Multispecialty comparison of point-of-care-ultrasound use, training, and barriers: a national survey of VA medical centers

Dana M. Resop, Department of Emergency Medicine, University of Wisconsin, Madison, WI, USA.
Brian Bales, Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
Rebecca G. Theophanous, Department of Emergency Medicine, Duke University, Durham, NC, USA.
Jessica Koehler, Department of Emergency Medicine, University of Michigan Medical School, Ann Arbor, MI, USA.
Jeremy S. Boyd, Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
Michael J. Mader, Research Service, South Texas Veterans Health Care System, San Antonio, TX, USA.
Jason P. Williams, Medicine Service, Atlanta VA Medical Center, Atlanta, GA, USA.
Robert Nathanson, Medicine Service, South Texas Veterans Health Care System, San Antonio, TX, USA.
Zahir Basrai, Emergency Medicine, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA.
Elizabeth K. Haro, Medicine Service, South Texas Veterans Health Care System, San Antonio, TX, USA.
Rahul Khosla, Department of Pulmonary, Critical Care and Sleep Medicine, George Washington University, Washington, DC, USA.
Erin Wetherbee, Pulmonary Section, Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, USA.
Harald Sauthoff, Medicine Service, VA NY Harbor Healthcare System, New York, NY, USA.
Nilam J. Soni, Medicine Service, South Texas Veterans Health Care System, San Antonio, TX, USA.
Christopher K. Schott, Critical Care Service, VA Pittsburgh Health Care Systems, University Drive C, Mail Route: 124-U, Pittsburgh, PA, 15240, USA. Christopher.Schott@va.gov.

Document Type

Journal Article

Publication Date

5-21-2025

Journal

The ultrasound journal

Volume

17

Issue

1

DOI

10.1186/s13089-024-00398-x

Keywords

Barriers; POCUS; Point of care ultrasound; Survey; Training; VA; Veterans Affairs

Abstract

BACKGROUND: As more specialties have begun to use Point-of-Care Ultrasound (POCUS) in patient care, hospitals and healthcare systems have been investing increasing resources in POCUS infrastructure (training, equipment, and administration). Since each specialty uses different POCUS applications, healthcare systems seek to identify commonalities and differences between specialties to make thoughtful investments in POCUS infrastructure to support each specialty's use of POCUS while minimizing redundancies. Historically, past studies have focused on POCUS use in individual specialties, primarily emergency medicine and critical care, but comparative studies of different specialties are needed to guide investment in POCUS infrastructure and bolster POCUS implementation across healthcare systems. We conducted a cross-sectional survey of all Veterans Affairs (VA) medical centers in the United States and compared data from 5 different specialties on current usage, training needs, and barriers to POCUS implementation. RESULTS: Data were collected from facility chiefs of staff (n = 130; 100% response rate) and chiefs of emergency medicine (n = 101; 92% response rate), critical care (n = 93; 83% response rate), hospital medicine (n = 105; 90% response rate), anesthesiology (n = 96; 77% response rate), and surgery (n = 104; 95% response rate). All specialties surveyed reported current POCUS use (surgery 54%, hospital medicine 64%, anesthesiology 83%, emergency medicine 90%, and critical care 93%) but more importantly, a greater desire for training was seen. Procedural POCUS applications were most often used by all specialties, despite decreased procedural POCUS use since 2015 for all specialties except critical care. Diagnostic POCUS use generally increased from 2015 to 2020, although use of specific POCUS applications varied significantly between specialties. Barriers limiting POCUS use included lack of training (53-80%), access to ultrasound equipment (25-57%), and POCUS infrastructure (36-65%). CONCLUSIONS: From 2015 to 2020, POCUS use increased significantly in emergency medicine, critical care, internal medicine, anesthesiology, and surgery, although use of specific applications varied significantly between specialties. Lack of training and POCUS infrastructure were common barriers to POCUS use across specialties. Desire for training exceeded current use for several POCUS applications. These findings can guide implementation and standardization of POCUS use in hospitals and healthcare systems.

Department

Medicine

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