Nationwide data-driven quality improvement in ultrasound medicine: insights from an indicator-based initiative in China.

Background: There are only a limited number of countries systematically tracking the quality of ultrasound at the national and institutional levels. Our study presents an example of a national, data-driven approach to ultrasound medicine quality measurement and improvement through indicators.

Aim: This study aims to establish a nationwide, indicator-based framework for measuring and improving the quality of ultrasound medicine in China. By developing and applying quality indicators, we seek to systematically evaluate performance, identify areas for improvement and guide data-driven quality enhancement efforts across institutions.

Methods: To enhance ultrasound quality and improve quality management, a leadership team was established. Pertinent quality indicators were developed as evaluation metrics. Quality improvement programmes were designed following the identification of key causes of suboptimal performance. A Plan-Do-Study-Act method was applied. Nationwide sample surveys were conducted annually to collect and document the relevant quality data. 10 ultrasound quality indicators were selected and comparisons of data from 2020 to 2023 were made. χ² tests were used to evaluate statistical differences.

Results: The ultrasound instruments quality inspection rate, the completion rate of notification of ultrasound critical findings within 10 min, the qualification rate of ultrasound reports remained and the completion rate of inpatient ultrasound examinations within 48 hours remained consistently high. The Breast Imaging Reporting and Data System utilisation rate of breast lesions in ultrasound reports, the concordance rate of ultrasound diagnoses, the accuracy rate of ultrasound diagnosis of breast lesions and the concordance rate of ultrasound diagnosis of ≥50% carotid stenosis all improved and showed an upward trend.

Conclusions: Indicator-based data can drive nationwide measurement, improvement and monitoring of ultrasound medicine quality. The use of indicators supports sustained efforts to improve quality and safety in ultrasound services.