22 - Growing Scope of IR Practice Through Implementation of a DVT Response Team: Our Institutional Experience
H. Bae, B. Lei
Purpose: Deep vein thrombosis (DVT) affects 1 out of every 1,000 adults and carries a significant morbidity and mortality. Venous duplex ultrasound is the diagnostic modality of choice for evaluation of DVT and can be performed in a variety of settings and multiple subspecialties may be equipped to both diagnose and treat DVT. The department which ultimately takes ownership of the management of DVT varies between institutions and practices. The outpatient imaging setting can be an area of opportunity for these departments, particularly interventional radiology (IR) to increase their role in the management of DVT. The purpose of our abstract is to discuss the clinical indications for DVT thrombectomy, detail a potential management algorithm in the setting of acute DVT diagnosis and describe how to implement a DVT response team in the outpatient setting.
Material and Methods: We describe our experience implementing an IR-led DVT response team at a large volume outpatient imaging center. The primary objectives of the response team are to provide the imaging center with a reliable provider contact and to facilitate rapid clinical follow up of acute and complex DVT. Upon diagnosis of a DVT, findings were immediately conveyed to the IR response team and after clinical evaluation and discussion with the referring provider, a disposition plan was formulated. When acute management was required, patients were sent to the emergency department as patients of IR and continued care was provided.
Results: Our DVT response team has created a streamlined process with reliable lines of communication, improvement in patient experience, and expanded scope of practice for our IR department. This alleviated many of the factors contributing to delayed patient care such contact with the referring provider, determination of a disposition plan, and consultation of a treating inpatient specialty service.
Conclusions: The role of IR in the treatment of DVT varies significantly from practice to practice. Opportunities to expand that role can be captured by identifying points of care where diagnosis and management of DVT can be improved. Through willingness to communicate and organize, we created a DVT response team for an outpatient imaging center with significant benefit to both our practice and our community.