Development and Implementation of a Novel Emergency Department-Based Procedure Team for Inpatient Hospital Procedures

Abstract

Background

Emergency medicine (EM) demands proficiency in a broad set of procedural skills for emergency physicians. However, there is a literature gap on integrating EM expertise into procedure teams, especially in inpatient settings.

Objectives

This study aims to outline the development and implementation of a novel ED-based procedure team for inpatient care.

Methods

This retrospective study conducted between June 6, 2022, and December 31, 2023, describes the development and implementation of an ED-based procedure team. Key procedures included central lines, arterial lines, and nontunneled dialysis catheters, with specific guidelines to ensure safety and consistency.

Results

During the study, the procedure team conducted 525 procedures. Midline insertions and paracentesis were the most common. The team performed an average of 27.3 procedures per month. Additional provider hours needed to complete the procedures averaged 4.8 per month and showed a trend toward stabilization over time. Financially, the team secured reimbursements for 516 cases at $98 per case, observing a positive trend in gross payments.

Conclusion

The ED Procedure team has played a pivotal role in delivering essential bedside procedures for the patient, demonstrating improvements in provider proficiency, resident training, and favorable revenue outcomes. The interdepartmental collaborative and well-coordinated efforts have ensured the timely completion of necessary procedures.