Improved Screening Reduces Transesophageal Study Cancellations at a Large Tertiary Israeli Medical Center
Cancellation of transesophageal echocardiography (TEE) tests leads to inefficient use of echocardiography laboratory (echo lab) time and wastes resources. To identify the causes of same-day TEE cancellations in hospitalized patients, to formulate a TEE order screening protocol, and to evaluate its e...
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Veröffentlicht in: | The Israel Medical Association journal 2023-05, Vol.25 (5), p.324-327 |
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creator | Hemi, Hagit Morelli, Olga Vaturi, Mordehay Kornowski, Ran Sagie, Alexander Shapira, Yaron Schwartzenberg, Shmuel |
description | Cancellation of transesophageal echocardiography (TEE) tests leads to inefficient use of echocardiography laboratory (echo lab) time and wastes resources.
To identify the causes of same-day TEE cancellations in hospitalized patients, to formulate a TEE order screening protocol, and to evaluate its efficacy at implementation.
We performed a prospective analysis of inpatients referred to a single tertiary hospital echo lab for TEE study by inpatient wards. A comprehensive screening protocol emphasizing active participation of all links directly involved in the chain of inpatient TEE referral was developed and implemented. Comparison of pre- and post-implementation of the new screening protocol on two consecutive periods of 6 months on TEE cancellation rates out of total ordered TEEs stratified by cause categories was performed.
: In total, 304 inpatient TEE procedures were ordered during the initial observation period; 54(17.8%) were canceled on the same day. The most common cancellation reasons were equally respiratory distress and patient not in fasted state (20.4% of total cancellations and 3.6% of all scheduled TEEs for each cause). Following implementation of the new screening process, total TEEs ordered (192) and cancelled (16) dropped significantly. A decrease in the rate of each cancellation category was observed, with statistical significance achieved for the overall cancellation rate (8.3% vs. 17.8%, P = 0.003), but not for the individual cancellation categories in split analysis.
A concerted effort to implement a comprehensive screening questionnaire significantly reduced same-day cancellations of scheduled TEEs. |
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To identify the causes of same-day TEE cancellations in hospitalized patients, to formulate a TEE order screening protocol, and to evaluate its efficacy at implementation.
We performed a prospective analysis of inpatients referred to a single tertiary hospital echo lab for TEE study by inpatient wards. A comprehensive screening protocol emphasizing active participation of all links directly involved in the chain of inpatient TEE referral was developed and implemented. Comparison of pre- and post-implementation of the new screening protocol on two consecutive periods of 6 months on TEE cancellation rates out of total ordered TEEs stratified by cause categories was performed.
: In total, 304 inpatient TEE procedures were ordered during the initial observation period; 54(17.8%) were canceled on the same day. The most common cancellation reasons were equally respiratory distress and patient not in fasted state (20.4% of total cancellations and 3.6% of all scheduled TEEs for each cause). Following implementation of the new screening process, total TEEs ordered (192) and cancelled (16) dropped significantly. A decrease in the rate of each cancellation category was observed, with statistical significance achieved for the overall cancellation rate (8.3% vs. 17.8%, P = 0.003), but not for the individual cancellation categories in split analysis.
A concerted effort to implement a comprehensive screening questionnaire significantly reduced same-day cancellations of scheduled TEEs.</description><identifier>ISSN: 1565-1088</identifier><identifier>PMID: 37245095</identifier><language>eng</language><publisher>Israel</publisher><subject>Appointments and Schedules ; Echocardiography, Transesophageal ; Humans ; Inpatients ; Israel ; Retrospective Studies ; Tertiary Care Centers</subject><ispartof>The Israel Medical Association journal, 2023-05, Vol.25 (5), p.324-327</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37245095$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hemi, Hagit</creatorcontrib><creatorcontrib>Morelli, Olga</creatorcontrib><creatorcontrib>Vaturi, Mordehay</creatorcontrib><creatorcontrib>Kornowski, Ran</creatorcontrib><creatorcontrib>Sagie, Alexander</creatorcontrib><creatorcontrib>Shapira, Yaron</creatorcontrib><creatorcontrib>Schwartzenberg, Shmuel</creatorcontrib><title>Improved Screening Reduces Transesophageal Study Cancellations at a Large Tertiary Israeli Medical Center</title><title>The Israel Medical Association journal</title><addtitle>Isr Med Assoc J</addtitle><description>Cancellation of transesophageal echocardiography (TEE) tests leads to inefficient use of echocardiography laboratory (echo lab) time and wastes resources.
To identify the causes of same-day TEE cancellations in hospitalized patients, to formulate a TEE order screening protocol, and to evaluate its efficacy at implementation.
We performed a prospective analysis of inpatients referred to a single tertiary hospital echo lab for TEE study by inpatient wards. A comprehensive screening protocol emphasizing active participation of all links directly involved in the chain of inpatient TEE referral was developed and implemented. Comparison of pre- and post-implementation of the new screening protocol on two consecutive periods of 6 months on TEE cancellation rates out of total ordered TEEs stratified by cause categories was performed.
: In total, 304 inpatient TEE procedures were ordered during the initial observation period; 54(17.8%) were canceled on the same day. The most common cancellation reasons were equally respiratory distress and patient not in fasted state (20.4% of total cancellations and 3.6% of all scheduled TEEs for each cause). Following implementation of the new screening process, total TEEs ordered (192) and cancelled (16) dropped significantly. A decrease in the rate of each cancellation category was observed, with statistical significance achieved for the overall cancellation rate (8.3% vs. 17.8%, P = 0.003), but not for the individual cancellation categories in split analysis.
