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Article

Hospitalist Perceptions of Barriers to Lung Ultrasound Adoption in Diverse Hospital Environments

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Division of Hospital Medicine, University of Colorado School of Medicine, Aurora, CO 80045, USA
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Division of Cardiology, University of Colorado School of Medicine, Aurora, CO 80045, USA
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Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine, Aurora, CO 80045, USA
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Division of General Internal Medicine, University of Colorado School of Medicine, Aurora, CO 80045, USA
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Medical Education Department, Abbott Northwestern Hospital, Minneapolis, MN 55407, USA
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Department of Hospital Medicine, HealthPartners, Bloomington, MI 55420, USA
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Department of Medicine, Denver Health, Denver, CO 80204, USA
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Human Systems Integration Division NASA Ames Research Center, Mountain View, CA 94043, USA
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Cardiovascular Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
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Division of Pulmonary and Critical Care Medicine and Division of General & Hospital Medicine, University of Texas Health San Antonio, San Antonio, TX 78229, USA
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Author to whom correspondence should be addressed.
Academic Editors: Marcello Demi and Gino Soldati
Diagnostics 2021, 11(8), 1451; https://doi.org/10.3390/diagnostics11081451
Received: 30 June 2021 / Revised: 5 August 2021 / Accepted: 6 August 2021 / Published: 11 August 2021
(This article belongs to the Special Issue Lung Ultrasound: A Leading Diagnostic Tool)
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. View Full-Text
Keywords: lung ultrasound; implementation science; point-of-care ultrasound lung ultrasound; implementation science; point-of-care ultrasound
MDPI and ACS Style

Maw, A.M.; Ho, P.M.; Morris, M.A.; Glasgow, R.E.; Huebschmann, A.G.; Barnard, J.G.; Metter, R.; Tierney, D.M.; Mathews, B.K.; Havranek, E.P.; Kissler, M.; Fleshner, M.; Burian, B.K.; Platz, E.; Soni, N.J. Hospitalist Perceptions of Barriers to Lung Ultrasound Adoption in Diverse Hospital Environments. Diagnostics 2021, 11, 1451. https://doi.org/10.3390/diagnostics11081451

AMA Style

Maw AM, Ho PM, Morris MA, Glasgow RE, Huebschmann AG, Barnard JG, Metter R, Tierney DM, Mathews BK, Havranek EP, Kissler M, Fleshner M, Burian BK, Platz E, Soni NJ. Hospitalist Perceptions of Barriers to Lung Ultrasound Adoption in Diverse Hospital Environments. Diagnostics. 2021; 11(8):1451. https://doi.org/10.3390/diagnostics11081451

Chicago/Turabian Style

Maw, Anna M., P. M. 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, and Nilam J. Soni 2021. "Hospitalist Perceptions of Barriers to Lung Ultrasound Adoption in Diverse Hospital Environments" Diagnostics 11, no. 8: 1451. https://doi.org/10.3390/diagnostics11081451

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