Introduction: Medical Procedure Services (MPS) have emerged as an effective model for delivering bedside procedures, offering a timely and accessible alternative to interventional radiology (IR) while simultaneously providing critical training opportunities for residents. We aimed to evaluate the impact an MPS has on hospital length of stay (LOS) and procedural efficiency, as measured by time from admission to thoracentesis (AtT), at a Canadian tertiary care centre. Methods: We queried our hospital's electronic medical records for all inpatient pleural fluid samples from patients admitted to Internal Medicine from January 1, 2023 to December 31, 2023 to compose the MPS cohort. A historical cohort of similar patients from January 1, 2013 to December 31, 2013 composed the IR cohort. LOS and AtT were compared between the two cohorts, and safety outcomes for the MPS cohort were reported. Results: Of 375 procedures, 180 (48%) were performed by the MPS. Performance of the procedure by the MPS significantly reduced AtT by 1.21 days (1.06 vs 2.27, p = 0.0166) and required fewer chest X-rays (0.94 vs 1.28, p = 0.0104), compared to IR-performed procedures. LOS was shorter in the MPS cohort (11 vs 12 days, p = 0.0934) but was not statistically significant. Safety outcomes for the MPS cohort including pneumothorax and bleeding rates were within previously reported literature ranges. Conclusion: Our findings support the benefits of an MPS model in reducing procedural delays and optimizing resource utilization for patients admitted to Internal Medicine undergoing thoracentesis.
Sljivic et al. (Sun,) studied this question.