January 2011

Establishing a definition of quality in cardiovascular imaging has been challenging, and there has been limited agreement on quality standards for imaging. Quality can be measured as adherence to established guidelines for the use of a technology to ensure patient satisfaction and outcomes. However, specific criteria to ensure quality must be established for each phase of the process, from considering a test for a patient to incorporating the results of the test appropriately into patient care. The purpose of this report is to provide a framework for echocardiographic quality assessment and improvement. Because this report builds on prior ASE efforts in this arena, some of the recommendations have been presented before. Because this document establishes guidelines in the various components of quality in echocardiographic imaging services, the initial goal is to highlight general recommendations for minimum quality standards and provide some numerical or threshold values for compliance. Thus, the standards recommended in this document are realistic goals for the average practitioner. Although these recommendations focus on adult echocardiography, most are applicable or can easily be modified for pediatric, fetal, and intraoperative echocardiography. Objective studies linking quality measures in echocardiography to outcomes are frequently lacking, and thus statements expressed in this document are based primarily on expert opinion.