1. RESEARCH POSTER PRESENTATION DESIGN © 2015
www.PosterPresentations.com
INTRODUCTION
The purpose of this study was to determine the
feasibility of promoting ultrasound scanning in general
medical practice across the UK as an additional GP skill.
METHODS
RESULTS
The chart shows the percentage of positive responses
received.
CONCLUSION
The introduction of GP USS would require a change in
culture, a veritable paradigm shift, but it can be hoped
that such a change is not only possible, but desirable, if
not inevitable.
• TO CHANGE THE WAY PRIMARY CARE IS DELIVERED
• TO GENERATE SAVINGS FOR THE NHS
• TO INCREASE PATIENT SATISFACTION
• TO RESTORE GP MORALE
The aim is to disrupt the status quo.
ABSTRACT
OBJECTIVES
THE PROCESS
The various stages of the project are illustrated in the
diagram.
CONCLUSION
Change is seldom easy, particularly where it affects the
culture of an organisation - “the way things are done”.
GPs need to think of ultrasound as the next step
beyond the stethoscope in the diagnostic process.
REFERENCES
Blois B (2012); Family Physician Using US for AAA screening; Canadian
Family Physician, March 2012, Vol. 58(3), pp. 172-178
Doddy J (2009); Using Ultrasound in Primary Care; GP (magazine) 5 February
2009
Katz JF and Yucel KE (2011); Letter to the Editor re Point-of-Care
Ultrasonography; The New England Journal of Medicine, 26 May 2011, Vol.
364, pp. 2075-2076
Moore CL and Copel JA (2011); Point-of-Care Ultrasonography; The New
England Journal of Medicine, 24 February 2011, Vol. 363, pp. 749-757
Rubano E, Mehta N, Caputo W, Paladino L and Sinert R (2013); Decent Meta-
Analysis of AAA shows great sensitivity at the bedside; Academy of Emergency
Medicine, February 2013, Vol. 20(2), pp. 128-138
ACKNOWLEDGEMENTS
Fiona Urquhart, my MBA supervisor, whose comments were always
constructive and who saw the potential of this project for service innovation.
Prof Budgie Hussain, who showed me many years ago how ultrasound
scanning can enhance the GPʼs diagnostic process.
Dr Joe Rosenthal, who provided invaluable insights into possibilities for
introducing ultrasound scanning into the medical student curriculum.
CONTACT
Dr David Lukey
Tel.: 077 6969 6612
Email: dvdlukey@aol.com
I. PILOT STUDY
The outcomes are expected to be:
1. A high level of patient satisfaction;
2. An increase in GP morale;
3. Plaudits for the CCG for being innovative.
II. ROLL-OUT TO THE REST OF THE UK
It is expected that the evidence gained from the
pilot study will persuade CCGs in England,
followed by the rest of the UK, to adopt
ultrasound as an additional GP skill.
HIG (Healthcare Innovations Group) Ltd
David Lukey; Kevin Rennie; Miguel Neumann; Lawrence Perry
FACILITATING THE USE OF ULTRASOUND SCANNING
IN GENERAL MEDICAL PRACTICE IN THE NATIONAL HEALTH SERVICE
It is gratifying to realise that the choice of scenario planning as the basis for the ultrasound
study has this endorsement.
GENERAL REVIEW RELEVANT TO NEW SERVICE DEVELOPMENT
In the following review of the theory related to the introduction of new services, the theory
will be linked to the GP ultrasound project at every stage, as theoretical concepts without
linkages to real undertakings will ultimately be of little value.
The introduction of any new product or service is bound to encounter resistance, and the
eventual success or failure of the venture will depend on whether the combined driving
force or the combined opposing force proves to be the stronger.
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This concept of opposing force fields was first postulated by Kurt Lewin as far back as the
1940s and is still frequently referred to by academics in the field of change management.
The driving forces are the positive forces for change, while the restraining forces are the
obstacles to change. In the GP ultrasound service which is the subject of this survey, the
driving forces are anticipated to be the enthusiasm of GPs, GP trainees and medical
students, with the possible alliance of academics, while the opposing forces are likely to be
0 25 50 75 100
GPs, trainees & students
Commissioners
Career sonographers
Providers of equipment
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Grönroos (2007) discusses various attempts at determining/measuring the quality of
service delivery, notably SERVQUAL, RATER and the ten service quality determinants
proposed by Berry et al. (1985). These ten determinants were Reliability,
Responsiveness, Competence, Access, Courtesy, Communication, Credibility,
Security, Understanding/Knowing the Customer, and Tangibles. There should be no
difficulty relating these ten determinants to the GP ultrasound service proposed in this
study, and it should also be clear that customer (patient) satisfaction should be high, as the
service should tick most (if not all) of the ten boxes.
In a later publication, Zeithaml et al. (1990) distilled these ten determinants down to five, to
create the RATER model, retaining Reliability, Responsiveness, Assurance and
Tangibles, and introducing Empathy, which covers previous determinants such as
courtesy, communication and understanding. Once again, it should easily comprehensible
how GP ultrasound is likely to rank high in patientsʼ perception of general medical service.
SERVQUAL is an instrument based on these five determinants of RATER, augmented by
a comparison between the customersʼ expectations of how the service should be delivered
and their perception of how it was delivered.
Kang and James (2004) took a critical look at the so-called “Grönroos model” or European
perspective, as opposed to the American perspective. The European perspective is that
quality consists of three dimensions - technical, functional and image - and that “image
functions as a filter in service quality perception” (p.1 of abstract). They conclude that the
13
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The investigative
net was spread
wide to include as
many stakeholders
as possible.
It was felt that a
mix of survey
techniques would
deliver the most
credible results.

2. RESEARCH POSTER PRESENTATION DESIGN © 2015
www.PosterPresentations.com