Feasibility of a Multidisciplinary Procedural Team Dedicated to Complex In-Patient Bedside Procedures

Hospitals have found difficulties performing routine procedures in a cost-effective and timely manner. We created a multidisciplinary "In-patient Procedural Team" (IPT) with the intent to meet the demand of nonvascular, nonenteral access procedures.

A team was assembled comprising advanced practice providers and sonographers with oversight by a surgeon. The IPT scope of practice includes thoracentesis, paracentesis, and lumbar punctures, performed at the bedside under ultrasound guidance.

During 11 months, 2,453 procedures were performed. Of those, 1,196 were paracentesis, 1,099 thoracentesis (with 70 pigtail chest tubes placed), and 88 lumbar punctures. An 80.9% decrease in average consult completion time (9.75 hours vs. 1.86 hours, p < .01) and an 80.9% decrease in case creation-to-procedure start time (13.92 hours vs. 2.66 hours, p < .01) were found. When compared with pre-IPT data, procedures were now completed a mean of 19.2 hours earlier than historic controls. An estimate of 710 off-floor nursing hours were saved. In total, 3,500 patient transports around the hospital were eliminated.

The creation of an IPT intended to tackle complex in-patient procedures is a safe way to reduce time-to-procedure and off-floor nursing time while maintaining high-quality standards.