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In this episode of Sonographers After Dark, Lara Williams dives into the real work behind accreditation, quality improvement, and leadership in the echo lab. While accreditation may be the framework, the true goal is building a culture of quality that improves patient care, strengthens reporting, and creates consistency across the lab.
Lara unpacks the common roadblocks teams face when implementing quality programs, from managing different personality types and navigating difficult conversations to gaining physician and administrative buy-in. She also breaks down the importance of structured reporting, IAC standards, ASE guidelines, timeliness requirements, discrepancy policies, and creating meaningful quality review systems that go beyond simply checking boxes. This episode is a practical discussion for sonographers, technical directors, ACS professionals, and lab leaders who want to better understand how to lead change, improve reporting accuracy, support staff growth, and build a quality program that is both sustainable and effective. Lara also shares insight into using objective scoring tools, peer review, and ongoing education to identify growth opportunities and strengthen lab performance over time. If you are stepping into leadership, preparing for accreditation, or trying to elevate quality in your lab, this episode is for you. 💜🩵 Watch the full episode here or listen on your favorite platform: Spotify, Apple Podcast, iHeartRadio YouTube: https://www.youtube.com/@SonographersAfterDark TikTok: https://www.tiktok.com/@sonographersafterdark Facebook: https://www.facebook.com/groups/sonographersafterdark Instagram: https://www.instagram.com/sonographersafterdark/ #sonographersafterdark #iheartecho #allaboutultrasound #loveecho #loveultrasound #bettercardiology #echoquality #cardiacultrasound
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This episode of Sonographers After Dark was sponsored by the American Society for Echocardiography, with support from an unrestricted educational grant from Bristol Myers Squibb.
In this episode, Lara Williams sits down with Margaret Kurnides, ACS, RDCS, FASE, and Amy Dillenbeck, MS, ACS, RDCS, RCS, FASE to discuss the growing adoption of goal-directed Valsalva in echocardiography and why it is transforming how sonographers evaluate patients with hypertrophic cardiomyopathy (HCM). The conversation explores how the traditional Valsalva maneuver often varies between sonographers, leading to inconsistent results. By contrast, the goal-directed approach creates a standardized and reproducible maneuver that can reliably unmask latent LVOT obstruction, which may be present in up to one-third of HCM patients who show no obstruction at rest. Margaret and Amy share practical insights from implementing the technique in clinical labs, including setup tips, infection-control considerations, and strategies for gaining physician and administrative buy-in. They also discuss imaging challenges, differentiating LVOT signals from mitral regurgitation, and the importance of correlating Doppler findings with the broader physiologic picture. The discussion takes on new urgency in the era of myosin inhibitor therapies, where accurate echocardiographic measurements—particularly LVOT gradients and ejection fraction—are critical for diagnosis, treatment selection, and medication titration. The group emphasizes why sonographers must understand the physiology behind HCM, not just the imaging protocol. The episode closes with a look at upcoming ASE micro-lessons on goal-directed Valsalva. If you scan echo—or teach it—this is a conversation about technique, physiology, and the evolving role of the sonographer in modern HCM care. Watch the full episode here or listen on your favorite platform: Spotify, Apple Podcast, iHeartRadio YouTube: https://www.youtube.com/@SonographersAfterDark TikTok: https://www.tiktok.com/@sonographersafterdark Facebook: https://www.facebook.com/groups/sonographersafterdark Instagram: https://www.instagram.com/sonographersafterdark/ #sonographersafterdark #iheartecho #allaboutultrasound #loveecho #loveultrasound #bettercardiology #echoquality #cardiacultrasound #hocm #hypertrophiccardiomyopathy #hcm #goaldirectedvalsalva It’s been almost a decade since Lara Williams and Judith Buckland, MBA, RDCS, FASE, last taught together (yes… the legendary “quack like a duck” kinetic learning moment is back). In this Sonographers After Dark episode, they reconnect to unpack how the ultrasound and echo world has transformed since 2016—through COVID-era shifts, remote education becoming the norm, and the rising demand to streamline the nonstop pressure on sonographers and physicians. Judith shares the real story behind her evolution from accreditation consulting to building process-driven quality systems—and why her biggest “aha” was that accreditation isn’t the destination… it’s the leverage that finally gets buy-in for standardization, peer review, and better outcomes. Together, they dig into the grind (and cost) of pursuing ACCME, the vision of bundling accreditation + QI + CME + credential requirements into one workflow, and the entrepreneur brain that keeps dreaming bigger. They also talk AI in echo (including vendor-agnostic automation, real-world “messy” data, and why this tech won’t replace sonographers—but can reduce burnout), plus what’s next: HOCM accreditation changes, goal-directed Valsalva, ICE/4D ICE advances, and the behind-the-scenes work of building platforms that make “better cardiology” possible.
