Evaluation of vascular and interventional procedures with time-action analysis: a pilot study.
OBJECTIVE
To provide an objective method to measure the efficiency of vascular and interventional procedures.


METHODS
The time-action analysis method is defined for peripheral vascular and interventional procedures. A taxonomy of actions is defined, geared specifically toward these procedures. The actions are: start-up/wrap-up, exchange, navigate, image, diagnose, treat, handle material, wait, compress puncture site, and unclassified. The recording method and analysis techniques are described. To show the type of data that can be obtained, the time-action analysis of 30 procedures is presented.


RESULTS
The results provide a detailed picture of the time spent on various actions. Of all actions, the most time is spent on compressing the puncture site (18.5%), whereas the highest frequency of actions are for exchange of catheters, guide wires, and sheaths (20.4 times per procedure). Radiation exposure can be analyzed in detail, which can yield directions for possible reduction. For instance, 5.2%-8.3% of the total radiation exposure occurs during preparation of imaging to adjust the position of the patient table and set the image intensifier diaphragm.


CONCLUSIONS
Time-action analysis provides an objective measurement method to monitor and evaluate vascular and interventional procedures. Potential applications and limitations of the technique are discussed.
Bakker
Niels H
NH
Department of Medical Physics, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. n.h.bakker@amc.uva.nl
Tanase
Dafina
D
Reekers
Jim A
JA
Grimbergen
Cornelis A
CA
D004867:Equipment Design; D006801:Humans; D016491:Peripheral Vascular Diseases / Q000175:diagnosis; D010865:Pilot Projects; D011677:Punctures; D011829:Radiation Dosage; D011834:Radiation Monitoring; D015641:Radiography, Interventional / Q000379:methods*; D025321:Surgery, Computer-Assisted / Q000379:methods; D013997:Time Factors; D016896:Treatment Outcome