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The true value of point-of-care ultrasound

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Point-of-care (POC) ultrasound is having a tremendous effect on efficiency, productivity and ultimately patient safety in hospitals around the world, however, its true value is still largely underestimated. The full potential of POC ultrasound is yet to be realised and it’s important to get the right system for the job, but not all systems are created equal.

Hospitals need a system that is easy to use, backed by a comprehensive training infrastructure. It must be well adapted to the hospital environment, robust and easy to clean for infection control, with a quick boot-up time. Reliability is essential, but with the support of exceptional service and maintenance to back you up, and of course, any system needs to be fit-for-purpose and future-proof, offering excellent image quality and the flexibility to upgrade as technology and user requirements change. Finally, any new piece of equipment needs to have the capacity to improve efficiency and throughput. 

It’s all about seeing what the various companies have to offer, and asking the right questions:

  • How important is product quality?
  • What about the service plan? Is it included or an additional cost?
  • What do I know about the company? lWill the company provide training or are they just interested in ‘shifting a box’?
  • What does a warranty really cover? Don’t forget to read the small print!
  • What will this system really cost? What is the total ownership cost over five years?
  • Overall, which product gives the best value for money? 

Simplicity and support

A key consideration is that most users of POC ultrasound will not be radiologists or sonographers, and will have little or no experience of using complex imaging equipment. It makes sense to be consistent by using the same systems or the same supplier within a department, so that operators are familiar with the controls. FUJIFILM SonoSite systems are purposefully intuitive to use, with some, like the X-Porte, based on touchscreen technology, reflecting the recent smartphone and tablet revolution. The X-Porte has the added advantage of a large screen, which makes it very easy to see the structures of interest during a procedure. It also features built-in learning modules, so that new users can simply work through the tutorials to become familiar with the instrument. 

Ease of use for buttons and controls is one thing, but it’s also essential that operators know what they’re looking at, and training is an important factor in making the most of this technology. FUJIFILM SonoSite systems come with access to online training through the SonoSite Institute as part of the package; the company is hugely committed to supporting its customers with ongoing education, setting up courses on hospital sites or at its Luton Education Centre, run by experienced ultrasound practitioners.

Adapted to the hospital environment

Hospitals are busy, chaotic places, and equipment has to be built to withstand the everyday use and abuse it will go through. FUJIFILM SonoSite systems and transducers are truly robust; the technology was originally designed for military applications and product designs have all passed a one-metre drop test. They are quick to boot up and, in comparison to many competitive systems, don’t require regular maintenance or servicing. They are extremely reliable, however any problems that do occur are swiftly resolved, thanks to a true five-year warranty that uniquely covers more than one transducer, and a fleet of loan instruments that can be rapidly swapped out to minimise downtime. 

Dr Justin Kirk-Bayley, consultant intensivist and anaesthetist at the Royal Surrey County Hospital in Guildford, has extensive experience of using FUJIFILM SonoSite instruments over several years, and really appreciates the excellent service he has received: “It is essential that any downtime is as short as possible, and the design of the X-Porte system especially lends itself to this, allowing the central processing unit to be quickly and easily exchanged should it prove necessary, without the need to remove the instrument for off-site repair. When we did have an issue with our X -Porte though, it was swapped out for another system within one or two working days, and then was back in working order a couple of days later. In contrast, a machine from another manufacturer in our theatre broke and was out of service for almost a month, which put extra pressure on our other resources. We really couldn’t have hoped for better service from FUJIFILM SonoSite and this makes a huge difference to our department efficiencies. The company consistently resolves issues within just a few days, providing solutions very quickly and keeping the time where an instrument is out of clinical use to a bare minimum.” 

Future-proof design

Dr Kirk-Bayley added: “The design of the X-Porte also lends itself to being flexible for upgrading, which is a key consideration whenever we’re purchasing new equipment. The platform is heavily software-based, and so has the capacity to evolve with our needs as subsequent enhancements are not limited by hardware constraints. An example is tissue Doppler, which wasn’t even available when we first bought the instrument. Now, not only is it installed on our system, but it’s also really excellent, giving us further confidence in our investment. This approach of an upgradable firmware with a software interplay makes sense as a way of futureproofing equipment. It also affirms the point of a five-year warranty – there would be no point in that if a system was obsolete two years down the line.”

The added value of effective infection control

The design of the X-Porte is a big advantage to infection control within the hospital, as Dr Kirk-Bayley explains: “Our X-Porte machine is used in the intensive care environment where infection, sometimes with multi-drug resistance, is a real issue. We needed a system that would resist some of the caustic solutions that we use to clean the ward environment, and that also had minimal nooks and crannies that would be harder to clean. I discussed this aspect of the X-Porte with the infection control team and they agreed that it ticked all the boxes for smooth and easy-to-clean design.”

