Introducing a New Care Path Strategy to Reduce Complications and Costs
Ultrasound-Guided Peripheral IVs Replace High-Risk Central Venous Catheter Line Placements in 84% of Patients
BOTHELL, WA– November 8, 2012– FUJIFILM Sonosite, Inc., the world leader and specialist in bedside and point-of-care ultrasound, announces new patient safety data achieved by Thomas Jefferson University Hospitals, Inc. (TJUH), a 957-bed academic medical center located in Philadelphia. Arthur Au, MD, a Clinical Instructor at Jefferson Medical College and Emergency Medicine physician at TJUH presented new data from an internal ultrasound-guidance study at the 2011 American College of Emergency Physicians (ACEP) conference.
Discovering a New Care Path Strategy
The goal of the study at TJUH was to determine if the number of Central Venous Catheter (CVC) placements could be reduced or replaced with a safer alternative− ultrasound-guided peripheral intravenous (USGPIVs) in patients with difficult IV access. The clinical challenge with most patients entering the emergency department includes: obesity, edema, or small veins that are difficult to visualize, making it incredibly difficult for a physician or nurse to place a peripheral IV.
With more than 5 million CVCs lines placed in US hospitals per year, this is one of the most common invasive procedures performed in the emergency department1. Unfortunately, CVC placements are risky procedures and are typically performed by inserting a large catheter into one of the patient's major vessels: the jugular vein (neck), femoral vein (groin), or the subclavian vein (chest). With the high-risk nature of the procedure, studies show that CVCs have a complication rate of about 15%, patients are more susceptible to acquiring a catheter-related blood stream infection and the procedure can result in morbidity2.
The study was conducted in two urban emergency departments utilizing Sonosite's M-Turbo ultrasound systems and the results showed that 85% of the time USGPIVs eliminated the need for the placement of CVCs in patients with difficult IV access. Assuming the standard CVC complication rate of approximately 15%, it was determined that in this group alone, the use of USGPIVs would reduce complication rates to 2.25%, which would significantly reduce healthcare costs in the emergency department.
"This data is pivotal for emergency medicine and the overall impact it can have on patient safety and cost reductions in the hospital," said Bon Ku, MD, MPP, of the Department of Emergency Medicine at TJUH. "TJUH is a Level 1 trauma center and has made it standard practice in the emergency departments that patients with difficult IV access undergo attempts at ultrasound-guided peripheral IV catheter placement before inserting a central venous catheter.
The results were reported online ahead of print July 12, 2012 in the American Journal of Emergency Medicine.
Preparation for New Medicare Regulations: Greater Attention to Cost Reductions
New data such as Jefferson's and its potential for cost savings is instrumental as new healthcare reform regulations go into effect, which will undoubtedly impact a hospital's bottom line. With the implementation of Medicare's Value-Based Purchasing Program (VBP), hospitals are required to track and report quality measures and will also begin to monitor the cost of each patient's stay. For instance, complications such as an iatrogenic pneumothorax (collapsed lung), can be a very expensive medical error with the cost per incident ranging from $17,000 to $45,000, according to a study by the Agency for Healthcare Quality and Research (AHRQ)3. This will be a Patient Safety Indicator under VBP in FY 2015 and will also figure into the cost efficiency calculations. Jefferson's data is the quintessential example of a proactive health system that is improving healthcare delivery and preparing hospitals for the future of healthcare reform.
About FUJIFILM Sonosite, Inc.
Sonosite, Inc. (www.sonosite.com), a subsidiary of FUJIFILM Corporation, is the innovator and world leader in bedside and point-of-care ultrasound and an industry leader in ultra high-frequency micro-ultrasound technology and impedance cardiography equipment. Headquartered near Seattle, the company is represented by ten subsidiaries and a global distribution network in over 100 countries. Sonosite's small, lightweight systems are expanding the use of ultrasound across the clinical spectrum by cost-effectively bringing high-performance ultrasound to the point of patient care.
1Feller-Klopman, D, "Ultrasound-Guided Internal Jugular Access," Chest, July, 2007: http://chestjournal.chestpubs.org/content/132/1/302.full
2Feller-Klopman, D, "Ultrasound-Guided Internal Jugular Access," Chest, July, 2007: http://chestjournal.chestpubs.org/content/132/1/302.full
3Zhan C, M Smith, and D Stryer. Incidences, Outcomes and Factors Associated with Iatrogenic Pneumothorax in Hospitalized Patients [abstract]. In: Academy Health Annual Research Meeting.; 2004; San Diego, Calif. Academy Health. 2004; 21: abstract no. 1862. http://www.academyhealth.org/files/2004/abstracts/quality.pdf
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