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European Journal of Echocardiography Advance Access published online on February 27, 2009
European Journal of Echocardiography, doi:10.1093/ejechocard/jen341
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org

Improved workflow, sonographer productivity, and cost-effectiveness of echocardiographic service for inpatients by using miniaturized systems

Luigi P. Badano*, Gaetano Nucifora, Savina Stacul, Pasquale Gianfagna, Marcello Pericoli, Lorenzo Del Mestre, Simonetta Buiese, Rossana Compassi, Giuseppe Tonutti, Luigi Di Benedetto and Paolo M. Fioretti

Department of Cardiopulmonary Sciences, Azienda Ospedaliero-Universitaria ‘S Maria della Misericordia’, P.le S Maria della Misericordia, 15, 33100 Udine, Italy

Received 20 December 2008; accepted after revision 29 December 2008.

* Corresponding author. Tel: +39 0432 552444; fax: +39 0432 482353. E-mail address: badano.luigi{at}aoud.sanita.fvg.it


  Abstract

Aims: The aim of this study was to assess the cost-effectiveness of using certified sonographers and miniaturized echocardiography systems to perform echocardiograms at bedside in comparison to moving inpatients from the admission department to the echocardiography laboratory (echo-lab).

Methods and results: From 26 September 2005 to 27 October 2005, 112 patients admitted in six hospital wards connected through a 100 Mbit LAN to the echo-lab were scanned within the admission ward by sonographers using a miniaturized echo system. Logistical data were collected and results were compared with those obtained from 194 consecutive patients coming from the same wards and studied in the echo-lab with high-end machines between 8 March 2005 and 15 April 2005. Performing echocardiograms in the admission department avoided long waiting time of the inpatients in the echo-lab before and after the study, increased the percentage of patients studied within 3 and 5 days from request (88 vs. 77% and 100 vs. 95%, respectively; P = 0.03), increased both sonographer (by 33.9%; P < 0.001) and echo-lab productivity (by 41%; P < 0.001), and reduced costs of echocardiograms by 29%.

Conclusion: Implementation of digital echocardiography, certified sonographers, and a miniaturized echo system allowed improvement of the cost-effectiveness of the service provided by the echo-lab for inpatients, and avoided patients' discomfort derived from prolonged waiting time before and after the exam.

Keywords: Echocardiography; Organization; Cardiac sonographer; Cost-effectiveness; Digital echocardiography; Miniaturized echocardiography system


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