Ensuring patient safety

The key reason to choose a POC ultrasound system is to provide exceptional image quality to guide clinicians in their everyday work. Anaesthesia and guidance for vascular access are perhaps the applications where the value of POC ultrasound can most clearly be seen contributing to patient safety. NICE guidelines for ultrasound-guided placement of central venous lines in adults and children were first issued in the UK in October 2002 and, although the directive doesn’t specify which systems to use, in practical terms the smaller, more portable POC instruments are ideal.

Dr James Bennett is a consultant anaesthetist at Birmingham Children’s Hospital, with an interest in vascular access and liver transplantation. For him, point-ofcare ultrasound has become an essential tool to safely aid anaesthesia over the last 15 years. He said: “Children with liver disease are a particularly demanding group when it comes to vascular access, and I now always use POC ultrasound guidance for insertion of central and arterial lines, and difficult peripheral venous access. I can firstly identify a vein to puncture and verify that it is suitable for what is needed. I can guide the cannulating needle safely and, as a consequence, most of these procedures are done first pass without complication. It becomes a purely technical exercise, just a needle into a vein, and it’s as easy as that. My skills are saved up for the difficult cases when POC ultrasound really comes into its own. It can demonstrate blocked or narrowed veins, as well as imaging collateral and aberrant vessels. The use of Doppler ultrasound also allows assessment of flow within the vessels. POC ultrasound does more for vascular access than just guiding a needle into the vein; you quickly get the information about vascular anatomy necessary to safely place a line.”

Improving efficiency and productivity

Although throughput is not the driving reason for Dr Bennett to use POC ultrasound, he recognises that it does still have a positive impact on his efficiency: “POC ultrasound guidance is so quick that accessing the vein is not a time limiting factor, unless it’s a particularly difficult case. It often saves time because I can clearly image a blocked vein and choose a different access site.” 

Where the technique really can save time and improve efficiencies is in establishing block rooms, where an area is set aside for administering regional anaesthesia for minor procedures that don’t require a general anaesthetic. Dr Kirk-Bayley described how this practice can make a significant impact on patient throughput for elective day surgery lists: “Block rooms have emerged in recent years and link very well with the aim of most hospitals to try to perform as much day case, high turnover surgery as possible. Regional anaesthesia fits well with this model and adding a block room means that there is never a delay of 45 minutes waiting for the anaesthetic to reach full maturation; there is always a patient ready to go in to surgery as soon as the previous procedure is completed. Turnover time between patients is one of the significant delays in theatre operational efficiency so this approach helps tremendously. At the same time, many patients who have regional anaesthesia for minor surgery can mobilise themselves to theatres, and just need an escort afterwards, taking any requirements for porters out of the equation and saving further time there.” 

A tried and trusted supplier

FUJIFILM SonoSite is a tried and trusted POC ultrasound supplier offering:

  • Robust, reliable, intuitive systems, with excellent image quality and a quick boot-up time.
  • No need for annual service or maintenance, and no additional hidden costs.
  •  Outstanding support in education and service – not just ‘shifting a box’.
  • A true five-year warranty for systems and transducers.
  • A one-off cost that covers total ownership over five years.

Dr Kirk-Bayley has the last word: “We have a fantastic relationship with FUJIFILM SonoSite, and that is always factored into our tendering process. We take into consideration not only the capabilities and reliability of the instrument, but also the quality of service, the warranty, and the level of customer support that we know we will receive. We looked at other suppliers and systems but, when compared objectively, the X-Porte was leagues ahead. When you put the whole package together, it just leaves everything else standing.”

 

FUJIFILM SonoSite Ltd
T +44 (0)1462 341151,
ukresponse@sonosite.com
www.sonosite.co.uk

 

 

 

 

 

 

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Upcoming Events

Webinar: How to be Compliant and Sustainable In Healthcare

ONLINE
19th March 2024 & 21st March 2024 10 am CET time o

POCT Innovators: The Power to Disrupt Series

Cloth Hall Court, Leeds. UK
20 March, 2024

Central Sterilising Club - Annual Scientific Meeting 2024

Crowne Plaza at Gerrard’s Cross
15th April 2024 – 16th April 2024

DECON UK 2024

National Conference Centre, Birmingham
17th April 2024

Infection Prevention & Control

National Conference Centre, Birmingham
23rd - 24th April 2024

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Coventry Building Society Arena
16th May 2024

Access the latest issue of Clinical Services Journal on your mobile device together with an archive of back issues.

Download the FREE Clinical Services Journal app from your device's App store

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