Podcast #173 - Promoting POCUS Utilization and Celebrating Wins

If you have not figured it out yet, point of care ultrasound (POCUS) is not going away anytime soon.  It is a powerful tool in the hands of clinicians across the world.  With its growing utilization, there are still many that are hesitant to implement it into their daily practice.  In this podcast, we talk about how to encourage others to start using POCUS.

We have talked about how to create change in the podcast in Podcast #54 with Patrick Bafuma.  Prior to that podcast we talked about trying to incorporate change in a slow changing environment during Podcast #44.  However, we are taking this from a specific angle by focusing on POCUS utilization specifically and how to celebrate those wins.

The first challenge when trying to incorporate change is to figure out how to introduce said change.  This can be done relatively easily with POCUS.  Show the people not familiar how you use the machine and how it changes management.  This does not have to be an "in your face" approach.  It can often be done discreetly by simply using your machine on a day-to-day basis.  If you work in a department where there are multiple physicians, PAs, or NPs working at the same time this becomes even easier.  Those individuals can now see you work in real-time.  Sometimes they may be inquisitive or skeptical early on while others will want to continue watching from a distance.  The more it is used, especially in cases that you are working with them together, the faster they will usually reach out.

By having them reach out to you versus trying to go to them directly, you accomplish two very important tasks.  The first is that your "pitch" is easier as they have already expressed some interest simply by asking questions.  Additionally, these will often be the same people who can become early adopters.  However, this will need to come with a goal in mind.  Are you wanting to promote the use by individuals at first or do you want to start a department wide program?  What kind of evidence are you wanting to provide?  Is your position in the department one that will help you gain more traction earlier on?  Who are the key decision makers and do they already have thoughts on POCUS?

Understanding barrier to implementation is extremely important, but especially so in POCUS.  It can be intimidating to those that are inexperienced and there may be local barriers to practice.  For example, if you are using a device that is not owned by the department does the hospital have a policy in place?  What kinds of questions or concerns might the individual departments have that could limit early use?  If the department already owns a machine but hardly anyone is using it (a frequent scenario), some of these barriers have already been addressed.  However, others will come up such as who will assess for quality of the images and how these images will be saved.

When incorporating change, it is important to have a "champion" (someone who is well respected and can further push change).  Depending on your position, you might be able to accomplish this role.  Otherwise, you may have to recruit someone else in your system.  In some cases, this champion may be obtained during the early adoption process after they have seen you use ultrasound.  The more support you have, the easier the process will be to move forward and to do so quickly.

Early buy-in is crucial and resistance should be expected.  Again, POCUS can be intimidating to the uninitiated but the champions are there to support you in the change.  Being prepared and having the mentality that this can be a challenging period will help better prepare you and others to make the push needed in your system.  While acceptance of POCUS is being gained, there is no room to stop.  It is vital to keep moving forward between various techniques including spaced repetition.  

Now that we know our blueprint to success, how do we actually apply this knowledge?  Many people will see data as only one point.  What can help sell it and take your success to the next level may sound surprising but it is anecdotes!  This is where we talk about celebrating wins.  Initially, this may mean that you celebrate your own wins.  This can be accomplished a few different ways.  You can talk about how your use of POCUS helped you during shift change when handing over a patient, demonstrating how POCUS helped during a group effort in a resuscitation, or even while volunteering to assist a colleague.

Over time as your wins catch the eye of others, you can start to celebrate their wins as they being their process in implementing POCUS.  This is essential as this now moves to encourage others to do the same while simultaneously giving confidence to the ones who have the wins.  These do not have to be big wins but can be as simple as showing how POCUS helped change management.  The bigger the effect, the more you should celebrate.  Get others to encourage new users at the same time.  Boasting these wins is a vital part of the actual implementation process and can be the final push needed to get POCUS utilization to your desired goals.

Let us know what you think by giving us feedback here in the comments section or contacting us on Twitter or Facebook.  Remember to look us up on Libsyn and on iTunes.  If you have any questions you can also comment below, email at thetotalem@gmail.com, or send a message from the page.  We hope to talk to everyone again soon.  Until then, continue to provide total care everywhere.

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