Nuts and bolts of running a pulmonary embolism response team: results from an organizational survey of the National PERT™ Consortium members.
OBJECTIVE
Pulmonary embolism response teams (PERT) are developing rapidly to operationalize multi-disciplinary care for acute pulmonary embolism patients. Our objective is to describe the core components of PERT necessary for newly developing programs.


METHODS
An online organizational survey of active National PERT™ Consortium members was performed between April and June 2016. Analysis, including descriptive statistics and Kruskal-Wallis tests, was performed on centers self-reporting a fully operational PERT program.


RESULTS
The survey response rate was 80%. Of the 31 institutions that responded (71% academic), 19 had fully functioning PERT programs. These programs were run by steering committees (17/19, 89%) more often than individual physicians (2/19, 11%). Most PERT programs involved 3-5 different specialties (14/19, 74%), which did not vary based on hospital size or academic affiliation. Of programs using multidisciplinary discussions, these occurred via phone or conference call (12/18, 67%), with a minority of these utilizing 'virtual meeting' software (2/12, 17%). Guidelines for appropriate activations were provided at 16/19 (84%) hospitals. Most PERT programs offered around-the-clock catheter-based or surgical care (17/19, 89%). Outpatient follow up usually occurred in personal physician clinics (15/19, 79%) or dedicated PERT clinics (9/19, 47%), which were only available at academic institutions.


CONCLUSIONS
PERT programs can be implemented, with similar structures, at small and large, community and academic medical centers. While all PERT programs incorporate team-based multi-disciplinary care into their core structure, several different models exist with varying personnel and resource utilization. Understanding how different PERT programs impact clinical care remains to be investigated.
a Frankel Cardiovascular Center and Institute for Healthcare Policy and Innovation, Department of Internal Medicine , University of Michigan Medical School , Ann Arbor , MI , USA.
Geoffrey
G
Barnes
b Penn Cardiovascular Outcomes, Quality and Evaluative Research Center , University of Pennsylvania Perelman School of Medicine , Philadelphia , PA , USA.
Jay
J
Giri
c Department of Emergency Medicine , Northwestern University Feinberg School of Medicine , Chicago , IL , USA.
D Mark
DM
Courtney
d Division of Pulmonary Critical Care and Sleep Medicine , Saint Louis University School of Medicine , Saint Louis , MO , USA.
Soophia
S
Naydenov
e Division of Cardiology, Lancaster General Health , University of Pennsylvania Medicine , Lancaster , PA , USA.
Todd
T
Wood
f Division of Hematology and Oncology, Department of Medicine , Massachusetts General Hospital, Harvard Medical School , Boston , MA , USA.
Rachel
R
Rosovsky
g Division of Cardiology, Section of Vascular Medicine, Department of Medicine , Massachusetts General Hospital, Harvard Medical School , Boston , MA , USA.
Kenneth
K
Rosenfield
h Center for Vascular Emergencies, Department of Emergency Medicine , Massachusetts General Hospital, Harvard Medical School , Boston , MA , USA.
Christopher
C
Kabrhel
D000046:Academic Medical Centers / Q000458:organization & administration; D005343:Fibrinolytic Agents / Q000008:administration & dosage; D006742:Hospital Bed Capacity; D006801:Humans; D008511:Medicine; D010348:Patient Care Team / Q000458:organization & administration*; D011655:Pulmonary Embolism / Q000188:drug therapy*; D017131:Thrombectomy / Q000379:methods; D015912:Thrombolytic Therapy / Q000379:methods*; D016306:Vena Cava Filters
D005343:Fibrinolytic Agents
Pulmonary Embolism; anticoagulation; deep vein thrombosis; thrombolysis