title: Validation of a new bedside echoscopic heart examination resulting in an improvement in echo-lab workflow.
abstract: BACKGROUND
  In daily cardiology practice, porters are usually required to transfer inpatients who need an echocardiogram to the echocardiographic department (echo-lab).
  
  
  OBJECTIVE
  To assess echo-lab personnel workflow and patient transfer delay by comparing the use of a new, ultraportable, echoscopic, pocket-sized device at the bedside with patient transfer to the echo-lab for conventional transthoracic echocardiography, in patients needing pericardial control after cardiac invasive procedures.
  
  
  METHODS
  After validation of echoscopic capabilities for pericardial effusion, left ventricular function and mitral regurgitation grade compared with conventional echocardiography, we evaluated echo-lab personnel workflow and time to perform bedside echoscopy for pericardial control evaluation after invasive cardiac procedures. This strategy was compared with conventional evaluation at the echo-lab, in terms of personnel workflow, and patients' transfer, waiting and examination times.
  
  
  RESULTS
  Concordance between echoscopy and conventional echocardiography for evaluation of pericardial effusion was good (0.97; kappa value 0.86). For left ventricular systolic function and mitral regurgitation evaluations, concordances were 0.96 (kappa value 0.90) and 0.96 (kappa value 0.86), respectively. In the second part of the study, the mean total time required in the bedside echoscopy group was 20.3±5.4 mins vs. 66.0±16.4 mins in the conventional echo-lab group (p<0.001). The echo-lab strategy needed porters in 100% of cases; 69% of patients needed a wheelchair.
  
  
  CONCLUSIONS
  The use of miniaturized echoscopic tools for pericardial control after invasive cardiac procedures was feasible and accurate, allowing improvement in echo-lab workflow and avoiding patient waiting time and transfer.
authors.affiliation: Service de cardiologie et d'échocardiographie, hôpital cardiologique Haut-Lévêque, avenue de Magellan, 33605 Pessac, France. patricia.reant@chu-bordeaux.fr
authors.forename: Patricia
authors.initials: P
authors.lastname: Réant
authors.forename: Marina
authors.initials: M
authors.lastname: Dijos
authors.forename: Florence
authors.initials: F
authors.lastname: Arsac
authors.forename: Aude
authors.initials: A
authors.lastname: Mignot
authors.forename: Fabienne
authors.initials: F
authors.lastname: Cadenaule
authors.forename: Annette
authors.initials: A
authors.lastname: Aumiaux
authors.forename: Christine
authors.initials: C
authors.lastname: Jimenez
authors.forename: Marilyne
authors.initials: M
authors.lastname: Dufau
authors.forename: Alain
authors.initials: A
authors.lastname: Prévost
authors.forename: Xavier
authors.initials: X
authors.lastname: Pillois
authors.forename: Patrick
authors.initials: P
authors.lastname: Fort
authors.forename: Raymond
authors.initials: R
authors.lastname: Roudaut
authors.forename: Stéphane
authors.initials: S
authors.lastname: Lafitte
mesh_terms: D000368:Aged; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D016009:Chi-Square Distribution; D018618:Echocardiography, Doppler, Color / Q000295:instrumentation*; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D005602:France; D006801:Humans; D007753:Laboratories; D008297:Male; D008875:Middle Aged; D008904:Miniaturization; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging* / Q000209:etiology; D010360:Patient Transfer; D010490:Pericardial Effusion / Q000000981:diagnostic imaging* / Q000209:etiology; D010561:Personnel Staffing and Scheduling; D019095:Point-of-Care Systems; D011237:Predictive Value of Tests; D011446:Prospective Studies; D013997:Time Factors; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D016277:Ventricular Function, Left; D057188:Workflow; D016526:Workload