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Impact of a bedside procedure service on general medicine inpatients: A firm‐based trial
Author(s) -
Lucas Brian P.,
Asbury Joseph K.,
Wang Yue,
Lee Kuenok,
Kumapley Rudolf,
Mba Benjamin,
Borkowsky Shane,
Asmar Abdo
Publication year - 2007
Publication title -
journal of hospital medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.128
H-Index - 65
eISSN - 1553-5606
pISSN - 1553-5592
DOI - 10.1002/jhm.159
Subject(s) - medicine , hospital medicine , service (business) , emergency medicine , medline , intensive care medicine , family medicine , economy , economics , political science , law
BACKGROUND Procedure services may improve the training of bedside procedures. However, little is known about how procedure services may affect the demand for and success of procedures performed on general medicine inpatients. OBJECTIVE Determine whether a procedure service affects the number and success of 4 bedside procedures (paracentesis, thoracentesis, lumbar puncture, and central venous catheterization) attempted on general medicine inpatients. DESIGN Prospective cohort study. SETTING Large public teaching hospital. PATIENTS Nineteen hundred and forty‐one consecutive admissions to the general medicine service. INTERVENTION A bedside procedure service was offered to physicians from 1 of 3 firms for 4 weeks. This service then crossed over to physicians from the other 2 firms for another 4 weeks. MEASUREMENTS Data on all procedure attempts were collected daily from physicians. We examined whether the number of attempts and the proportion of successful attempts differed based on whether firms were offered the beside procedure service. RESULTS The number of procedure attempts was 48% higher in firms offered the service (90 versus 61 per 1000 admissions; RR 1.48, 95% CI 1.06–2.10; P = .030). More than 85% of the observed increase was a result of procedures with therapeutic indications. There were no differences between firms in the proportions of successful attempts or major complications. CONCLUSIONS The availability of a procedure service may increase the overall demand for bedside procedures. Further studies should refine the indications for and anticipated benefits from these commonly performed invasive procedures. Journal of Hospital Medicine 2007;2:143–149. © 2007 Society of Hospital Medicine.