SHM Converge Scientific Abstract ePoster Gallery-Impact of a Hospital Medicine Procedure Service on Interventional Radiology Referrals

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This project evaluated whether launching a hospital medicine procedure service (MPS) would reduce direct referrals to Interventional Radiology (IR) for common bedside procedures: central venous lines, lumbar puncture, paracentesis, and thoracentesis.<br /><br />The MPS began hospital-wide in July 2020. Data collection started in January 2021 to track inpatient procedures performed by IR without prior MPS consultation. In March 2022, the team launched a collaborative improvement effort with IR to encourage consultation with MPS before sending patients to IR, especially on resource-limited days. In June 2022, the IR consult system was updated to prompt MPS involvement for these procedures.<br /><br />From January 2021 through October 2024, 1,742 procedures were referred directly to IR without MPS involvement. Before the intervention, IR handled an average of 58 such procedures per month. After implementation, monthly direct-to-IR referrals fell to 37.5 in the first post-implementation year, then to 23 in the next year, and to 20.4 in the most recent period. Overall, this represented a sustained 65% reduction compared with pre-implementation levels.<br /><br />The findings suggest that hospital-wide MPS implementation, combined with multidisciplinary process improvements and workflow changes, can significantly reduce unnecessary IR use for routine bedside procedures. This approach may improve procedural resource management, reduce IR overcrowding, and provide a useful model for hospital medicine, IR, and administrators.

Asset Subtitle

Christopher J. King

Meta Tag

Author List Carolina Ortiz Lopez, Christopher J. King, Henry R. Kramer

Category Innovations

Concept Hospital Medicine Procedure Service

Concept Interventional Radiology

Concept Direct-to-IR Referral

Concept Procedure Volume

Concept Procedural Safety

Distinguished Non-Finalist

Presenter Organization University of Colorado, Division of Hospital Medicine

Presenting Author Christopher J. King

Track Quality Improvement

Keywords

hospital medicine procedure service

interventional radiology

bedside procedures

direct referrals

central venous lines

lumbar puncture

paracentesis

thoracentesis

workflow improvement

resource management

Hospital Medicine Procedure Service

Interventional Radiology

Direct-to-IR Referral

Procedure Volume

Procedural Safety