This book addresses the wide range of issues that face the program leader from how to choose a site and how to negotiate for equipment, to how to determine staffing requirements and how to anticipate and defuse possible turf issues with other programs and services in the hospital or healthcare facility. The early chapters of this book focus on the leadership of your program whether in your department or institution. The second section centers on education at all levels recognizing that smaller machines have made ultrasound available for medical students to advanced practitioners. The third section provides detailed logistics on equipment, maintenance, and safety. The fourth section focuses on a quality improvement program and includes a chapter on the workflow process. For those with limited budgets we also offer a section on practical operating and educational solutions. The fifth section offers insight into hospital level credentialing, quality assurance, national politics, and recent issues with accreditation. This is followed by reimbursement and coding. The last section covers topics in specialized communities. Chapters focus on ultrasound in global health, emergency medical services, pediatrics, critical care, community and office based practices. Multiple US working documents including checklists, graphs, spreadsheets, tables, and policy appendices are included.