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Interventional radiology clinic visit prior to outpatient Mediport placement improves patient satisfaction
JVIR
’
Scientific Session
Monday
June 2015. Fisher exact test and Z test were used to assess differences; a p-value of 0.05 was considered significant. Results: A total of 358 responses (9.6% response rate) was received. The majority were US based (330/358, 92%) and fellowship trained (332/358, 93%). Only 5% (14/262) of respondents felt that UAE was not safe for any women who desire future pregnancy. Roughly half (122/241, 51%) of respondents do not currently include the possibility of missed or delayed diagnosis of cancer in their informed consent process. Of those who discuss the risk, most quote a value of 1 in 1000 (69/241, 29%). Respondents with more experience were more likely to discuss risk of missed cancer compared to those with less experience (29/42, 69% for 15þ years vs 18/52, 35% for 0-5 years, po0.001). Conclusions: There is room for improvement in our informed consent process for UAE. All interventional radiologists, particularly the younger generation, should discuss the risk of missed or delayed diagnosis of cancer with patients. References
4:04 PM
Abstract No. 195
Interventional radiology clinic visit prior to outpatient Mediport placement improves patient satisfaction L. Brody1, J. Erinjeri1, R. Thornton2, S. Solomon3; 1 Memorial Sloan-Kettering Cancer Center, New York, NY; 2 N/A, Yorktown Heights, NY; 3N/A, New York, NY. Purpose: Patient preparation for mediport placement has historically been performed by referring clinicians. We sought to determine whether patient preparation / satisfaction could be improved by seeing patients in Interventional Radiology (IR) clinic prior to mediport placement. Materials and Methods: IRB approval was not required for this quality assurance study. Patients from predefined referring clinics were seen in IR clinic prior to mediport placement. An IR RN was responsible for education and preparation for this group. Teaching and preparation for all other patients was the responsibility of the referring clinic. From 11/5/13 – 1/3/14, all patients undergoing outpatient mediport placement by the IR service were asked to complete a short survey prior to the procedure; most questions utilized a 5-point Likert scale. Univariate and multivariate analysis was performed to determine whether IR clinic affected patient satisfaction and perceived preparedness. Results: 49 patients were seen IR clinic, with referring clinics responsible for 105. Patients prepared by IR were significantly more likely to feel that: their questions were answered
S91
(po0.0018); they received education materials (po0.0002); they knew how to care for their wound (po0.0013); their instructions were clear (po0.0002); and the procedure was easy to schedule (po0.0002). Overall satisfaction with scheduling, teaching and preparation was also significantly better (po0.01). Having all questions answered and ease of scheduling were the strongest independent predictors of overall satisfaction (OR 2.2 and 2.0 respectively). Conclusions: Despite an extra clinic visit, patients undergoing OP mediport placement were significantly more satisfied with scheduling, teaching and preparation when these tasks were performed by IR staff. References 1. Lutjeboer J, Burgman MC, Chung K, van Erkel AR. Impact on Patient’s Safety and Satisfaction of Instrumentation of an Outpatient Clinic in Interventional Radiology (IPSIPOLI-Study): A Quasi-Experimental Prospective Study. CVIR 2015; 38:543–551. 2. Swichuk J, Sacks D, Pentecost M, et al. Clinical practice of interventional and cardiovascular radiology: Current Status, Guidelines for Resource Allocation, Future Directions. J Am Coll Radiol 2004; 1:720–727.
