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


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%.


CONCLUSIONS
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.
Badano
Luigi P
LP
Department of Cardiopulmonary Sciences, Azienda Ospedaliero-Universitaria S Maria della Misericordia, P.le S Maria della Misericordia, 15, 33100 Udine, Italy. badano.luigi@aoud.sanita.fvg.it
Nucifora
Gaetano
G
Stacul
Savina
S
Gianfagna
Pasquale
P
Pericoli
Marcello
M
Del Mestre
Lorenzo
L
Buiese
Simonetta
S
Compassi
Rossana
R
Tonutti
Giuseppe
G
Di Benedetto
Luigi
L
Fioretti
Paolo M
PM
D000368:Aged; D000488:Allied Health Personnel / Q000191:economics / Q000458:organization & administration*; D016009:Chi-Square Distribution; D003362:Cost-Benefit Analysis; D004452:Echocardiography / Q000191:economics* / Q000295:instrumentation; D017598:Efficiency, Organizational / Q000191:economics* / Q000706:statistics & numerical data; D005260:Female; D006739:Hospital Administration; D006760:Hospitalization; D006801:Humans; D008297:Male; D008904:Miniaturization / Q000295:instrumentation*; D017146:Models, Organizational; D019095:Point-of-Care Systems / Q000191:economics*; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D013997:Time Factors; D016526:Workload / Q000191:economics