SHM Converge Scientific Abstract ePoster Gallery-Moving the Line: A Hospitalist-Run Procedure Service Expedites Outpatient Oncology Care

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This report describes an expansion of a hospitalist-run procedure service at UCLA Medical Center from inpatient bedside procedures to outpatient vascular access placement for oncology patients. The service began partnering with the oncology department to place temporary apheresis catheters for patients needing CAR T-cell therapy, stem cell transplantation, or stem cell donation. Because apheresis and hemodialysis catheters are larger and may carry higher complication risk than standard central lines, the institution separated line-placement privileges, making the procedure service’s expertise especially relevant.<br /><br />The study’s primary endpoint was complication rate, and the secondary endpoint was procedure wait time. The authors compared 43 consecutive patients treated by the procedure team with 17 earlier patients referred to interventional radiology before the partnership. Results showed that the procedure service was safe: over 30 days, there were no major complications and only one minor complication, a small hematoma at the access site. The service also improved efficiency, cutting mean wait time nearly in half compared with interventional radiology (7.6 days vs 14.8 days, p=0.041).<br /><br />The authors conclude that a hospitalist-run procedure service can safely perform outpatient apheresis catheter placements despite the potential complexity of these lines. This model helped oncology patients begin potentially life-saving treatment faster and may also support resident training and supervision. More broadly, the experience suggests that procedure services can bridge procedural gaps across the health system, reduce delays, shorten length of stay, and help avoid unnecessary hospital admissions.

Asset Subtitle

Alexandra M. Glaeser

Meta Tag

Author List Alexandra M. Glaeser, Catherine E. Durant, Gary Feigenbaum

Category Innovations

Concept Apheresis Catheter

Concept Complication Rate

Concept Femoral Catheter

Concept Outpatient Oncology

Concept Bedside Procedure Service

Distinguished Non-Finalist

Presenter Organization Univeristy of California Los Angeles, Department of Medicine

Presenting Author Alexandra M. Glaeser

Track Quality Improvement

Keywords

hospitalist-run procedure service

UCLA Medical Center

outpatient vascular access

apheresis catheters

oncology patients

CAR T-cell therapy

stem cell transplantation

complication rate

procedure wait time

interventional radiology

Apheresis Catheter

Complication Rate

Femoral Catheter

Outpatient Oncology

Bedside Procedure Service