PMU42 - ECONOMIC AND ORGANIZATIONAL IMPACT OF A VASCULAR ACCESS TEAM IN AN ITALIAN HOSPITAL

Abstract

To identify clinical, economic and organizational impacts of the introduction of a Vascular Access Team (VAT) in a hospital of central Italy. The analysis was performed through the estimation of the savings associated with the reduction of complication rate (i.e. catheter related infections) and with the involvement of medical/technical staff for catheter implantation (patient management, needed competences). Economic and organizational impact analysis of a single hospital in two different scenarios: pre (Scenario 1) and post (Scenario 2) VAT creation. The identification of the hospital was based on its significance in terms of number of procedures (about 2.500 catheter insertion in one year) and healthcare professionals (HCPs) involved. The two scenarios were compared in terms of: number of catheter implantation and devices used (CICC, PORT or PICC), HCPs involved, catheter-related infections, costs of staff, devices and infections. Data were obtained from different sources: literature review; interviews with clinicians and nurses. Interviews were conducted using a questionnaire with both open and multiple-choice questions. The study showed that the introduction of the VAT in the analyzed hospital generated an increase in the number of catheter insertion (2.626 in scenario 2 compared to 1.764 in scenario 1) and in savings (about 946.000 €) thanks to a significant reduction of catheter-related infections incidence (14 per 1.000 catheter days in scenario 1 and 0,6 per 1.000 catheter days in scenario 2) and a better HCPs management. The present study indicated that the introduction of a VAT has generated a series of benefits: better catheter management, savings due to decrease of infections incidence and to a better use of HCPs, decrease of CVC and PORT inappropriate implant, continuing professionals’ development and better internal training.