PMID- 35797494
OWN - NLM
STAT- MEDLINE
DCOM- 20220816
LR  - 20221005
IS  - 1553-5606 (Electronic)
IS  - 1553-5592 (Linking)
VI  - 17
IP  - 8
DP  - 2022 Aug
TI  - Creation of a medical procedure service in a tertiary medical center: Blueprint 
      and procedural outcomes.
PG  - 594-600
LID - 10.1002/jhm.12901 [doi]
AB  - BACKGROUND: Medical Procedure Services (MPS) may represent a solution to the 
      educational gap in procedural training among internal medicine residents and the 
      unmet need for the clinical provision of non-urgent inpatient procedures. 
      However, there is little guidance available to help launch an MPS. Furthermore, 
      procedural outcomes from a newly initiated MPS, including those comparing 
      trainees versus attending physicians, are lacking. OBJECTIVE: To describe the 
      blueprint used in the design, implementation, and ongoing oversight of an MPS and 
      to report its procedural outcomes. DESIGN, SETTINGS AND PARTICIPANTS: Vanderbilt 
      University Medical Center (VUMC), Nashville, Tennessee. INTERVENTION: The launch 
      of an MPS at a large tertiary academic hospital. MAIN OUTCOME AND MEASURES: 6,152 
      procedural consultations resulting in 5,320 attempted procedures over a 
      four-and-a-half year period. RESULTS: The primary proceduralist was a supervised 
      resident in 58.7% (3124 /5,320) and an attending in 41.3% (2,196/5,320) of 
      procedures. The overall success rate was 91.1% (95% CI: 90.3-91.9%) and the major 
      complication rate was 0.7% (95% CI: 0.5-1.0%). There was no difference in the 
      mean number of attempts required to complete a procedure (1.6 vs 1.5 attempts, 
      p=0.68) and the complication rates between supervised residents and attending 
      proceduralists, respectively (20/3,124 vs 20/2,196, p=0.26). CONCLUSION: At a 
      tertiary academic medical center, the implementation and maintenance of MPS 
      is feasible, safe, and results in high rates of successful procedures performed 
      by supervised residents. Procedures performed by supervised residents require 
      comparable number of attempts for completion and carry similar risks as those 
      performed alone by attendings.
CI  - (c) 2022 Society of Hospital Medicine.
FAU - Buell, Kevin G
AU  - Buell KG
AUID- ORCID: 0000-0001-5718-3328
AD  - Department of Medicine, Vanderbilt University Medical Center, Nashville, 
      Tennessee, USA.
FAU - Hayat, Muhammad H
AU  - Hayat MH
AD  - Department of Medicine, Vanderbilt University Medical Center, Nashville, 
      Tennessee, USA.
FAU - Walsh, David W
AU  - Walsh DW
AUID- ORCID: 0000-0001-7474-473X
AD  - Department of Medicine, Division of Hospital Medicine, Medical College of Georgia 
      at Augusta University, Augusta, Georgia, USA.
FAU - Wooldridge, Kathleene T
AU  - Wooldridge KT
AD  - Department of Medicine, Division of Hospital Medicine and Public Health, Section 
      of Hospital Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, 
      USA.
FAU - Vasilevskis, Eduard E
AU  - Vasilevskis EE
AD  - Department of Medicine, Division of Hospital Medicine and Public Health, Section 
      of Hospital Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, 
      USA.
AD  - Geriatric Research Education and Clinical Center, VA Tennessee Valley Healthcare 
      System, Nashville, Tennessee, USA.
FAU - Heller, Lawrence T
AU  - Heller LT
AD  - Department of Medicine, Division of Hospital Medicine and Public Health, Section 
      of Hospital Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, 
      USA.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20220707
PL  - United States
TA  - J Hosp Med
JT  - Journal of hospital medicine
JID - 101271025
SB  - IM
MH  - Clinical Competence
MH  - Hospitals
MH  - Humans
MH  - *Internal Medicine/education
MH  - *Internship and Residency
MH  - Medical Staff, Hospital
EDAT- 2022/07/08 06:00
MHDA- 2022/08/17 06:00
CRDT- 2022/07/07 15:53
PHST- 2022/05/21 00:00 [revised]
PHST- 2022/01/04 00:00 [received]
PHST- 2022/05/29 00:00 [accepted]
PHST- 2022/07/08 06:00 [pubmed]
PHST- 2022/08/17 06:00 [medline]
PHST- 2022/07/07 15:53 [entrez]
AID - 10.1002/jhm.12901 [doi]
PST - ppublish
SO  - J Hosp Med. 2022 Aug;17(8):594-600. doi: 10.1002/jhm.12901. Epub 2022 Jul 7.