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Impact of Performing Nonurgent Interventional Radiology Procedures on Weekends
Muneeb Ahmed1, Ammar Sarwar1, Donna Hallett1
1Department of Radiology, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, Massachusetts.
Abstract:
Most clinical services limit weekend care to urgent or emergent situations. However, providing access to nonemergent procedures on weekends may reduce length of hospital stay and unnecessary admissions. No data are available on the impact of providing nonemergent interventional radiology (IR) procedural services on weekends. A retrospective review of nonurgent IR inpatient services on weekends over a 12-month period was performed. Using intent-to-treat analysis, 453 procedures were performed on 447 patients on 100 weekend days. Procedures included venous access (116 of 453, 25.6%), dialysis interventions (83 of 453, 18.3%), enteral access (73 of 453, 16.1%), genitourinary interventions (37 of 453, 8.2%), venous interventions (35 of 453, 7.7%), biliary interventions (33 of 453, 7.3%), percutaneous drainage (32 of 453, 7.1%), biopsy (24 of 453, 5.3%), arterial interventions (14 of 453, 3.1%), and other (3 of 453, 0.7%). Routine weekend procedural services allowed 108 of 447 (24.2%) patients to be discharged earlier than anticipated if such services were not available, resulting in 174 hospital days gained. Procedures were performed earlier than anticipated in 268 of 447 (60.0%) patients resulting in 415 days of progression of care gained over the 12-month period. For dialysis interventions, 35% (29 of 83) of patients received hemodialysis within 24 hours of intervention, and 25 patients were discharged early with 33 hospital days saved. IR procedures were performed on patients from 97% of the hospital inpatient units (22 of 23 inpatient or observation units, and 10 of 10 intensive care units) over the 12-month period. In conclusion, increased availability of nonurgent IR services on weekends can directly reduce hospital length of stay as well as improve progression of inpatients toward an early discharge.
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