Point-of-care ultrasound in general medicine: establishing a new service.

Point-of-care ultrasound (POCUS) is increasingly used in general medicine to support focussed bedside diagnosis and management. However, many implementation models depend on individual clinicians scanning their own patients. This limits equity of access, slows accumulation of provider experience and makes rapid departmental scale-up challenging. To describe the development and early implementation of a hybrid general medicine consultative POCUS service designed to improve access and scalability at a quaternary teaching hospital in Australia. In February 2025, the Alfred Health General Medicine Department implemented a consultative POCUS model delivered by credentialled specialists and a POCUS fellow. The model combined clinician-performed scans for patients under credentialled providers with an intradepartmental referral service for other general medicine patients. Scans were performed predominantly during business hours and documented using a structured template. Critical findings were verbally communicated. Key implementation elements included formal departmental credentialling, device access, a departmental logbook and active case-finding during the initial implementation phase. Major challenges included limited credentialled provider availability, variable clinician familiarity with POCUS, image storage limitations and dependence on a dedicated fellow. Over 12 months, 683 scans were performed, representing approximately one out of five admissions to the Alfred General Medicine wards. Most studies involved cardiac, pulmonary or combined cardiopulmonary assessment. Our experience suggests a hybrid consultative model may be a feasible approach to improving access to POCUS and accelerating departmental adoption during early implementation.