Cost drivers in endovascular pulmonary embolism interventions

Callese, Tyler E.; Moriarty, John M.; Maehara, C.; Cusumano, L.; Mathevosian, S.; Enzmann, D.; Padia, S.A.; Srinivasa, R.N.

doi:10.1016/j.crad.2022.09.129

Cited by 10 publications

(2 citation statements)

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“…This method allows calculation of cost for the entire cycle of care as it calculates cost relative to the specific amount of time a patient uses a resource. TDABC has been used to discuss utility of management options in severe post-thrombotic syndrome and in acute pulmonary embolism management, but wider utilization is due 46,47 . TDABC can help inform choices to adjust workflow utilization in perioperative anticoagulation.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

“…TDABC has been used to discuss the utility of management options in severe postthrombotic syndrome and in acute pulmonary embolism management, but wider utilization is due. 46 47 TDABC can help inform choices to adjust workflow utilization in perioperative anticoagulation. To enhance unity in quality delivery, certification in anticoagulation competency should be incentivized.…”

Section: Potential Economic Impactmentioning

confidence: 99%

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Anticoagulation Stewardship to Bridge the Implementation Gap in Perioperative Anticoagulation Management

Tafur,

Barnes,

Bhagirath

et al. 2024

TH Open

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Lack of alignment of care protocols among providers in healthcare is a driver of increased costs and suboptimal patient outcomes. Perioperative anticoagulation management is a good example of a complex area where protocol creation is a clinical challenge that demands input of multiple experts. Questions regarding the need for anticoagulation interruptions are frequent. Yet, due to layers of complexity involving analysis of anticoagulation indication, surgical risk, and anesthesia-associated bleeding risk as well as institutional practices, there is heterogeneity in how these interruptions are approached. The recent perioperative anticoagulation guidelines from the American College of Chest Physicians summarize extensive evidence for the management of anticoagulant and antiplatelet medications in patients who undergo elective interventions. However, implementation of these guidelines by individual clinicians is highly varied and often does not follow the best available clinical evidence. Against this background, anticoagulation stewardship units, which exist to improve safety and quality monitoring for the anticoagulated patient, are of growing interest. These units provide a bridge for implementation of value-based, high quality guidelines for patients who need perioperative anticoagulation interruption. We use a case to pragmatically illustrate the problem and tactics for change management and implementation science that may facilitate adoption of perioperative anticoagulation guidelines.

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Section: Accepted Manuscriptmentioning

confidence: 99%

Section: Potential Economic Impactmentioning

confidence: 99%