Impacts of a care process model and inpatient electrophysiology service on cardiovascular implantable electronic device infections: a preliminary evaluation

Eugene M. Tan, Avish Nagpal, Daniel C. DeSimone, Brenda Anderson, Jane Linderbaum, Thomas de Ziel, Zhuo Li, Muhammad R. Sohail, Yong-Mei Cha, Erica Loomis, Raul Emilio Espinosa, Paul Andrew Friedman, Kevin Greason, Henry Schiller, Abinash Virk, Walter R. Wilson, James M. Steckelberg, Larry M. Baddour

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Purpose: 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). Methods: This retrospective review compared hospital length of stay (LOS), mortality, and times to subspecialty consultation and procedures before and after CPM and HRS availability. Results: 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. Conclusions: The CPM and HRS were associated with favorable outcomes, but further integration of CPM features into hospital workflow is needed.

Original languageEnglish (US)
Pages (from-to)1-8
Number of pages8
JournalJournal of Interventional Cardiac Electrophysiology
DOIs
StateAccepted/In press - Aug 26 2017

Keywords

  • Cardiac device
  • CRT
  • ICD
  • Infection

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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    Tan, E. M., Nagpal, A., DeSimone, D. C., Anderson, B., Linderbaum, J., de Ziel, T., Li, Z., Sohail, M. R., Cha, Y-M., Loomis, E., Espinosa, R. E., Friedman, P. A., Greason, K., Schiller, H., Virk, A., Wilson, W. R., Steckelberg, J. M., & Baddour, L. M. (Accepted/In press). Impacts of a care process model and inpatient electrophysiology service on cardiovascular implantable electronic device infections: a preliminary evaluation. Journal of Interventional Cardiac Electrophysiology, 1-8. https://doi.org/10.1007/s10840-017-0282-2