Miriam E Peckham1, Yoshimi Anzai2, Lubdha M Shah3, Geoffry de Gennaro4, Justin A Costello5, Troy A Hutchins6. 1. Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah. Electronic address: Miriam.Peckham@hsc.utah.edu. 2. Associate Chief Medical Quality Officer, Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah. 3. Director of Spine Imaging, Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah. 4. Boise Radiology Group, Boise, Idaho. 5. Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah. 6. Chief Value Officer, Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah.
Abstract
OBJECTIVE: Spine interventional pain injections have dramatically increased in volume in the past three decades. High referral volumes at our institution necessitated using both a hospital-based interventional suite and a clinic-based suite scheduled on a first-come, first-served basis. We sought to determine whether the clinic-based suite provided benefits in efficiency and health system cost in comparison with the hospital suite without compromising quality of care. METHODS: To investigate differences between outpatient procedures performed in hospital-based procedure rooms (HBPRs) and clinic-based procedure rooms (CBPRs), we reviewed all consecutive outpatient spine interventional pain procedures performed by the interventional neuroradiology service over a 12-month period. We analyzed procedure complexity, fluoroscopic times, procedural times, patient wait times, and health system costs for each case, as well as any complications. RESULTS: Our analysis demonstrated similar procedural complexity between sites with decreased average fluoroscopic time (112 seconds versus 163 seconds, P = .002), procedural time (17 min versus 28 min, P < .001), and wait time (20 min versus 38 min, P < .001) in the CBPR versus the HBPR. In cases without trainee involvement, procedural and wait times were decreased (P < .001, P = .008) with no difference in fluoroscopy time (P = .18). There were no complications at either site. The analysis of cost to the health system demonstrated that procedures in the HBPR cost >14 times the amount to perform than in the CBPR. DISCUSSION: Performing spine interventional pain procedures in a CBPR adds value by decreasing procedural, fluoroscopic, wait times, and health system cost compared with an HBPR without compromising safety.
OBJECTIVE: Spine interventional pain injections have dramatically increased in volume in the past three decades. High referral volumes at our institution necessitated using both a hospital-based interventional suite and a clinic-based suite scheduled on a first-come, first-served basis. We sought to determine whether the clinic-based suite provided benefits in efficiency and health system cost in comparison with the hospital suite without compromising quality of care. METHODS: To investigate differences between outpatient procedures performed in hospital-based procedure rooms (HBPRs) and clinic-based procedure rooms (CBPRs), we reviewed all consecutive outpatient spine interventional pain procedures performed by the interventional neuroradiology service over a 12-month period. We analyzed procedure complexity, fluoroscopic times, procedural times, patient wait times, and health system costs for each case, as well as any complications. RESULTS: Our analysis demonstrated similar procedural complexity between sites with decreased average fluoroscopic time (112 seconds versus 163 seconds, P = .002), procedural time (17 min versus 28 min, P < .001), and wait time (20 min versus 38 min, P < .001) in the CBPR versus the HBPR. In cases without trainee involvement, procedural and wait times were decreased (P < .001, P = .008) with no difference in fluoroscopy time (P = .18). There were no complications at either site. The analysis of cost to the health system demonstrated that procedures in the HBPR cost >14 times the amount to perform than in the CBPR. DISCUSSION: Performing spine interventional pain procedures in a CBPR adds value by decreasing procedural, fluoroscopic, wait times, and health system cost compared with an HBPR without compromising safety.