STREAM EXECUTIVE
BRIEFING
Subject
Cardiac Echo-sonography Training
Date of Stream Executive Team Meeting 02/04/09
Author
Kane Wyborn Workforce Planning and Development Officer
SITUATION

Currently there is an area wide need for cardiac sonographers to meet demand in
echocardiography services

There is particular need in Tamworth and surrounding districts for cardiac sonography
services
BACKGROUND
To become an accredited sonographer, persons with an appropriate degree (for example,
in medical imaging, nursing, health or science) can undertake a relevant two-year diploma
through a university or the Australian Society of Ultrasound in Medicine. Most courses
require students to be employed as sonographers and therefore most students will be
experienced sonographers by the time they graduate. Sonography procedures do not
attract a Medicare rebate unless the sonographer is accredited. Many of the larger public
and private hospitals attempt to meet their own need for sonographers by offering
training to those of its medical imaging staff who are interested in entering the
specialisation. The number of persons completing relevant courses averaged 65 a year in
the three years to 2005 which represents a training rate of 5.7 per cent a year based on
estimated employment of 1000 to 1100. There are no precise figures on supply to the
occupation from interstate and overseas immigration. However, data from the Australian
Sonographer Accreditation Registry suggest that supply from sources other than local
graduations averaged 38 a year between 2002 and 2005. The number of newly-accredited
sonographers in NSW increased to 105 in 2006 but it is unclear how many of these would
be working predominantly in NSW (DEEWR, 2007).
Shortages were evident in both the public and private sectors in Sydney and regional NSW.
The majority of advertisements attracted few responses and these were mostly from
current student sonographers or from science and health professionals wishing to become
student sonographers. Positions requiring specialised skills in areas such as cardiac or
vascular sonography proved particularly difficult to fill. In a typical example, one prominent
public hospital advertised for three cardiac sonographers but only attracted one applicant
who was recruited despite the need to provide her with further training (DEEWR, 2007).
In the Hunter New England Area Health Service (HNEAHS) the majority of cardiac
sonography in the public health system takes place at the John Hunter Hospital. Additional
services are provided at the Calvary Mater Hospital, Belmont Hospital and Maitland
Hospital. Cardiac Sonography in the HNEAHS is undertaken mainly by cardiac
technologists; however in areas where access to cardiac technologists with appropriate
skills is limited radiographers and medical officers perform cardiac sonography
STREAM EXECUTIVE
BRIEFING
The NSW (Public) Health Employees State Award states the following:
1) Cardiac Technician - means a person who performs ECGs, Exercise Stress Testing and
Holter Loop Recorders.
2) Cardiac Technologist - Grade 1 - means a person who has attained a Bachelor of Science
Degree or qualifications or competencies deemed equivalent by the employer and may be
required to perform ECGs, Exercise Stress Testing, Holter-Loop event recorders as well as
VVI pacemakers, dual chamber pacing/cardiac catheter and Implantable Cardiac
defibrillators (ICDs).
3) Cardiac Technologist - Grade 2 - means a person who has attained a Post Graduate Degree
in Sonography or qualifications or competencies deemed equivalent by the employer and
performs Cardiac Sonography or Electrophysiological Studies (EPS).
4) Senior Cardiac Technologist - means a person who can perform all duties of Cardiac
Technologist Grade 1 and assists the Chief Cardiac Technologist with management, either
through; Undertaking supervisory duties in a Deputy or Second in Charge role overseeing
other Cardiac Technicians and/or Cardiac Technologists; and/or have responsibility for the
day to day running of a discreet function within the department.
5) Chief Cardiac Technologist - means a person who can perform all the functions of a
Cardiac Technologist and who is responsible for the management of the department
including the development of operational protocols.
Cardiac Technologists Award Rates from the Health Employees State Award
Grades
Rate from
Rate from
Rate from
Grade 1
1.7.2008
1.7.2009
1.7.2010
Year 1
917.90
953.70
990.90
Year 2
952.30
989.40
1,028.00
Year 3
1,010.90
1,050.30
1,091.30
Year 4
1,080.10
1,122.20
1,166.00
Year 5
1,154.80
1,199.80
1,246.60
Year 6
1,228.40
1,276.30
1,326.10
Year 7
1,288.00
1,338.20
1,390.40
Year 8
1,329.60
1,381.50
1,435.40
Year 1
1,288.00
1,338.20
1,390.40
Year 2
1,329.60
1,381.50
1,435.40
Year 3
1,430.10
1,485.90
1,543.90
Senior Cardiac
Technologist
Year 1
1,430.10
1,485.90
1,543.90
Year 2
1,478.00
1,535.60
1,595.50
Chief Cardiac
Technologist
Year 1
1,519.20
1,578.40
1,640.00
Year 2
1,685.70
1,751.40
1,819.70
Grade 2
Source: NSW Health
STREAM EXECUTIVE
BRIEFING
ASSESSMENT
Workforce Profile of Cardiac Technologist Grade 2
Cardiac Technologist Grade 2: Current Active Staff all HNE at 26/3/09
Employee Base Cost Code
Award Code Description
Description
Award Profile Description
Cardiac Technologist Grade 2 Cardiology - C.S.U. ~John Hunter ECG
Cardiac Technologist Grade 2 Cardiology - C.S.U. ~John Hunter ECG
Cardiac Technologist Grade 2 Cardiology - C.S.U. ~John Hunter ECG
Cardiac Technologist Grade 2 Cardiology - C.S.U. ~John Hunter Heart/Lung Tech & Assistant
Cardiac Technologist Grade 2 Cardiology - C.S.U. ~John Hunter ECG
Cardiac Technologist Grade 2 Cardiology - C.S.U. ~John Hunter ECG
Cardiac Technologist Grade 2 Cardiology - C.S.U. ~John Hunter Heart/Lung Tech & Assistant
Cardiac Technologist Grade 2 Cardiology - C.S.U. ~John Hunter Heart/Lung Tech & Assistant
Grand Total
Source: HNE Business Objects
Total
1
1
1
1
1
1
1
1
8
Current figures on activity at the JHH are as follows
JHH and Belmont:
Echo: 285
Echo Adult: 762
Echo - Paediatric: 259
There are problems in classifying and coding. This may only represent a small proportion of actual
activity
Outside of the JHH echocardiography is performed by various staff
Manning:



