Improving appropriate use of echocardiography and single-photon emission computed tomographic myocardial perfusion imaging: a continuous quality improvement initiative.

Background: Appropriate use criteria for cardiovascular imaging have been published, but compliance in practice has been incomplete, with persistent high rates of inappropriate use. The aim of this study was to show the efficacy of a continuous quality improvement (CQI) initiative to favorably influence the appropriate use of outpatient transthoracic echocardiography and single-photon emission computed tomographic (SPECT) myocardial perfusion imaging (MPI) in a large cardiovascular practice.

Methods: In this prospective study, a multiphase CQI initiative was implemented, and its impact on ordering patterns for outpatient transthoracic echocardiography and SPECT MPI was assessed.