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Published in: Journal of Interventional Cardiac Electrophysiology 1/2017

01-10-2017

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

Authors: 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

Published in: Journal of Interventional Cardiac Electrophysiology | Issue 1/2017

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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.
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Metadata
Title
Impacts of a care process model and inpatient electrophysiology service on cardiovascular implantable electronic device infections: a preliminary evaluation
Authors
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
Publication date
01-10-2017
Publisher
Springer US
Published in
Journal of Interventional Cardiac Electrophysiology / Issue 1/2017
Print ISSN: 1383-875X
Electronic ISSN: 1572-8595
DOI
https://doi.org/10.1007/s10840-017-0282-2

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