ECHO SONOGRAPHERS TRAINING IN SAUDI ARABIA PRESENT AND FUTURE DR. MOHAMMAD ALGHAMDI Consultant Cardiologist, KACC Assistant Professor, KSAU-HS Chairman: CV Technology Program, KACC/KSAU-HS MAIN REFERENCES 1
KSA- A HUGE COUNTRY 2,250,000 Km² KSA- POPULATION GROWTH 2
KSA- POPULATION GROWTH KSA- POPULATION GROWTH 3
BETTER HEALTH CARE SERVICES Mothers death Infant death Neonatal death Children death BETTER HEALTH, LONGER LIFE 4
DISEASE SPECIFIC MORTALITY IN KSA HEALTH EXPENDITURE 5
HEALTH EXPENDITURE (BILLIONS) 180.00 160.00 160.00 140.00 120.00 100.00 80.00 60.00 40.00 20.00 0.00 100.00 108.00 86.50 61.20 68.70 52.30 44.40 39.50 27.10 31.00 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 HEALTH EXPENDITURE 2015 6
ECHO DEMAND IN KSA Population growth Better access to care Increasing older age population High incidence of CV disease High prevalence of chronic illnesses Better health care provision High public awareness & expectations Implementation of quality standards 7
EXISTING CARDIAC SONOGRAPHER PROGRAMS No. Training Center 1 Dammam University Bachelor (high school grads) 2 Military Hospital Diploma (univ. grads) 3 National Guard Diploma (univ. grads) 4 Makkah (KAMC) Diploma(univ. grads) 5 Qaseem (PSCC) Diploma (univ. grads) 6 Princess Norah University 7 Others? Bachelor(high school grads) Type Duration Recognition by SCFHS 4 yes active 3 yes active Current Status 2 no under upgrade to Bch degree 2? new 2? new 4? new ECHO SONOGRAPHER DEMAND-SUPPLY Population growth Aging population High disease prevalence Expanding medical services Increasing health care facilities Lack of vision & planning Lack of training facilities Lack of training staff Lack of curriculum Lack of support Limited training centers Limited enrolment seats High leak of graduates 8
WORLD WIDE PROBLEM There is increased demand for cardiac sonographers and so far, supply has not kept pace with demand * * Judy Rosenbloom, executive secretary of ASE. SONOGRAPHER JOB GROWTH 39% for diagnostic Projected Job Growth (2012-2022) medical sonographers and cardiovascular technologists and technicians* Sources: *U.S. Bureau of Labor Statistics 9
UNIVERSITY OF DAMMAM UNIVERSITY OF DAMMAM 10
UNIVERSITY OF DAMMAM P.S. MILITARY MEDICAL CITY PROGRAM 11
P.S. MILITARY MEDICAL CITY PROGRAM P.S. MILITARY MEDICAL CITY PROGRAM 12
KING SAUD BIN ABDEL AZIZ UNIVERSITY FOR HEALTH SCIENCES PRINCESS NOURAH UNIVERSITY 13
PRINCESS NORA UNIVERSITY كلية الصحة وعلوم التأهيل College of health and Rehabilitation Sciences قسم التقنيات الطبية تقنيات القلب Department of biomedical technology Cardiac technology برنامج تقنية القلب من البرامج المهمة التي تسهم في تشخيص حاالت أمراض القلب و األوعية الدموية بشكل كبير وفعال, حيث يتم تزود الخريجات بالمعرفة النظرية والتطبيق السريري الالزم باستخدام تقنيات تشخيصيه دقيقه كأجهزة قياس كهرباء القلب و قياس الجهد و التحمل من خالل رؤيه واسعه من المقرارات والدورات التدريبيه والبرامج التقنيه وذلك يحقق الهدف وهو تخريج طالب أكفاء مؤهلين وقادرين على تحمل المسؤلية لتلبيه الطلب المتزايد على أخصائي تقنيه القلب بالمملكة. SCFHS ACCREDITED PROGRAMS 14
MOH RECOMMENDATIONS FOR ECHO SERVICES MOH RECOMMENDATIONS 15
CURRENT MOH HOSPITALS MOH HOSPITALS AND BEDS 16
NON-MOH GOVERNMENTAL HOSPITALS PRIVATE HOSPITALS 17
ALL TOGETHER CURRENT NEED Number of beds No echo services needed Hospitals <=100 beds (n= 39) Net result One sonographer per 100 beds Ministry Of Health Other Government hospitals Private hospitals 38,970 5240 1950 31,780 318 11,497 - - - 114 14,310 - - - 143 Total 64,777 - - - 575 18
PRIVATE SECTOR STAFFING 3% ANNOUNCEMENT FOR MOH JOBS 19
CARDIOVASCULAR TECHNOLOGIST JOBS FUTURE DIRECTION MOH Number of beds 20
MOH 10-YEAR PLAN 2009-2018 plan 100 new hospitals MOH HOSPITALS OPENED IN THE LAST 5 YEARS Total: 72 Hospitals 21
MOH HOSPITALS UNDER CONSTRUCTION Total: 147 Hospitals NEAR FUTURE NEED Ministry Of Health Other Government hospitals Private hospitals Number of beds No echo services needed Hospitals <=100 beds (n= 39) Net result One sonographer per 100 beds 38,970 5240 1950 31,780 318 11,497 - - - 114 14,310 - - - 143 Total 64,777 - - - 575 New projects 37,250 - - - 372 New total 102,027 947+ 22
MOH CARDIAC CENTERS HOW CAN WE SOLVE THE PROBLEM? With assumption of: Having 10 active training centers & Each center is producing 5 sonographers/year We need 20 years to achieve a total of 1000 (Years needed = 1000/10X5) To half the duration we need to: Double the training centers (20) Double the yearly graduates/center (10) 23
