SHM Converge Scientific Abstract ePoster Gallery-Creation of an Educational Hospitalist Procedure Service

Pdf Summary

This project describes the creation of a hospital medicine (HM) procedure service at a community teaching hospital, led by HM fellows in collaboration with interventional radiology (IR). The team first assessed procedural demand and existing coverage, then focused the service on three high-need bedside procedures: paracentesis, thoracentesis, and lumbar puncture. A weekly schedule was built to ensure a proceduralist was available for six hours at the start of the week, improving access by capturing patients over the weekend, with additional limited coverage during regular hospitalist shifts.<br /><br />The service was developed to address common barriers to procedure programs, including staffing, training, and sustainability, while also increasing IR capacity by shifting selected bedside procedures to HM. Fellowship training was central to the model: privileged team members, fellows, and residents participated in procedures, creating ongoing staffing and educational opportunities. Collaboration with IR also provided mentorship for hospitalists who were initially less experienced, helping expand the team over time.<br /><br />Over approximately 11 months, the service completed 108 procedures: 60 paracenteses, 41 thoracenteses, and 7 lumbar punctures. Reported outcomes included 124 hours of radiology time saved, 60 hours of learner involvement, and a 0% complication rate. Preliminary data suggested improved efficiency, with average time to procedure decreasing from 111.9 hours before the service to 17.6 hours after implementation, and a possible reduction in length of stay, though these results were noted as confounded by measurement bias.<br /><br />Overall, the initiative improved access to bedside procedures, enhanced trainee education, supported IR capacity, and may help extend procedural care to outpatient and rural settings, including critical access hospitals.

Asset Subtitle

Joshua Slep

Meta Tag

Author List Adelle Kurtz, Claudia K. Geyer, Joshua Slep, Seth Stein, Zachary Mueller

Category Innovations

Concept Bedside Procedure Service

Concept Thoracentesis

Concept Paracentesis

Concept Lumbar Puncture

Concept Interventional Radiology

Distinguished Non-Finalist

Presenter Organization Central Maine Medical Center

Presenting Author Joshua Slep

Track Other

Keywords

hospital medicine

procedure service

community teaching hospital

interventional radiology

paracentesis

thoracentesis

lumbar puncture

bedside procedures

fellowship training

procedure access

Bedside Procedure Service

Thoracentesis

Paracentesis

Lumbar Puncture

Interventional Radiology