Operational Efficiency and Productivity Improvement Initiatives in a Large Cardiac Catheterization Laboratory

Reed, Grant W.; Hantz, Scott; Cunningham, Robert J.; Krishnaswamy, Amar; Ellis, Stephen G.; Khot, Umesh N.; Rak, Joe; Kapadia, Samir

doi:10.1016/j.jcin.2017.09.025

Cited by 13 publications

(10 citation statements)

References 8 publications

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“…Goals to balance high efficiency and high quality care can be challenging. A systematic approach focused on efficiency can decrease resource utilization, yet minimize impact on patient care . This study highlights such an ongoing effort.…”

Section: Discussionmentioning

confidence: 90%

Frequency of CIED remote monitoring: A quality improvement follow‐up study

Dechert

Bradley

Serwer

et al. 2019

Pacing Clinical Electrophis

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Background: Based on the findings of a prior study of CIED (Cardiac Implantable Electrical Device) remote monitoring (RM) frequency at the same center, the University of Michigan Congenital Heart Center (UMCHC) instituted a quality improvement (QI) change to reduce the frequency of routine CIED RM from every 2 months to every 3 months. The objective of this study is to determine the impact of this QI initiative to reduce workload without compromising patient care.Methods: This is a single-center, retrospective cohort study of all UMCHC patients with CIEDs followed via Medtronic CareLink CIED remote monitoring system from July 2015 to June 2017, after the QI change in 2014. The primary outcome was success of transition to new monitoring schedule. Secondary outcomes included complications, incidence of actionable events (AES), patient compliance, and change in workload. Outcomes were compared to the prior study. Results: There were 325 patients (mean age was 24 ± 14 years) included, of who 293 (90%) completely transitioned to the new RM schedule. During the study period, 96 transmissions included AES (4% of total), of which 50 (52%) were asymptomatic and discovered on routine monitoring. No patient experienced a complication attributable to decreased RM frequency. The mean number of interrogations decreased by 1.6 per patient over the 2-year period compared to prior study. Conclusions:This study demonstrated successful implementation of a QI initiative to reduce CIED monitoring frequency at a single center with no patient adverse events. The intervention reduced workload and potentially improved patient compliance with routine RM. K E Y W O R D Spediatric, quality improvement, remote monitoring of CIED wileyonlinelibrary.com/journal/pace

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Section: Discussionmentioning

confidence: 90%

Frequency of CIED remote monitoring: A quality improvement follow‐up study

Dechert

Bradley

Serwer

et al. 2019

Pacing Clinical Electrophis

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“…Longer procedural time will eventually cause longer turnover time, delaying the next procedure in line. 11 Another issue is hypothermia in infants, which can quickly develop in a catheterisation laboratory cold environment. These issues became a problem because no integrated infant warmer was available in our cath lab.…”

Section: Discussionmentioning

confidence: 99%

A retrograde approach for transcatheter valvotomy procedure in infants with pulmonary atresia intact ventricular septum (PA-IVS): retrograde versus antegrade approach

et al. 2022

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Introduction: This study evaluates the retrograde approach compared to the antegrade approach in infants with PA-IVS who underwent transcatheter pulmonary valvotomy procedure at National Cardiovascular Center Harapan Kita, Jakarta, Indonesia. Material and method: This is a single-centre retrospective study conducted from January 2017 to June 2019 consisting of infants undergoing transcatheter pulmonary valvotomy procedures from our centre. Results: Among 3733 records of cardiac catheter procedure in paediatric patients during the last 3 years, there were 12 subjects with PA-IVS, where five subjects were done by antegrade approach and seven by retrograde approach. The retrograde approach is shown to excel the antegrade approach in terms of procedural time by 58.64 minutes (CI 95 % 32.97–84.29, p = 0.008) and PA-RV crossing time by 27 minutes (CI 95 % 14.01–39.99, p = 0.02). There was no significant difference in contrast used (120.23 ± 25.77 versus 150.27 ± 39.26 ml/BSA, p = 0.518), and right ventricle to pulmonary artery systolic pressure gradient after valvotomy (39.571 ± 5.814 versus 53.52 ± 29.15, p = 0.329) between the retrograde and the antegrade approach. Conclusion: The retrograde approach offered shorter procedural time and comparably satisfying results than the antegrade approach. The shorter procedural time was preferred due to the shorter duration of general anaesthesia, which may decrease the risk of neurodevelopmental deficits in the patient.

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“…A pesquisa concluiu que a categoria de enfermeiros prevalece em relação às demais e identificou três modelos de organização dos cuidados de reabilitação: um interno, com foco nos cuidados prestados especificamente pelos enfermeiros de reabilitação; outro externo, em que a prestação de cuidados é assegurada por uma equipe especializada (fisioterapeutas) externa à unidade; e o terceiro como um modelo misto, no qual os cuidados são prestados pela equipe (enfermeiros) da organização hospitalar em articulação com uma equipe externa especializada. Análise (12) sobre a experiência de um Programa de Melhoria da Eficiência implementado em um laboratório de cardiologia mostrou que o primeiro passo envolve a composição de uma equipe multiprofissional de liderança e instituição da gerência de enfermagem, supervisores de enfermagem, administradores de departamentos e médicos. Em seguida, esses profissionais devem mapear o fluxograma do processo de trabalho, descrevendo cada passo necessário para assegurar a continuidade dos cuidados de um paciente típico.…”

Section: Gestão Com Foco Na Melhoria Do Cuidadounclassified

Evidências sobre modelos de gestão em enfermagem nos serviços hospitalares: revisão integrativa

Silva¹,

Góis²,

Almeida³

et al. 2021

Acta Paulista De Enfermagem

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Operational Efficiency and Productivity Improvement Initiatives in a Large Cardiac Catheterization Laboratory

Abstract: A systematic approach to reducing inefficiencies can improve cath lab start times, turnaround times, and overall productivity. This knowledge may be helpful in assisting other cath labs in similar efficiency improvement initiatives.

Cited by 13 publications

References 8 publications

Frequency of CIED remote monitoring: A quality improvement follow‐up study

Frequency of CIED remote monitoring: A quality improvement follow‐up study

A retrograde approach for transcatheter valvotomy procedure in infants with pulmonary atresia intact ventricular septum (PA-IVS): retrograde versus antegrade approach

Evidências sobre modelos de gestão em enfermagem nos serviços hospitalares: revisão integrativa

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