The Role of Education in Decreasing No Call Rates of Routine Anatomy Scans
ePoster
Authors: Joslyn Isaac, University of Louisville OBGYN Edward Miller, University of Louisville OBGYN Emily Root, University of Louisville Hospital Kaitlyn Ellis, University of Louisville School of Medicine Jeremy Gaskins, University of Louisville ,
Leading ultrasound societies recommend that all pregnant women undergo a routine second trimester anatomic survey. For a variety of reasons, different structures can be difficult to visualize. This necessitates the patient returning for an additional scan, a “no call examination.” Although there are some maternal and fetal factors that lead to difficulty in evaluating certain anatomic systems, there are also user-dependent differences between sonographers. Decreasing the no call rate has significant impacts on both the clinical practice site and the patient. The goal of our study is to evaluate if trending sonographers no call rate, trending no call rate by body system, and providing continuing education will decrease the no call rate in our practice. This is a quality improvement study retrospectively analyzing second trimester ultrasound reports from January 1, 2022 through July 31, 2023. The no call rate was calculated before and after two interventions: informing each sonographer of their individual no call rate and providing didactic sessions. Data included maternal, fetal, and ultrasound characteristics. Maternal and neonatal characteristics were compared using descriptive statistics. Summary statistics were determined using means, standard deviations, counts, and proportions. In the pre-intervention data, the no call rate was found to be 34.4%. As expected, no call rate varied significantly between several sonographers, ranging from 13.6%-52.1% (p < 0.001). The features that were most consistently unseen (therefore the reason for a no-call) were the heart (31.1%), head (16.7%), and spine (14.8%). In the post-intervention data, the overall no call rate significantly improved to 28.5% (p=0.004). Our study showed a significant difference between sonographers regarding the no call rate for routine second trimester anatomy ultrasounds. It also showed that educating sonographers about their individual no call rate and implementing systems-based didactics improved the overall no call rate.