Bohmann Katja, Burgdorf Christof, Zeus Tobias, Joner Michael, Alvarez Héctor, Berning Kira Lisanne, Schikowski Maren, Kasel Albert Markus, van Mark Gesine, Deutsch Cornelia, Kurucova Jana, Thoenes Martin, Frank Derk, Wundram Steffen, Bramlage Peter, Miller Barbara, Veulemans Verena
Cardiothoracic Surgery Department, Heart and Vessel Center Bad Bevensen, 29549 Bad Bevensen, Germany.
Cardiology Department, Heart and Vessel Center Bad Bevensen, 29549 Bad Bevensen, Germany.
J Clin Med. 2022 Feb 23;11(5):1205. doi: 10.3390/jcm11051205.
The transcatheter aortic valve implantation (TAVI) treatment pathway is complex, leading to procedure-related delays. Dedicated TAVI coordinators can improve pathway efficiency. COORDINATE was a pilot observational prospective registry at three German centers that enrolled consecutive elective patients with severe aortic stenosis undergoing TAVI to investigate the impact a TAVI coordinator program. Pathway parameters and clinical outcomes were assessed before (control group) and after TAVI coordinator program implementation (intervention phase). The number of repeated diagnostics remained unchanged after implementation. Patients with separate hospitalizations for screening and TAVI had long delays, which increased after implementation (65 days pre- vs. 103 days post-implementation); hospitalizations combining these were more efficient. The mean time between TAVI and hospital discharge remained constant. Nurse ( = 0.001) and medical technician ( = 0.008) working hours decreased. Patient satisfaction increased, and more consistent/intensive contact between patients and staff was reported. TAVI coordinators provided more post-TAVI support, including discharge management. No adverse effects on post-procedure or 30-day outcomes were seen. This pilot suggests that TAVI coordinator programs may improve aspects of the TAVI pathway, including post-TAVI care and patient satisfaction, without compromising safety. These findings will be further investigated in the BENCHMARK registry.
经导管主动脉瓣植入术（TAVI）的治疗流程复杂，会导致与手术相关的延误。专门的TAVI协调员可以提高流程效率。COORDINATE是在德国三个中心开展的一项前瞻性观察性试点注册研究，纳入连续接受TAVI治疗的重度主动脉瓣狭窄择期患者，以调查TAVI协调员项目的影响。在TAVI协调员项目实施前（对照组）和实施后（干预阶段）评估流程参数和临床结果。实施后重复诊断的次数保持不变。筛查和TAVI分开住院的患者存在较长延误，实施后有所增加（实施前65天 vs. 实施后103天）；将这些合并的住院治疗效率更高。TAVI与出院之间的平均时间保持不变。护士（=0.001）和医疗技术人员（=0.008）的工作时间减少。患者满意度提高，且报告称患者与工作人员之间的联系更加一致/密切。TAVI协调员提供了更多的TAVI术后支持，包括出院管理。未观察到对术后或30天结果有不良影响。该试点表明，TAVI协调员项目可能会改善TAVI流程的各个方面，包括TAVI术后护理和患者满意度，且不影响安全性。这些发现将在BENCHMARK注册研究中进一步调查。