Watch the full episode here or listen on your favorite platform: Spotify, Apple Podcast, iHeartRadio YouTube: https://www.youtube.com/@SonographersAfterDark TikTok: https://www.tiktok.com/@sonographersafterdark Facebook: https://www.facebook.com/groups/sonographersafterdark Instagram: https://www.instagram.com/sonographersafterdark/ #sonographersafterdark #iheartecho #allaboutultrasound #loveecho #loveultrasound #bettercardiology #cardioserv #echoaccreditation #echoquality #cardiacultrasound #hocm #hypertrophiccardiomyopathy #hcm In this powerful episode of Sonographers After Dark, Lara sits down with Joy Guthrie, PhD., ACS, RDMS, RDCS, RVT, FSDMS, FASE, to discuss the evolution of advanced practice sonography and what it truly means to elevate our profession.
Joy shares the story behind launching one of the first Advanced Cardiac Sonography programs in 2016—and how it expanded to include Advanced Perinatal Ultrasound and Advanced Vascular tracks. Designed for experienced sonographers with at least three years of clinical practice and a bachelor’s degree, these hybrid programs combine online coursework with immersive on-campus residency. The result? Graduates who return to their institutions with increased responsibility, new job descriptions, and higher compensation. Together, Lara and Joy explore: • The shift toward advanced roles in cardiac, vascular, and perinatal imaging • Why many “advanced” roles aren’t labeled that way—but function at a higher clinical level • How accreditation and positions like Technical Director have reshaped expectations (often requiring ACS-level expertise) • The development of the CAAHEP Pathway program for advanced practice • Gaining physician buy-in and aligning with collaborative, extender-style practice models • Practical application tips for competitive advanced program admission • The unique challenges of pediatric echocardiography training and why hands-on experience is non-negotiable This episode is more than a conversation—it’s a roadmap for sonographers who are ready to expand their scope, elevate patient care, and help define the next generation of our profession. If you’ve ever wondered what the future of advanced sonography looks like… this is it. #SonographersAfterDark #AllAboutUltrasound #iheartecho #LoveUltrasound #LoveEcho💜 Watch the full episode here or listen on your favorite platform: Spotify, Apple Podcast, iHeartRadio YouTube: https://www.youtube.com/@SonographersAfterDark TikTok: https://www.tiktok.com/@sonographersafterdark Facebook: https://www.facebook.com/groups/sonographersafterdark Instagram: https://www.instagram.com/sonographersafterdark/ In this episode of Sonographers After Dark, Lara sits down with Dr. Judy Hung (Mass General Hospital, Boston) for a candid, sonographer-focused conversation on valvular heart disease—and why high-quality echocardiography drives real clinical decisions in today’s structural heart era. Dr. Hung shares what drew her to valve disease through the lens of physiology and hemodynamics, and why echo is the frontline tool for determining whether stenosis or regurgitation is truly hemodynamically significant. The discussion dives into common valve-assessment pitfalls—like failing to chase the highest aortic stenosis gradients with multiple windows, skipping the non-imaging (Pedoff) probe, and missing key steps in MR quantification (zoom, baseline shift, and PISA setup). They also unpack how echo data influences heart team decisions for TAVR, why sonographer training and career pathways matter for retention, and how the profession may evolve with AI-assisted measurements and improving 3D transthoracic imaging—without replacing the need for skilled sonographers. Plus: a few fun rapid-fire moments (equitherapy with "donkeys,” talking to chickens, and an echo myth Dr. Hung is ready to retire for good). If you’re ready to level up your valve game—this one’s for you. 💜💙🩵
Watch the full episode here or listen on your favorite platform: Spotify, Apple Podcast, iHeartRadio YouTube: https://www.youtube.com/@SonographersAfterDark TikTok: https://www.tiktok.com/@sonographersafterdark Facebook: https://www.facebook.com/groups/sonographersafterdark Instagram: https://www.instagram.com/sonographersafterdark/ What really goes into building an echocardiography training program from scratch?
In this episode of Sonographers After Dark, Lara sits down with Daniel Bourque for an honest, behind-the-scenes conversation about launching and sustaining a hospital-based echocardiography program at Orlando Health. Daniel shares the five-year journey of developing an employer-backed echo program—from navigating state licensing, board reviews, and massive documentation requirements to selecting students, building clinical rigor, and fostering real-world decision-making at the bedside. With over 1,300–1,500 clinical scanning hours, early hands-on exposure, and strong internal recruitment, this program is a powerful example of what’s possible when education stays rooted in clinical reality. Together, Lara and Daniel unpack:
Because strong programs don’t happen overnight—and the work behind them deserves to be seen. 💜💙 Watch the full episode here or listen on your favorite platform: Spotify, Apple Podcast, iHeartRadio YouTube: https://www.youtube.com/@SonographersAfterDark TikTok: https://www.tiktok.com/@sonographersafterdark Facebook: https://www.facebook.com/groups/sonographersafterdark Instagram: https://www.instagram.com/sonographersafterdark/ In this episode of Sonographers After Dark, Lara sits down with Kelly Thorson, DHSc, MSRS, MS, ACS, RDCS, FASE, to talk about what it takes to build—and sustain—excellence in pediatric and fetal echocardiography. Kelly shares practical insight on recruiting and training pediatric echo sonographers, why mentorship and lifelong learning matter, and how sonographers can grow into research, education, and leadership pathways. They also dive into the real-world integration of 3D echo and strain in pediatric labs—how to train teams, improve consistency, and expand access to advanced imaging even outside academic centers.
