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Establishing an ultrasound-guided vascular access program: A powerful tool for patient care

by Gus Iversen, Editor in Chief | March 22, 2022
Richard Fabian
Healthcare Business News spoke once again with Fujifilm SonoSite president and COO Richard Fabian about what is clearly a passion of his: ensuring that peripheral IVs are inserted correctly on the first try using point-of-care ultrasound guidance.

He explains that it is a simple but powerful way to improve nurse satisfaction, patient care, comfort and perception—and the resulting savings can be significant.

HCB News: Why is an ultrasound-guided peripheral IV program so important for a hospital? And how does it differ from the traditional approach to IV insertion?
Richard Fabian: For hospitals, these programs mean major, measurable improvements in patient safety and in the quality of care. They may also mean savings in the realm of millions per year from more efficient patient throughput, better use of staff time, reducing more expensive and risky procedures and avoidable complications, and improving time to treatment—something especially important particularly in the ED. The source of these benefits is simple: empowering front-line clinicians to use ultrasound to guide the placement of peripheral IV lines.

HCB News: How would a hospital measure these benefits?
RF: Let’s start with the scope, which is massive. The number of peripheral IVs placed in the US every year is somewhere between 200 and 300 million. Within this number, there are millions of patients whose veins are so difficult to access—whether because of anatomy, or because they have an illness or another complicating factor—that they get escalated from nurse to nurse and physician to physician before the PICC (peripherally inserted central catheter) team gets involved. These patients may even undergo a central venous catheter (CVC) procedure, which is much riskier and far more costly than a peripheral IV. At St. Joseph’s Healthcare System in New Jersey, their vascular access program saved a total of $3.5 million in three years, in part by reducing referrals out for PICCs and CVCs.

The benefits will be slightly different depending on the hospital department in question, but for emergent care, the time-to-treatment is certainly one of the most consequential. A PICC takes upwards of 45 minutes to place, while an ultrasound-guided PIV takes between 5 and 10 minutes. Many time-sensitive lifesaving therapies cannot be administered without an IV placed, nor can emergency patients be transferred to surgery or critical care unit. For the vast majority of all patients, not just in the ED, that IV placement is the first point of contact with their care team, and it affects their experience and how they perceive the hospital and their care.

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