Abstract
Introduction
Patient-centered cardiac testing is predicated on choosing the right test for the right patient. We studied the effects of changing from script-driven scheduling to nurse-driven protocoling of stress tests.
Methods and Results
A protocol nurse reviewed records before scheduling and communicated with patients and ordering providers if needed. We found that instituting nurse protocolling of all non-imaging (ETT) and nuclear (MPI) stress tests (N = 3071) resulted in protocol changes in 37% of our patients, and reduced the proportion of tests that could not be performed as scheduled by 56% and cancelations by 71% (P < 0.001 for each). These changes were sustained over two successive 6-month periods following a baseline observation period of 6 months. For MPI, the most frequent nurse interventions were re-protocoling as stress-first MPI (12% of tests), changing test location for clinical reasons (13%), changing stress modality (7%), and care coordination (5%).
Conclusions
Changing from script-driven scheduling to protocol nursing contributed measurably to patient-centered testing.
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Abbreviations
- ETT:
-
Exercise treadmill test
- MPI:
-
Myocardial perfusion imaging
- LBBB:
-
Left bundle branch block
- ECG:
-
Electrocardiogram
- BMI:
-
Body mass index
- SPECT:
-
Single-photon emission computed tomography
- PET:
-
Positron emission tomography
- FTE:
-
Full time equivalent
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Disclosure
P. Salimi, J. Niggel, and F. Keating have no conflict of interest to declare.
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Salimi, P.N., Niggel, J.B. & Keating, F.K. How to achieve patient-centered testing: role of the protocol nurse. J. Nucl. Cardiol. 26, 536–540 (2019). https://doi.org/10.1007/s12350-017-0911-2
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DOI: https://doi.org/10.1007/s12350-017-0911-2