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 Espinosa; Paul A. Friedman; Kevin Greason; Henry Schiller; Abinash Virk; Walter R. Wilson; James M. Steckelberg; Larry M. Baddour

doi:10.1007/s10840-017-0282-2

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 Espinosa, Paul A. Friedman, Kevin Greason, Henry Schiller, Abinash Virk, Walter R. Wilson, James M. Steckelberg, Larry M. Baddour

Research output: Contribution to journal › Article › peer-review

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 language	English (US)
Pages (from-to)	117-124
Number of pages	8
Journal	Journal of Interventional Cardiac Electrophysiology
Volume	50
Issue number	1
DOIs	https://doi.org/10.1007/s10840-017-0282-2
State	Published - Oct 1 2017

Keywords

CRT
Cardiac device
ICD
Infection

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine
Physiology (medical)

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10.1007/s10840-017-0282-2

Cite this

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., Friedman, P. A., Greason, K., Schiller, H., Virk, A., Wilson, W. R., Steckelberg, J. M., & Baddour, L. M. (2017). Impacts of a care process model and inpatient electrophysiology service on cardiovascular implantable electronic device infections: a preliminary evaluation. Journal of Interventional Cardiac Electrophysiology, 50(1), 117-124. https://doi.org/10.1007/s10840-017-0282-2

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. et al.
In: Journal of Interventional Cardiac Electrophysiology, Vol. 50, No. 1, 01.10.2017, p. 117-124.

Research output: Contribution to journal › Article › peer-review

Tan, EM, Nagpal, A, DeSimone, DC, Anderson, B, Linderbaum, J, De Ziel, T, Li, Z, Sohail, MR, Cha, YM, Loomis, E, Espinosa, R, Friedman, PA, Greason, K, Schiller, H, Virk, A, Wilson, WR, Steckelberg, JM & Baddour, LM 2017, 'Impacts of a care process model and inpatient electrophysiology service on cardiovascular implantable electronic device infections: a preliminary evaluation', Journal of Interventional Cardiac Electrophysiology, vol. 50, no. 1, pp. 117-124. https://doi.org/10.1007/s10840-017-0282-2

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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.",

keywords = "CRT, Cardiac device, ICD, Infection",

author = "Tan, {Eugene M.} and Avish Nagpal and DeSimone, {Daniel C.} and Brenda Anderson and Jane Linderbaum and {De Ziel}, Thomas and Zhuo Li and Sohail, {Muhammad R.} and Cha, {Yong Mei} and Erica Loomis and Raul Espinosa and Friedman, {Paul A.} and Kevin Greason and Henry Schiller and Abinash Virk and Wilson, {Walter R.} and Steckelberg, {James M.} and Baddour, {Larry M.}",

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doi = "10.1007/s10840-017-0282-2",

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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

AU - Friedman, Paul A.

AU - Greason, Kevin

AU - Schiller, Henry

AU - Virk, Abinash

AU - Wilson, Walter R.

AU - Steckelberg, James M.

AU - Baddour, Larry M.

PY - 2017/10/1

Y1 - 2017/10/1

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 - CRT

KW - Cardiac device

KW - ICD

KW - Infection

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

Abstract

Keywords

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