Timeout for Contrast: Using Physician Behavior Modification to Reduce Contrast in the Catheterization Laboratory.

Area of Science:

• Cardiology
• Nephrology
• Health Informatics

Background:

• Rising contrast media use increases healthcare burden due to complications like contrast-induced nephropathy (CIN).
• CIN is a frequent complication following cardiac catheterization procedures.

Purpose of the Study:

• To assess the effectiveness of physician behavioral modification in reducing contrast media volume during procedures.
• To evaluate the impact of a preprocedure checklist intervention on contrast usage.

Main Methods:

• Retrospective analysis of 12,118 cardiac catheterization cases from January 2013 to August 2016.
• Introduction of a maximum allowed contrast volume on the preprocedure checklist in September-October 2013.
• Comparison of contrast volumes before and after the intervention, analyzing trends over three years.

Main Results:

• Mean contrast used decreased from 118 ml pre-intervention to 105 ml (year 1), 106 ml (year 2), and 99 ml (year 3) post-intervention.
• A significant and sustained reduction in radiocontrast use was observed across all operators and procedures.
• The intervention demonstrated a clear impact on physician behavior regarding contrast administration.

Conclusions:

• A simple physician behavioral modification, via a revised timeout procedure, significantly reduced contrast media use.
• This reduction in contrast exposure lowers patient risk for dose-dependent contrast-induced nephropathy (CIN) and related complications.
• The observed decrease in contrast usage was sustained over a three-year period, indicating long-term effectiveness.