4:13 PM
Abstract No. 196
Using LEAN principles to integrate the vascular team into ED and inpatient vascular study reporting: impact on length-of-stay and hospitalization cost A. Bhakoo, B. Olivieri, R. Beasley; Mount Sinai Medical Center, Miami Beach, FL. Purpose: To evaluate the impact of using LEAN principles in peripheral vascular study reporting to reduce hospitalization length of stay and cost for PAD patients. Materials: Materials: Data from a quality improvement project to expedite initiation of patient care on PAD patients through prompt communication with physicians who routinely consult the multidisciplinary vascular/wound healing team led by the VIR Division at our hospital. Methodology: Comparison was made of time from study completion to vascular consult and to discharge for two patient groups; those whose physicians were notified by VIR of the findings at study completion (n¼28) and those whose physicians consulted VIR/vascular specialists without early notification (n¼47). Cohort-match analysis (based on Rutherford classification) comparing the average time to vascular consult and average time to discharge in the two groups of patients was performed. Inclusion criteria: All ER and inpatients referred to vascular specialists within our hospital for PAD management following an ultrasound from 11/2013 through 4/2015. Exclusion criteria: Patients with a concomitant acute medical problem during admission, ex: ACS, cholecystitis. Hospital Adjusted Expenses per inpatient day was obtained from the latest Kaiser Family Foundation data for nonprofit hospitals in our state. Results: Data was first analyzed for statistical significance using t-tests for each dependent variable and found to be significant with p-values of 0.03. For all Rutherford classes, the data demonstrates that earlier communication from an integrated vascular team for positive studies decreases time to consult with decreased time to discharge and cost savings.
MONDAY: Scientific Sessions
1. Ravina J, Ciraru-Vigneron N, Bouret J, et al. Arterial embolisation to treat uterine myomata. The Lancet. 1995; 346(8976):671–672. 2. McCarthy M. US agency warns against morcellation in hysterectomies and myomectomies. BMJ. 2014; 348:g2872. 3. Dariushnia SR, Nikolic B, Stokes LS, Spies JB, Society of Interventional Radiology Standards of Practice Committee. Quality improvement guidelines for uterine artery embolization for symptomatic leiomyomata. J Vasc Interv Radiol. 2014; 25(11):1737–1747. 4. Stokes LS, Wallace MJ, Godwin RB, Kundu S, Cardella JF, Society of Interventional Radiology Standards of Practice Committee. Quality improvement guidelines for uterine artery embolization for symptomatic leiomyomas. J Vasc Interv Radiol. 2010; 21(8):1153–1163.
’
’
Scientific Session
Monday
June 2015. Fisher exact test and Z test were used to assess differences; a p-value of 0.05 was considered significant. Results: A total of 358 responses (9.6% response rate) was received. The majority were US based (330/358, 92%) and fellowship trained (332/358, 93%). Only 5% (14/262) of respondents felt that UAE was not safe for any women who desire future pregnancy. Roughly half (122/241, 51%) of respondents do not currently include the possibility of missed or delayed diagnosis of cancer in their informed consent process. Of those who discuss the risk, most quote a value of 1 in 1000 (69/241, 29%). Respondents with more experience were more likely to discuss risk of missed cancer compared to those with less experience (29/42, 69% for 15þ years vs 18/52, 35% for 0-5 years, po0.001). Conclusions: There is room for improvement in our informed consent process for UAE. All interventional radiologists, particularly the younger generation, should discuss the risk of missed or delayed diagnosis of cancer with patients. References
4:04 PM
Abstract No. 195
Interventional radiology clinic visit prior to outpatient Mediport placement improves patient satisfaction L. Brody1, J. Erinjeri1, R. Thornton2, S. Solomon3; 1 Memorial Sloan-Kettering Cancer Center, New York, NY; 2 N/A, Yorktown Heights, NY; 3N/A, New York, NY. Purpose: Patient preparation for mediport placement has historically been performed by referring clinicians. We sought to determine whether patient preparation / satisfaction could be improved by seeing patients in Interventional Radiology (IR) clinic prior to mediport placement. Materials and Methods: IRB approval was not required for this quality assurance study. Patients from predefined referring clinics were seen in IR clinic prior to mediport placement. An IR RN was responsible for education and preparation for this group. Teaching and preparation for all other patients was the responsibility of the referring clinic. From 11/5/13 – 1/3/14, all patients undergoing outpatient mediport placement by the IR service were asked to complete a short survey prior to the procedure; most questions utilized a 5-point Likert scale. Univariate and multivariate analysis was performed to determine whether IR clinic affected patient satisfaction and perceived preparedness. Results: 49 patients were seen IR clinic, with referring clinics responsible for 105. Patients prepared by IR were significantly more likely to feel that: their questions were answered
