ASE/SCA recommendations and guidelines for continuous quality improvement in perioperative echocardiography.

The American Society of Echocardiography (ASE), established in 1975, has long encouraged the assessment of quality in the practice of echocardiography. To that end it has published and continues to develop documents establishing guidelines for the practice of echocardiography (1–8). In 1995, the ASE published a series of recommendations specifically for Continuous Quality Improvement (CQI) in echocardiography (9). The accelerated growth of the clinical application of echocardiography combined with the complexity of ultrasound technology, conduct of examinations, and interpretation of results were cited as some of the reasons for developing a CQI program. In the following document, the ASE and the Society of Cardiovascular Anesthesiologists (SCA) seek to establish recommendations and guidelines for a CQI program specific to the perioperative environment. Using the prior ASE publication on CQI as the foundation, we will 1) present a rationale for CQI in the perioperative period, 2) define the components of a perioperative echocardiography service, 3) establish the principles of CQI as they relate to the practice of perioperative echocardiography and 4) assess whether CQI programs are effective in the perioperative period. The recommendations and guidelines set forth in this document are to be applied to any echocardiographic procedure performed in the intraoperative period as well as to any in the immediate preor postoperative period when it is performed independently of the CQI program of an established Level III echocardiographic service.