Author + information
- Christopher Statile,
- Samuel Hanke,
- Richard Czosek,
- Enisa Handlon,
- James Brown,
- Amy Donnellan and
- Jeffrey Anderson
Background: Variability in medical practice is associated with higher cost without improved outcome. Our aim was to standardize the evaluation and treatment of dizziness/syncope and track resultant cost savings.
Methods: A multidisciplinary team developed a care algorithm using best evidence and expert consensus for evaluation of otherwise healthy pediatric patients with dizziness or syncope. Quality improvement methods guided acceptance and implementation of the algorithm into our cardiology clinics. Primary outcome measure was weekly mean charge per patient, primarily driven by the number of cardiac tests ordered. Total charges were compared using patient billing data. Statistical process control charts evaluated the system over time. Baseline data (11/2015-3/2016) were collected and data were monitored after implementation of the algorithm through 8/2016.
Results: There were 104 patients identified during the baseline period: median age 14.3 years (2.9-8.4), with 9 patients (9%) <8 years; 64% female; 82% Caucasian. After algorithm implementation, there were 279 patients evaluated: median age 15 years (1.4-19), with 27 patients (10%) <8 years; 63% female; 85% Caucasian. There was a dramatic shift in mean charge per patient from $1,784 to $1,098 (Figure), driven primarily by reduction in testing beyond an electrocardiogram.
Conclusions: Standardization of evaluation for pediatric patients presenting with dizziness/syncope resulted in a significant charge decrease for our patients.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Congenital Heart Disease: Advances in Quality Improvement for Pediatric Cardiac Care
Abstract Category: 10. Congenital Heart Disease: Pediatric
Presentation Number: 1143-019
- 2017 American College of Cardiology Foundation