Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

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

Version 1 : Received: 30 June 2021 / Approved: 1 July 2021 / Online: 1 July 2021 (07:43:46 CEST)

A peer-reviewed article of this Preprint also exists.

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. 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.

Journal reference: Diagnostics 2021, 11, 1451
DOI: 10.3390/diagnostics11081451

Abstract

Despite the many advantages of lung ultrasound (LUS) in the diagnosis and management of patients with dyspnea, adoption among hospitalists has been slow. We performed semi-structured interviews of hospitalists from 4 diverse health systems in the US 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 27 hospitalists invited, we performed in-terviews of 22 from 4 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 perceived benefits of LUS for patients, clinicians and health systems, an important 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.

Keywords

lung ultrasound; implementation science; point of care ultrasound

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