Feasibility of a Multidisciplinary Procedural Team Dedicated to Complex In-Patient Bedside Procedures.

Abstract

Introduction: Hospitals have found difficulties performing routine procedures in a cost-effective and timely manner. We created a multidisciplinary "In-patient Procedural Team" (IPT) with the intent to meet the demand of nonvascular, nonenteral access procedures.

Methods: A team was assembled comprising advanced practice providers and sonographers with oversight by a surgeon. The IPT scope of practice includes thoracentesis, paracentesis, and lumbar punctures, performed at the bedside under ultrasound guidance.

Results: During 11 months, 2,453 procedures were performed. Of those, 1,196 were paracentesis, 1,099 thoracentesis (with 70 pigtail chest tubes placed), and 88 lumbar punctures. An 80.9% decrease in average consult completion time (9.75 hours vs. 1.86 hours, p < .01) and an 80.9% decrease in case creation-to-procedure start time (13.92 hours vs. 2.66 hours, p < .01) were found. When compared with pre-IPT data, procedures were now completed a mean of 19.2 hours earlier than historic controls. An estimate of 710 off-floor nursing hours were saved. In total, 3,500 patient transports around the hospital were eliminated.

Conclusions: The creation of an IPT intended to tackle complex in-patient procedures is a safe way to reduce time-to-procedure and off-floor nursing time while maintaining high-quality standards.