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The Use of Additionally Trained Sonographers as Ultrasound Practitioners

Our First-Year Experience

Department of Radiology, University of Michigan Medical Center, Ann Arbor, Michigan USA.

Address correspondence to Ronald Bude, MD, B1D 502, Department of Radiology, University of Michigan Medical Center, 1500 E Medical Center Dr, Ann Arbor, MI 48109-0030 USA. E-mail: ronbude{at}umich.edu

Objective. Two sonographers were trained to help manage an abrupt, permanent increase in the number of ultrasound examinations in our department. Called "ultrasound practitioners," they functioned as physician assistants and triaged 20 to 30 cases per day, allowing the cases to be batch read at a formal reading at day’s end. We report our first-year experience with this program. Methods. Two sonographers with 10 and 30 years of experience, respectively, were trained to triage and dictate cases. Once trained, they triaged the cases of 20 to 30 patients per day. Reports were predictated with voice recognition technology. A radiologist was always readily available to provide support, and consultation with a radiologist was always obtained for the infrequent verbal reports that were requested. Reports from the practitioner were graded subjectively on a 4-point scale for the first year, according to the modification required at formal readout (A, no change; B, minor change not affecting patient care; C, moderate change not affecting care in a dramatic way; and D, major change markedly affecting care). Results. Practitioner 1 monitored the examinations of 2858 patients. The graded report results were as follows: A, 96.2%; B, 3.5%; C, 0.3%; and D, 0.00%. Practitioner 2 monitored the examinations of 2825 patients. The graded report results were as follows: A, 96.1%; B, 3.6%; C, 0.2%; and D, 0.00%. There were no category D reports. Conclusions. The results far exceeded expectations, with a very low rate of category B and C reports and an absence of category D reports. The practitioners allowed the cases of 20 to 30 patients to be batch read by the existing radiologist staff at the end of the day.

Key Words: diagnostic radiology • efficacy study • observer performance • radiologists • radiology • socioeconomic issues • sonographer • ultrasound

Abbreviations: ABR, American Board of Radiology • PACS, picture-archiving and communications system

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