A concerted effort to implement a comprehensive screening questionnaire significantly reduced same-day cancellations of scheduled TEEs.</description><subject>Appointments and Schedules</subject><subject>Echocardiography, Transesophageal</subject><subject>Humans</subject><subject>Inpatients</subject><subject>Israel</subject><subject>Retrospective Studies</subject><subject>Tertiary Care Centers</subject><issn>1565-1088</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo1UM1OwzAYywHExuAVUI5cKn1JkyU9ooqfSUNIbJyrtPk6gtq0JCnS3p4C42QfbMv2GVkyuZYZA60X5DLGDwAuJRQXZJErLmYml8Rt-jEMX2jprgmI3vkDfUU7NRjpPhgfMQ7juzmg6eguTfZIS-Mb7DqT3OAjNYkaujXhgHSPITkTjnQTg8HO0We0rpl9JfqE4Yqct6aLeH3CFXl7uN-XT9n25XFT3m2zkTOWMm2sZjaXvBCaQ9syFGAVNK2uUVutarsu1hZyqQuFUjIhCiVq1UANkNdK5ity-5c77_qcMKaqd_G3scdhihWfY4ErED_Sm5N0qnu01RhcPw-o_u_JvwHI4WBN</recordid><startdate>202305</startdate><enddate>202305</enddate><creator>Hemi, Hagit</creator><creator>Morelli, Olga</creator><creator>Vaturi, Mordehay</creator><creator>Kornowski, Ran</creator><creator>Sagie, Alexander</creator><creator>Shapira, Yaron</creator><creator>Schwartzenberg, Shmuel</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>202305</creationdate><title>Improved Screening Reduces Transesophageal Study Cancellations at a Large Tertiary Israeli Medical Center</title><author>Hemi, Hagit ; Morelli, Olga ; Vaturi, Mordehay ; Kornowski, Ran ; Sagie, Alexander ; Shapira, Yaron ; Schwartzenberg, Shmuel</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p211t-8ad81d35294820ff1e40d70cf8be8d87bd696d035897e55144974b7c0b003b753</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Appointments and Schedules</topic><topic>Echocardiography, Transesophageal</topic><topic>Humans</topic><topic>Inpatients</topic><topic>Israel</topic><topic>Retrospective Studies</topic><topic>Tertiary Care Centers</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hemi, Hagit</creatorcontrib><creatorcontrib>Morelli, Olga</creatorcontrib><creatorcontrib>Vaturi, Mordehay</creatorcontrib><creatorcontrib>Kornowski, Ran</creatorcontrib><creatorcontrib>Sagie, Alexander</creatorcontrib><creatorcontrib>Shapira, Yaron</creatorcontrib><creatorcontrib>Schwartzenberg, Shmuel</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>The Israel Medical Association journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hemi, Hagit</au><au>Morelli, Olga</au><au>Vaturi, Mordehay</au><au>Kornowski, Ran</au><au>Sagie, Alexander</au><au>Shapira, Yaron</au><au>Schwartzenberg, Shmuel</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Improved Screening Reduces Transesophageal Study Cancellations at a Large Tertiary Israeli Medical Center</atitle><jtitle>The Israel Medical Association journal</jtitle><addtitle>Isr Med Assoc J</addtitle><date>2023-05</date><risdate>2023</risdate><volume>25</volume><issue>5</issue><spage>324</spage><epage>327</epage><pages>324-327</pages><issn>1565-1088</issn><abstract>Cancellation of transesophageal echocardiography (TEE) tests leads to inefficient use of echocardiography laboratory (echo lab) time and wastes resources.
To identify the causes of same-day TEE cancellations in hospitalized patients, to formulate a TEE order screening protocol, and to evaluate its efficacy at implementation.
We performed a prospective analysis of inpatients referred to a single tertiary hospital echo lab for TEE study by inpatient wards. A comprehensive screening protocol emphasizing active participation of all links directly involved in the chain of inpatient TEE referral was developed and implemented. Comparison of pre- and post-implementation of the new screening protocol on two consecutive periods of 6 months on TEE cancellation rates out of total ordered TEEs stratified by cause categories was performed.
: In total, 304 inpatient TEE procedures were ordered during the initial observation period; 54(17.8%) were canceled on the same day. The most common cancellation reasons were equally respiratory distress and patient not in fasted state (20.4% of total cancellations and 3.6% of all scheduled TEEs for each cause). Following implementation of the new screening process, total TEEs ordered (192) and cancelled (16) dropped significantly. A decrease in the rate of each cancellation category was observed, with statistical significance achieved for the overall cancellation rate (8.3% vs. 17.8%, P = 0.003), but not for the individual cancellation categories in split analysis.
A concerted effort to implement a comprehensive screening questionnaire significantly reduced same-day cancellations of scheduled TEEs.</abstract><cop>Israel</cop><pmid>37245095</pmid><tpages>4</tpages></addata></record> |
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source | MEDLINE; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
subjects | Appointments and Schedules Echocardiography, Transesophageal Humans Inpatients Israel Retrospective Studies Tertiary Care Centers |
title | Improved Screening Reduces Transesophageal Study Cancellations at a Large Tertiary Israeli Medical Center |
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