Dr Wickremesinghe(Physician)
Dr Connor(Anaesthetist/Intensivist)
No figures available at time of tabling
Tamworth:


Average of 5/week conducted by the Advanced Trainee – no cardiac echo-sonographer
Dr Sam Adera and Dr Alexander Levendall offsite echo-sonography
Armidale:

No Public echo-sonography service
Maitland:



Advanced Trainee
Sonographer
No figures available at time of tabling
Calvary Mater:
 No figures available at time of tabling
STREAM EXECUTIVE
BRIEFING

There are a number of programs to facilitate training in echocardiography at various
institutions. As stated above, the program is at graduate diploma level and is offered by
universities and professional groups. Please see the list below for educational options
Current Programs in Ultrasonography at 26/3/09
Conferring Body (Please Click Hyperlink)
ASAR Accredited Qualifications
Diploma of Medical Ultrasonography (Cardiac)
Australasian Society for
Diploma of Medical Ultrasonography (General)
Ultrasound in Medicine (ASUM)
Diploma of Medical Ultrasonography (Vascular)
Diploma of Medical Ultrasonography (Obstetric)
Graduate Diploma of Applied Science (Medical
Charles Sturt University
Ultrasound)
Master of Applied Science (Medical Ultrasound)
Post Graduate Diploma in Medical Imaging Science —
Curtin University of Technology
Ultrasound (for students enrolled prior to 1/1/2000)
Master of Medical Sonography, incorporating the
Graduate Diploma
Monash University
Graduate Diploma in Medical Ultrasound
Master of Medical Ultrasound
Graduate Diploma in Applied Science (Medical
Ultrasound)
Master of Applied Science (Medical Ultrasound)
Queensland University of Technology
Graduate Certificate in Applied Science (Breast
Ultrasound)
Graduate Diploma in Cardiac Ultrasound
Master of Cardiac Ultrasound
Source: Australian Sonographer Accreditation Register (ASAR). http://www.asar.com.au/programs.html
STREAM EXECUTIVE
BRIEFING
Current Programs in Ultrasonography at 26/3/09
Conferring Body
ASAR Accredited Qualifications
Graduate Diploma (Sonography)
RMIT University
Graduate Diploma of Ultrasonography
Master of Applied Science (Sonography)
Graduate Diploma of Health Science (Medical
Sonography)
Graduate Diploma of Health Science with Certificates of
Specialisation in Vascular Sonography
Graduate Diploma of Health Science with Certificates of
Specialisation in Cardiac Sonography (for students
University of Sydney— Cumberland Campus
enrolled prior to 31/3/2006 and students enrolled after
8/3/2009)
Master of Health Science (Medical Sonography)
Master of Health Science with Certificates of
Specialisation in Cardiac and Vascular Sonography (for
students enrolled prior to 31/3/2006 and students
enrolled after 8/3/2009)
Source: Australian Sonographer Accreditation Register (ASAR). http://www.asar.com.au/programs.html
RECOMMENDATION
It is recommended that:

Training program be investigated and endorsed by the Cardiac Stream after a cost/benefit
analysis

Discussions commence with cardiac technologists and other trainers regarding the amount of
time required to facilitate training

Review possible positions that may be used as training positions
STREAM EXECUTIVE
BRIEFING
APPENDIX
v) RISK ASSESSMENT
Please write a brief risk description, including the current risk rating and the acceptable
targeted risk rating.
Treatment
Number
Current risk rating
Targeted risk rating
Risk Description
Current Treatments
Please complete additional and/or proposed treatment/s required, and tick the impact (high,
medium, low) each treatment is expected to have in achieving the targeted risk rating.
Treatment
Number
Impact the proposed treatment/s
Proposed Treatments
will have on the risk
(Tick)
High
Medium
Low
Guide for Completion: the HNEAHS Corporate Risk Matrix below uses the same
Consequence and Likelihood criteria as the NSW Health Severity Assessment Code
System.
LIKELIHOOD
CONSEQUENCE
Frequent
Likely
Possible
Unlikely
Rare
Serious
A
C
E
F
G
Major
B
D
H
I
M
Moderate
J
K
L
N
O
Minor
P
Q
R
V
W
Minimum
S
T
U
X
Y