Background: Bedside procedures are safe, cost effective, and efficient when performed by trained hospitalist physicians, unfortunately it is a skill that has been lost over the years when not practiced after residency. Interventional radiologists (IR) perform the bulk of these procedures in many different hospitals, but this can lead to delay in patient care, increased length of stay (LOS) due to huge backlogs. In the fall of 2018, we created a hospitalist run procedure team, to perform beside Ultrasound guided paracentesis, thoracentesis, lumbar punctures, Knee arthrocentesis, Central Lines, Dialysis access, complex IV access, Skin biopsies, suprapubic catheter exchanges etc. We reduced IR wait times by 20% in the very first month we started!
Purpose: The purpose of the hospitalist procedure team was to reduce IR wait times, decrease delay in patient care, reduce hospital length of stay by performing many of the simpler, safe procedures within the scope of the Internal Medicine residency trained physician at bedside with ultrasound guidance rather than wait for availability of IR suite/ fluoroscopy.
Description: We created a hospitalist procedure service four years ago, we have grown from two proceduralists to sixteen proceduralists now, perform around 2000 procedures per year, which has greatly increased the value of hospital medicine, reduced IR wait time for more complex procedures, reduced LOS, decreased costs (IR versus bedside), decreased delay in patient care, increased hospitalist and facility revenue, increased patient satisfaction, and even have a popular medical student and residency elective in procedures to train future doctors!
Conclusions: One of the cardiothoracic surgeons gave us the nick name ” Interventional Hospitalists”, and true to the name, we have performed over 8000 safe bedside procedures over the last 4 years, with a complication rate less than or equal to Interventional radiology. A well trained, competent, procedural hospitalist can greatly augment the value of a hospitalist group, reduce delay in patient care, reduce LOS, increase patient satisfaction, reduce disruption in anticoagulation holds, reduce patient transportation costs and increase practice/facility revenue.