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- Title
Impacts of a care process model and inpatient electrophysiology service on cardiovascular implantable electronic device infections: a preliminary evaluation.
- Authors
Tan, Eugene; Nagpal, Avish; DeSimone, Daniel; Anderson, Brenda; Linderbaum, Jane; De Ziel, Thomas; Li, Zhuo; Sohail, Muhammad; Cha, Yong-Mei; Loomis, Erica; Espinosa, Raul; Friedman, Paul; Greason, Kevin; Schiller, Henry; Virk, Abinash; Wilson, Walter; Steckelberg, James; Baddour, Larry; Tan, Eugene M; DeSimone, Daniel C
- Abstract
<bold>Purpose: </bold>Cardiovascular implantable electronic device infection (CIEDI) rates are rising. To improve outcomes, our institution developed an online care process model (CPM) and a specialized inpatient heart rhythm service (HRS).<bold>Methods: </bold>This retrospective review compared hospital length of stay (LOS), mortality, and times to subspecialty consultation and procedures before and after CPM and HRS availability.<bold>Results: </bold>CPM use was associated with shortened time to surgical consultation (median 2 days post-CPM vs. 3 days pre-CPM, p = 0.0152), pocket closure (median 4 vs. 5 days, p < 0.0001), and days to new CIED implant (median 7 vs. 8 days, p = 0.0126). Post-HRS patients were more likely to have a surgical consultation (OR 7.01, 95% CI 1.56-31.5, p = 0.011) and shortened time to pocket closure (coefficient - 2.21 days, 95% CI - 3.33 to - 1.09, p < 0.001), compared to pre-HRS.<bold>Conclusions: </bold>The CPM and HRS were associated with favorable outcomes, but further integration of CPM features into hospital workflow is needed.
- Subjects
LENGTH of stay in hospitals; SURGICAL &; topographical anatomy; MEDICAL care; ELECTROPHYSIOLOGY; SURGERY; CARDIAC pacemakers; COMPARATIVE studies; HEALTH facilities; HOSPITAL patients; IMPLANTABLE cardioverter-defibrillators; INFECTION; LONGITUDINAL method; RESEARCH methodology; MEDICAL cooperation; COMPLICATIONS of prosthesis; RESEARCH; SURVIVAL analysis (Biometry); DEPARTMENTS; EVALUATION research; RETROSPECTIVE studies
- Publication
Journal of Interventional Cardiac Electrophysiology, 2017, Vol 50, Issue 1, p117
- ISSN
1383-875X
- Publication type
journal article
- DOI
10.1007/s10840-017-0282-2