Abstract

Background: Implementing Point-of-care ultrasound (POCUS) in community practice could help to decide upon and
prioritise initial treatment, procedures and appropriate specialist referral or conveyance to hospital. A recent literature
review suggests that image quality, portability and cost of ultrasound devices are all improving with widening indications for community POCUS, but evidence about community POCUS use is needed in the UK. We aimed to explore
views of clinical practitioners, actively using ultrasound, on their experiences of using POCUS and potential facilitators
and barriers to its wider implementation in community settings in the UK.

Methods: We conducted a qualitative interview study with practitioners from community and secondary care settings actively using POCUS in practice. A convenience sample of eligible participants from different clinical specialties
and settings was recruited using social media adverts, through websites of relevant research groups and snowball
sampling. Individual semi-structured interviews were conducted online using Microsoft Teams. These were recorded,
transcribed verbatim, and analysed using a Framework approach supported by NVivo 12.

Results: We interviewed 16 practitioners aged between 40 and 62 years from different professional backgrounds,
including paramedics, emergency physicians, general practitioners, and allied health professionals.
Participants identified key considerations and facilitators for wider implementation of POCUS in community settings
in the UK: resource requirements for deployment and support of working devices; sufficient time and a skilled workforce; attention to training, education and support needs; ensuring proper governance, guidelines and quality assurance; workforce considerations; enabling ease of use in assisting decision making with consideration of unintended consequences; and more robust evidence to support perceptions of improved patient outcomes and experience.

Conclusions: POCUS could be useful for improving patient journey and health outcomes in community care, but
this requires further research to evaluate outcomes. The facilitators identified could help make community POCUS a
reality.