Hospitalist perceptions of barriers to lung ultrasound adoption in diverse hospital environments

Anna M. Maw, P. Michael Ho, Megan A. Morris, Russell E. Glasgow, Amy G. Huebschmann, Juliana G. Barnard, Robert Metter, David M. Tierney, Benji K. Mathews, Edward P. Havranek, Mark Kissler, Michelle Fleshner, Barbara K. Burian, Elke Platz, Nilam J. Soni

Research output: Contribution to journalArticlepeer-review

Abstract

Despite the many advantages of lung ultrasound (LUS) in the diagnosis and management of patients with dyspnea, its adoption among hospitalists has been slow. We performed semi-structured interviews of hospitals from four diverse health systems in the United States to understand determinants of adoption within a range of clinical settings. We used the diffusion of innovation theory to guide a framework analysis of the data. Of the 27 hospitalists invited, we performed 22 interviews from four hospitals of diverse types. Median years post-residency of interviewees was 10.5 [IQR:5-15]. Four main themes emerged: (1) There are important clinical advantages to LUS despite operator dependence, (2) LUS enhances patient and clinician experience, (3) Investment of clinician time to learn and perform LUS is a barrier to adoption but yields improved efficiency for the health system and (4) Mandated training and use may be necessary to achieve broad adoption as monetary incentives are less effective. Despite the perceived benefits of LUS for patients, clinicians and health systems, a significant barrier to broad LUS adoption is the experience of time scarcity by hospitalists. Future implementation strategies should focus on changes to the clinical environment that address clinician barriers to learning and adoption of new skills.

Original languageEnglish (US)
Article number1451
JournalDiagnostics
Volume11
Issue number8
DOIs
StatePublished - Aug 2021

Keywords

  • Implementation science
  • Lung ultrasound
  • Point-of-care ultrasound

ASJC Scopus subject areas

  • Clinical Biochemistry

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