💜💙#SonographersAfterDark #iHeartEcho #AllAboutUltrasound #LoveUltrasound #LoveEcho Watch the full episode here or listen on your favorite platform: Spotify, Apple Podcast, iHeartRadio YouTube: https://www.youtube.com/@SonographersAfterDark TikTok: https://www.tiktok.com/@sonographersafterdark Facebook: https://www.facebook.com/groups/sonographersafterdark Instagram: https://www.instagram.com/sonographersafterdark/ From Guidelines to Growth with Dr. Anita Moon-Grady: How Sonographers Excel in Fetal Cardiology1/23/2026 In this episode of Sonographers After Dark, Lara sits down with Dr. Anita Moon‑Grady, pediatric cardiologist at UCSF, for a deep dive into the evolving world of fetal echocardiography training and career development. Dr. Moon-Grady shares how fetal echo sonographers are trained within her program, and how additional fetal expertise is built through mentored learning, progressive responsibility, and certification.
Together, Lara and Anita unpack what true career progression looks like in fetal cardiology—from senior to principal sonographer roles—and why fetal board certification matters. The conversation explores the cross-training divide between obstetrics and pediatric cardiology, highlighting realistic training timelines, skill transfer, and the unique challenges sonographers face when entering fetal echo from different clinical backgrounds. Dr. Moon-Grady also reflects on her work with the American Society of Echocardiography and the AIUM to harmonize fetal echocardiography guidelines across specialties, helping standardize exams, expectations, and training pathways nationwide. ✨ This episode is a must-listen for sonographers curious about fetal echo, leaders shaping training programs, and anyone passionate about advancing fetal heart care through collaboration and education. 💙 #SonographersAfterDark #iHeartEcho #AllAboutUltrasound #LoveUltrasound #LoveEcho #FetalEcho #Fetal Echocardiography Watch the fullepisode here or listen on your favorite platform: Spotify, Apple Podcast, iHeartRadio YouTube: https://www.youtube.com/@SonographersAfterDark TikTok: https://www.tiktok.com/@sonographersafterdark Facebook: https://www.facebook.com/groups/sonographersafterdark Instagram: https://www.instagram.com/sonographersafterdark/ Travel sonography sounds glamorous—but what’s it actually like? Lara and Lydia keep it real as they talk through the highs, lows, and logistics of life as a travel ultrasound professional.
Lydia shares how she made the leap after hospital experience, why flexibility and new environments fueled her growth, and what surprised her most along the way. They dive into negotiating pay and schedules, understanding tax homes, extending contracts, and why adaptability and a good attitude go a long way at new facilities. If you’re considering travel work—or already living out of a suitcase—this candid conversation will help you navigate the road with clarity, confidence, and community. 💜💙 Watch the full episode here or listen on your favorite platform: Spotify, Apple Podcast, iHeartRadio YouTube: https://www.youtube.com/@SonographersAfterDark TikTok: https://www.tiktok.com/@sonographersafterdark Facebook: https://www.facebook.com/groups/sonographersafterdark Instagram: https://www.instagram.com/sonographersafterdark/ What does it really take to build a hospital-based echocardiography program from scratch—inside one of the busiest labs in the country?
In this episode, Lara Williams is joined by Amy Dillenbeck, who leads the echo training program at Cleveland Clinic, for a candid, behind-the-scenes conversation about launching a sonography school after COVID-era staffing challenges pushed facilities to think differently. Amy walks through the early overwhelm (researching successful programs, navigating Ohio requirements, creating objectives and lesson plans, recruiting, marketing—plus all the unexpected parts like scheduling, payments, and yes… snow days). They discuss why the program intentionally accepts only 8 students per year, how clinical support from staff sonographers makes or breaks the student experience, and how the results have exceeded every expectation--100% graduation, placement, and board pass rates, plus 23 hires in 3 years helping strengthen staffing and elevate lab culture. They also dive deep into HOCM, where Amy shares what she’s seeing shift in evaluation and why sonographers play a critical role in not missing LVOT obstruction. You’ll learn the practical “how-to” behind goal-directed Valsalva—a more standardized, measurable approach that can improve consistency and help unmask gradients without losing your images. Finally, Amy and Lara talk ASE, attending Scientific Sessions, why involvement builds confidence and opportunity, and what the FASE designation can mean for sonographers who want to lead, teach, and level up. 💜💙 #SonographersAfterDark #iheartecho 🎧 New episodes drop every Friday at 5 PM ET. Watch the fullepisode here or listen on your favorite platform: Spotify, Apple Podcast, iHeartRadio YouTube: https://www.youtube.com/@SonographersAfterDark TikTok: https://www.tiktok.com/@sonographersafterdark Facebook: https://www.facebook.com/groups/sonographersafterdark Instagram: https://www.instagram.com/sonographersafterdark/ 
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