The Echocardiography Quality Improvement (EQI) Program assesses the ability of a facility to perform diagnostic testing with formal recognition of this competence through accreditation. The EQI program supports both pediatric and adult services, with the adult program applying to patients aged 18 and over. It also provides facilities with the tools they need to standardize their processes, address diminishing resources, mitigate risk and drive continual quality improvement; ultimately improving patient safety across pediatric and adult populations. 

Standards for Provision of Echocardiography In Ontario (The Standards) 

The EQI Advisory Panel released Standards for Provision of Echocardiography in Ontario, after being asked jointly by the Ministry of Health and Ontario Medical Association in 2012 to develop standards of practice and accreditation criteria for echocardiography in Ontario. In that same year, the Echocardiography Quality Improvement (EQI) Program was also established to support facilities in achieving the standards.  

The Standards were developed with 6 principles in mind: 

1. Patients are not harmed by care they receive.  
2. Continuous quality improvement and critical oversight is essential to maintain standard of practice.  
3. Personnel who provide care are appropriately qualified.  
4. There are systems in place to provide appropriate clinical care and patient privacy.  
5. The Echo examinations and reports demonstrate quality care is being provided. 
6.  Only clinically appropriate examinations are conducted.  

Echocardiography Quality Improvement Program Accreditation Requirements 

Accreditation Canada released the Echocardiography Quality Improvement Program Accreditation Requirements (the Requirements) in 2025 after an extensive review of current guidelines and references and in consultation with the EQI Advisory Panel. The Program Requirements replaced the Standards for Provision of Echocardiography in Ontario and have been refreshed where appropriate to reflect changing practice and to ensure facilities meet legislated requirements of medical service providers. The Program Requirements have been adapted to meet the needs of various jurisdictions within Canada and globally where Echocardiography services are being provided, while maintaining specific Ontario related requirements. 

Accompanying each Requirement is “What To Look For” guidance information that explains the intent of the requirement and provides insight into its application. The Requirements are divided into sections for ease of preparation and assessment: 

1. Organizational Structure, Personnel Policies and Training, and Management 
2. Quality Management System 
3. Physical Environment 
4. Equipment and Supplies 
5. Pre-Examination Process 
6. Examination Process 
7. Quality Assurance 
8. Post-Examination Process (Reporting) 
9. Information System including Picture Archiving Communications Systems 
10. Safety