Publication:

Enhancing efficiency in length of stay for ventricular assist device patients during routine right heart catheterization

Background Left ventricular assist device (LVAD) patients undergoing right heart catheterization (RHC) were traditionally admitted pre- and post-procedure for inpatient anticoagulation bridging. From 2021 to 2025, transition to outpatient RHC and eliminate length of stay (LOS) using an IACT-PDCA initiative enhanced with virtual ventricular assist device (VAD) clinic reminders.

Methods In 2021-2024, patients were instructed to complete international normalized ratio (INR) testing 3 days before RHC. In early 2025, a retrospective review revealed cancellations due to missed INR testing. Consequently, we integrated a virtual VAD clinic in 2025, with reminders initiated 7 days prior to ensure timely INR testing.

Results LOS was reduced to zero days; INR-related cancellations were nearly eliminated. Estimated cost savings totaled ~875,744 SAR.

Conclusions A staged quality improvement approach using IACT-PDCA and virtual care effectively transformed RHC workflow into a sustainable outpatient model.