Cardiopulmonary Point-of-Care Ultrasonography for Hospitalist Management of Undifferentiated Dyspnea

1. Implementing a structured POCUS protocol for inpatients with undifferentiated dyspnea was associated with a 30% reduction in length of stay

Evidence Rating Level: 2 (Good) 

In patients hospitalized with undifferentiated dyspnea, timely differentiation between cardiac and pulmonary etiologies remains challenging. This quality improvement study employed a stepped-wedge cluster randomized design to evaluate a collaborative model integrating cardiopulmonary point-of-care ultrasonography (POCUS), performed by hospitalists with sonographer support and remote cardiologist interpretation, into the assessment of 208 adults. The intervention was associated with a 30.3% reduction in length of stay (mean 8.3 vs. 11.9 days) and significant cost savings of $751,537, equating to $3,055 saved per bed-day avoided. However, despite structured training, only 20% of hospitalists performed POCUS independently, citing barriers such as insufficient training and time constraints. These findings underscore the potential of POCUS to enhance hospital efficiency and reduce costs but highlight the need for improved educational strategies and incentives to promote broader clinician adoption and sustainable implementation.

Click to read this study in JAMA Network Open

Image: PD

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