashboard.

Data was anonymised and plotted to show individual results compared with the reference values set by a panel of experts.

Provided feedback instantly

Each participant received a “report card” via email with a visual comparison of their results to the benchmark.

The results are just the start...
this is where the discussion begins. The exercise aims to serve as a catalyst for discussion to bring the entire team onto the same page.

Sample "report card"

QI Measurement Activity – Report Card Tes · Accredited Sonographer Thank you for taking part in our Quality Improvement (QI) activity. This was designed to show how straightforward QI can be in da

Best Practices for QA/QI Activities in Echo

To make QI work for your team, keep these principles in mind:

Keep it simple

Choose a small number of focused metrics.

Use results as a starting point for discussion

Let the data prompt conversation about technique, rather than dictate a “pass/fail” outcome.

Be non-punitive

The goal is learning, not blaming.

Benchmark against agreed standards

Set reference values using expert consensus.

Provide feedback quickly

Immediate feedback makes the exercise more engaging and actionable.

Repeat regularly

Regular check-ins help track improvement over time.

QI doesn’t have to mean a major audit or a formal accreditation exercise.

It can be as simple as a one-page form, a shared spreadsheet, and a short debrief session with your team.

When we measure, we learn. When we learn, we improve.

Webinar Available in The Echo Chamber
QA Walk-Through with Tony Forshaw

Who Should Watch?

Anyone looking to measure accuracy and reproducibility in echocardiography.

Session objectives

Understand the role of Quality Improvement (QI) in echocardiography – Explain why QI is essential for accuracy, reproducibility, and better patient outcomes.
Identify different types of Quality Assurance (QA) activities – Differentiate between quantitative measurement audits, categorical assessment reviews, peer review processes, and image quality checks.
Design and implement a targeted audit exercise– Learn how to select a focus area, set reference standards, and capture data using simple tools such as Google Forms and Sheets.
Analyse and interpret QI results– Understand how to benchmark performance against agreed standards and identify opportunities for improvement.
Create a learning-focused, non-punitive QI culture– Develop strategies to present results in a way that encourages discussion, alignment, and team-wide engagement.

How Do I Register?

If you have already registered for an Echo Chamber session in the past, or you are a current member...
Just head over to the dashboard, you are already in!

Note: premium registration is required to watch the replay , and certificates of attendance for CME.

Exciting new QA tools