Standardizing Point-of-Care Ultrasound Credentialing Across a Large Health Care System

Point-of-care ultrasound (POCUS) is becoming prevalent in the daily practice of bedside clinicians. As large health care systems standardize practice patterns, an organized approach of credentialing physicians in POCUS is paramount for quality and patient safety. This study describes a systematic approach of credentialing a diverse group of community emergency physicians (EPs) across a large health care system. A multimodal POCUS credentialing initiative for EPs was implemented across 11 hospitals between January 1, 2017, and July 1, 2018, that included (1) standardization of POCUS credentialing for all hospitals in the system, (2) tiered POCUS credentialing (Basic and Intermediate) for manageable attainment of goals with a required POCUS course, (3) automatic privileges for EPs who completed residency or practice-based POCUS pathways prior to employment, and (4) implementation of a practice-based pathway for competency assessment for noncredentialed physicians. Key factors for implementation included executive administrative support, dedicated POCUS courses, equipment standardization, a robust electronic medical record capable of logging training scans, and competency assessment for attainment of privileges. Through the initiative, 78/106 EPs achieved Intermediate credentialing, and 28/106 were without POCUS privileges. All 28 noncredentialed EPs completed the required Basic POCUS course. Almost half (13/28) completed the initiative and became credentialed. From 2016 to 2018, the number of EPs performing scans increased from 52 to 112, and the number of POCUS scans increased from 928 to 3,007. A standardized POCUS credentialing initiative can be successfully implemented in large health care systems. Other specialties can use this initiative to implement POCUS into their daily practice.