Implementation of paediatric three-dimensional echocardiography: a quality improvement intervention and process analysis

We performed a quality improvement intervention to increase three-dimensional transthoracic echocardiography performance for high-yield paediatric patient populations undergoing pre-procedural echocardiograms. Following implementation, the percentage of eligible patients receiving three-dimensional imaging increased significantly from a baseline of 20.3% to a maximum of 90.9%, with minimal impact on workflow. For programmes interested in increasing three-dimensional imaging, we recommend (1) establishing a core group of champions, (2) targeting a clear and measurable goal, and (3) developing a robust system for identifying candidates for three-dimensional imaging.