KEEP IN MIND: 20-30% attrition rate Part time job Early retirement Promotion to admin positions Move to academic career Work outside the Kingdom Work-related MSD Others Outpatient echo studies INPATIENT-OUTPATIENT DISTRIBUTION Statistics 2010 Total Adult Echocardiogram 4,000 3,500 3,000 2,500 2,000 1,500 1,000 500 0 1,958 1,972 5,257 Inpatient Outpatient Total Adult 24
ADULT ECHO STUDIES IN KACC ADULT TTE ECHO VOLUMES TREND 13,348 14,457 15,490 17,565 Y2011 Y2012 Y2013 Y2014 EMPLOYER (MOH) EXPECTATIONS Education & credentials: Associate degree (Diploma) in CV Technology with two (2) years experience in Echo Registered in Saudi Council for Health Specialties Bachelor of Applied Sciences College, Radiology Specialty with special training in Echo Nursing specialty with diploma in echo 25
EMPLOYER EXPECTATIONS Language: Proficient in English; spoken, written and comprehension Knowledge: Skills: Medical terminology Patient safety, infection control, and quality assurance protocols Performing and operating the cardiac equipment Using customer service concepts including explaining the procedure to patients Documentation including the use of computer skills Abilities: To position the patient at ease using pleasant, relaxed manner To organize time and prioritize work appropriately To communicate effectively Work duties: Obtain necessary medical information before performing the procedure Acquire clear images and accurate measurements CONCEPT OF TRAINING "Training for echocardiography was historically provided on the job, however today the job requires formal training and education and employers increasingly are requiring cardiac sonographers to complete their training in accredited educational programs".* * Judy Rosenbloom, executive secretary of ASE. 26
SONOGRAPHERS TRAINING TRAINING REQUIREMENTS 27
TRAINING REQUIREMENTS SONOGRAPHERS CREDENTIALING 28
TRAINING CENTER REQUIREMENTS Structured program Well planned Curriculum Theoretical knowledge Technical skills Staffing Medical Technical Equipment Number & quality Admin support RELATED PROFESSION PARTIES Saudi Commission For Health Specialties Accreditation and professional categorization Echocardiography fellowship Scientific Board Saudi Group of Echocardiography Specify training requirements Design curriculum guidelines Saudi Group of Cardiovascular Technology Implementation of guidelines Quality control of training Training centers Candidates selection/enrolment Conducting actual training Ministry of education Undergraduate education 29
SAUDI GROUP OF ECHO. SAUDI GROUP OF ECHO. 30
SAUDI GROUP OF ECHO. SAUDI SOCIETY OF CV TECHNOLOGISTS 31
SAUDI SOCIETY OF CV TECHNOLOGISTS SAUDI SOCIETY OF CV TECHNOLOGISTS 32
SAUDI SOCIETY OF CV TECHNOLOGISTS Founded in November 2011 Under the umbrella of Saudi Heart Association Objectives Recognize the need to create and maintain professional standards Promote continuing education Act as an advocate for Invasive and Non-Invasive Cardiovascular Technologists. Involves allied health professionals from: Cardiac catheterization Electrophysiology Echocardiogram Cardiac Imaging ECG THE SAUDISCT, MORE OBJECTIVES Promotes the highest quality care to patients undergoing invasive and non-invasive procedures by providing scope of practice, orientation guidelines, position statements and written standards. Provides premium educational offering to invasive and noninvasive specialists at reasonable costs. Acts as an advocate for the profession. Supports invasive and non-invasive cardiovascular leaders. Update and publish studies and researches for accredited CVT programs, and medical journals. Community awareness, and preventive Heart diseases education for public and School students. 33
WHAT IS MISSING? Collaboration Sharing ideas Responsibility Integration Goals and objectives Expertise Coordination Planning Efforts Representation (identity) CONCLUSIONS There is a huge demand for cardiac sonographers in the Kingdom of Saudi Arabia More training programs and training opportunities are required More efforts and collaborative work of the related professional groups are needed 34
ECHO SONOGRAPHER, THE UNKNOWN SOLDIER 35