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The impact of a pulmonary embolism response team on the efficiency of patient care in the emergency department.

Abstract：

:The concept of a pulmonary embolism response team (PERT) is multidisciplinary, with the hope that it may positively impact patient care, hospital efficiency, and outcomes in the treatment of patients with intermediate and high risk pulmonary embolism (PE). Clinical characteristics of a baseline population of patients presenting with submassive and massive PE to URMC between 2014 and 2016 were examined (n = 159). We compared this baseline population before implementation of a PERT to a similar population of patients at 3-month periods, and then as a group at 18 months after PERT implementation (n = 146). Outcomes include management strategies and efficiency of the emergency department (ED) in diagnosing, treating, and dispositioning patients. Before PERT, patients with submassive and massive PE were managed fairly conservatively: heparin alone (85%), or additional advanced therapies (15%). Following PERT, submassive and massive PE were managed as follows: heparin alone (68%), or additional advanced therapies (32%). Efficiency of the ED in managing high risk PE significantly improved after PERT compared with before PERT; where triage to diagnosis time was reduced (384 vs. 212 min, 45% decrease, p = 0.0001), diagnosis to heparin time was reduced (182 vs. 76 min, 58% decrease, p = 0.0001), and the time from triage to disposition was reduced (392 vs. 290 min, 26% decrease, p < 0.0001). Our analysis showed that following PERT implementation, patients with intermediate and high risk acute PE received more aggressive and advanced treatment modalities and received significantly expedited care in the ED.

journal_name

J Thromb Thrombolysis

journal_title

Journal of thrombosis and thrombolysis

authors

Wright C,Elbadawi A,Chen YL,Patel D,Mazzillo J,Acquisto N,Groth C,Van Galen J,Delehanty J,Pietropaoli A,Trawick D,James White R,Cameron P,Gosev I,Barrus B,Kumar NG,Cameron SJ

doi

10.1007/s11239-019-01875-0

subject

Has Abstract

pub_date

2019-08-01 00:00:00

pages

331-335

issue

2

eissn

0929-5305

issn

1573-742X

pii

10.1007/s11239-019-01875-0

journal_volume

48

pub_type

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