S91
(po0.0018); they received education materials (po0.0002); they knew how to care for their wound (po0.0013); their instructions were clear (po0.0002); and the procedure was easy to schedule (po0.0002). Overall satisfaction with scheduling, teaching and preparation was also significantly better (po0.01). Having all questions answered and ease of scheduling were the strongest independent predictors of overall satisfaction (OR 2.2 and 2.0 respectively). Conclusions: Despite an extra clinic visit, patients undergoing OP mediport placement were significantly more satisfied with scheduling, teaching and preparation when these tasks were performed by IR staff. References 1. Lutjeboer J, Burgman MC, Chung K, van Erkel AR. Impact on Patient’s Safety and Satisfaction of Instrumentation of an Outpatient Clinic in Interventional Radiology (IPSIPOLI-Study): A Quasi-Experimental Prospective Study. CVIR 2015; 38:543–551. 2. Swichuk J, Sacks D, Pentecost M, et al. Clinical practice of interventional and cardiovascular radiology: Current Status, Guidelines for Resource Allocation, Future Directions. J Am Coll Radiol 2004; 1:720–727.
4:13 PM
Abstract No. 196
Using LEAN principles to integrate the vascular team into ED and inpatient vascular study reporting: impact on length-of-stay and hospitalization cost A. Bhakoo, B. Olivieri, R. Beasley; Mount Sinai Medical Center, Miami Beach, FL. Purpose: To evaluate the impact of using LEAN principles in peripheral vascular study reporting to reduce hospitalization length of stay and cost for PAD patients. Materials: Materials: Data from a quality improvement project to expedite initiation of patient care on PAD patients through prompt communication with physicians who routinely consult the multidisciplinary vascular/wound healing team led by the VIR Division at our hospital. Methodology: Comparison was made of time from study completion to vascular consult and to discharge for two patient groups; those whose physicians were notified by VIR of the findings at study completion (n¼28) and those whose physicians consulted VIR/vascular specialists without early notification (n¼47). Cohort-match analysis (based on Rutherford classification) comparing the average time to vascular consult and average time to discharge in the two groups of patients was performed. Inclusion criteria: All ER and inpatients referred to vascular specialists within our hospital for PAD management following an ultrasound from 11/2013 through 4/2015. Exclusion criteria: Patients with a concomitant acute medical problem during admission, ex: ACS, cholecystitis. Hospital Adjusted Expenses per inpatient day was obtained from the latest Kaiser Family Foundation data for nonprofit hospitals in our state. Results: Data was first analyzed for statistical significance using t-tests for each dependent variable and found to be significant with p-values of 0.03. For all Rutherford classes, the data demonstrates that earlier communication from an integrated vascular team for positive studies decreases time to consult with decreased time to discharge and cost savings.
MONDAY: Scientific Sessions
1. Ravina J, Ciraru-Vigneron N, Bouret J, et al. Arterial embolisation to treat uterine myomata. The Lancet. 1995; 346(8976):671–672. 2. McCarthy M. US agency warns against morcellation in hysterectomies and myomectomies. BMJ. 2014; 348:g2872. 3. Dariushnia SR, Nikolic B, Stokes LS, Spies JB, Society of Interventional Radiology Standards of Practice Committee. Quality improvement guidelines for uterine artery embolization for symptomatic leiomyomata. J Vasc Interv Radiol. 2014; 25(11):1737–1747. 4. Stokes LS, Wallace MJ, Godwin RB, Kundu S, Cardella JF, Society of Interventional Radiology Standards of Practice Committee. Quality improvement guidelines for uterine artery embolization for symptomatic leiomyomas. J Vasc Interv Radiol. 2010; 21(8):1153–1163.
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