Improving Workflow Efficiency: Starting with Paracentesis

In this episode, host Dr. Aaron Fritts interviews Dr. Karen Brown, Section Chief for Interventional Radiology at the University of Utah about how she improved workflow by creating a paracentesis service that has shortened procedure time, decreased hospital length of stay, and improved patient and referring provider satisfaction.

Dr. Brown begins by reviewing the standard workflow for performing paracentesis before implementing her new program. She says paracentesis used to be done in a procedure room, and would often take quite long, delaying other procedures that were a better use of the room. Though a simple procedure, paracentesis can take quite some time to fully drain the ascites.

Dr. Brown and colleagues conducted a trial that compared standard wall suction to the Renova pump. Patients preferred Renova due to less capturing of bowel and adjusting of the catheter. They found that by using the Renova pump, they could cut the procedure time down by almost half. She says that hiring an advanced practice provider (APP) that was designated to paracentesis was key to improving the efficiency of the daily IR workflow. The other advantage to Renova is its portability. She says that this helped her get paracenteses out of procedure rooms because the APP can now do paracenteses anywhere, even at the bedside for an inpatient.

We end by discussing recommendations for IRs who are interested in improving efficiency in their practices. Dr. Brown says that the key is to make the case to administrators or purchasers that procedure room time is money. By speeding up the process for paracentesis, she has also been able to increase the number of paracenteses they do per year and decrease hospital length of stay for patients who are waiting for a paracentesis before discharge, which has saved both time and money.