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 language | English (US) |
|---|---|
| Pages (from-to) | 1-8 |
| Number of pages | 8 |
| Journal | Journal of Interventional Cardiac Electrophysiology |
| DOIs | |
| State | Accepted/In press - Aug 26 2017 |
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Keywords
- Cardiac device
- CRT
- ICD
- Infection
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Physiology (medical)
Cite this
Impacts of a care process model and inpatient electrophysiology service on cardiovascular implantable electronic device infections : a preliminary evaluation. / Tan, Eugene M.; Nagpal, Avish; DeSimone, Daniel C.; Anderson, Brenda; Linderbaum, Jane; de Ziel, Thomas; Li, Zhuo; Sohail, Muhammad R.; Cha, Yong-Mei; Loomis, Erica; Espinosa, Raul Emilio; Friedman, Paul Andrew; Greason, Kevin; Schiller, Henry; Virk, Abinash; Wilson, Walter R.; Steckelberg, James M.; Baddour, Larry M.
In: Journal of Interventional Cardiac Electrophysiology, 26.08.2017, p. 1-8.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Impacts of a care process model and inpatient electrophysiology service on cardiovascular implantable electronic device infections
T2 - a preliminary evaluation
AU - Tan, Eugene M.
AU - Nagpal, Avish
AU - DeSimone, Daniel C.
AU - Anderson, Brenda
AU - Linderbaum, Jane
AU - de Ziel, Thomas
AU - Li, Zhuo
AU - Sohail, Muhammad R.
AU - Cha, Yong-Mei
AU - Loomis, Erica
AU - Espinosa, Raul Emilio
AU - Friedman, Paul Andrew
AU - Greason, Kevin
AU - Schiller, Henry
AU - Virk, Abinash
AU - Wilson, Walter R.
AU - Steckelberg, James M.
AU - Baddour, Larry M.
PY - 2017/8/26
Y1 - 2017/8/26
N2 - 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.
AB - 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.
KW - Cardiac device
KW - CRT
KW - ICD
KW - Infection
UR - http://www.scopus.com/inward/record.url?scp=85028300319&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85028300319&partnerID=8YFLogxK
U2 - 10.1007/s10840-017-0282-2
DO - 10.1007/s10840-017-0282-2
M3 - Article
C2 - 28844107
AN - SCOPUS:85028300319
SP - 1
EP - 8
JO - Journal of Interventional Cardiac Electrophysiology
JF - Journal of Interventional Cardiac Electrophysiology
SN - 1383-875X
ER -