SHM Converge Scientific Abstract ePoster Gallery-Echo-Nomics: Balancing Echocardiogram Utilization With Quality Care

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Northwell Health’s quality initiative, “ECHO-NOMICS,” aimed to reduce overuse of inpatient transthoracic echocardiography (TTE) while maintaining care quality. The project addressed rising TTE use, which is often of limited clinical value, by targeting ordering practices among hospitalists.<br /><br />The intervention, implemented from August 2023 to July 2024, included an EMR-integrated live dashboard to identify active TTE orders and flag patients who had had an echocardiogram within the prior 12 months. The team also created indication-specific algorithms for common scenarios such as syncope and heart failure, conducted weekly chart reviews with direct provider feedback, and used an escalation plan during high-volume periods to reinforce best practices.<br /><br />During the results period, 1,028 chart reviews were completed and 194 TTE orders were flagged, yielding an intervention rate of 18.87%. Of these, 103 TTEs were successfully canceled, a 10% cancellation rate. Overall TTE utilization decreased from 39.06 to 33.97 TTEs per 100 patient discharges, and turnaround time improved from 27.14 to 25.33 hours.<br /><br />The initiative also produced a positive culture shift within the hospitalist team. Providers became more diligent in documenting clear clinical indications for TTE orders, more consistently reviewed prior and outpatient echocardiograms to avoid redundancy, and showed increased awareness of active TTE orders, reducing duplicate ordering.<br /><br />Overall, the project demonstrated that a collaborative, data-driven approach can reduce unnecessary echocardiogram use, improve efficiency, and support better resource stewardship without compromising patient care.

Asset Subtitle

Omer Alomari

Meta Tag

Author List Kurien Mathews, Luis Quiel, Omer Alomari, Theodore Strange, Thomas Gut, Wissam Diab

Category Innovations

Concept Inpatient Transthoracic Echocardiography

Concept Overuse

Concept Appropriateness

Concept Quality of Care

Concept Quality Initiative

Distinguished Non-Finalist

Presenter Organization Staten Island University Hospital - Northwell Health

Presenting Author Omer Alomari

Track Quality Improvement

Keywords

Northwell Health

ECHO-NOMICS

transthoracic echocardiography

TTE overuse

hospitalist ordering practices

EMR dashboard

echocardiogram cancellation

clinical decision support

resource stewardship

quality improvement

Inpatient Transthoracic Echocardiography

Overuse

Appropriateness

Quality of Care

Quality Initiative