Streamlining operation of an admitting service for interventional radiology

The authors describe how operations of an inpatient admitting service for interventional radiology were improved by developing a clinic and hiring a physician's assistant. The service, begun in 1982, was managed by a senior radiologist and fellows. Because of increasing admissions (from a mean of 52 per year in 1982-1985 to 110 per year in 1985-1987), a 1/2-day, twice-weekly clinic was created in 1985 to evaluate new patients and perform follow-up examinations. In 1986 a physician's assistant was hired to assist in the clinic and during patient admissions. Use of the clinic and physician's assistant streamlined patient flow and management during hospitalization. This resulted in a decrease in mean length of stay for patients undergoing angioplasty (from 3.74 days in 1982-1983 to 2.41 days in 1986-1987). This decrease means cost savings for the hospital under the prospective payment system. Other benefits include improved physician-patient relationships and follow-up, new patients for colleagues (15% of patients had anatomy unsuitable for interventional procedures and were referred to staff surgeons), and increased professional fees.