PO-01-051 EARLY PHYSICIAN ARRIVAL TO ELECTROPHYSIOLOGY LABORATORY INCREASES LAB EFFICIENCY BY DECREASING PREPARATION TIME

Abstract

Many cardiac arrhythmia patients benefit from interventions performed in the electrophysiology (EP) lab. EP labs are a valuable resource that if not used efficiently may lead to delay in patient care, increased cost to the medical system, and challenges with recruiting and retaining staff. Prep time is defined as the time from when a patient (pt) enters a procedural room until the procedure start. Prep time is affected by many factors, including but not limited to: pt factors, staffing ratios, sedation plan, need for invasive hemodynamic monitoring, and complexity of procedure (proc). Physician arrival to the EP lab is an important component of prep time. To determine if earlier physician arrival to the EP lab shortens prep time. Pt and physician in-room times, proc start times, and proc characteristics were recorded over a 5 month period from 5/22 through 8/22. Quantitative data was divided into subgroups based on proc type – ablation (abl) or device. Means and standard deviation of physician arrival time and proc start time were calculated. A scatter plot of proc start time compared to physician arrival was created and a best-fit polynomial regression was performed (Fig 1). Point of maximum correlation (PMC) was calculated using Pearson’s method and linear regression was applied from that point onward. Cases that were understaffed and VT ablation were highlighted. Of 539 cases, 235 (44%) were device implants and 304 (56%) were abl. The difference between the earliest average physician arrival time compared to the latest average physician arrival time was 17min for device and 16 min for abl. Prep time was 15 minutes shorter for the earliest arriving physician for device, and 28 min shorter for abl. The PMC for abl and device implants were 25mins and 30mins respectively. Every minute of delay after the PMC was directly related to the MD not being present in the lab. For the interval prior to the PMC, there are many factors causing delays in the lab, leading to questionable direct correlation between MD arrival and prep time. The minimum prep time for both abl and implants appears to be 20 mins in this lab with the current staffing and culture. Earlier MD in room times increase lab efficiency by reducing procedure start times.Tabled 1Mean in Room Times to Access (min) +/-SDAblationDevice ImplantMean Pt Room to EP RoomMean Pt Room to AccessMean Pt Room to EP RoomMean Pt Rm to AccessEP115+/-1347+/-1111+/-1246+/-10EP211+/-942+/-1011+/-942+/-10EP318+/-850+/-1213+/-1647+/-16EP425+/-1449+/-1126+/-2149+/-16EP524+/-1660+/-2021+/-1652+/-14EP68+/-1032+/-84+/-837+/-9EP78+/-831+/-107+/-637+/-7 Open table in a new tab