VUMC Procedure Service

Dr. Tyson Heller
April 24, 2017

At Vanderbilt we recognize that learning from experience is the dominant source for improving our knowledge and building our confidence, and we seek to find areas in which to improve the learner experience for that end goal. We have recognized through multiple surveys and literature reviews that formal bedside procedural training and standardized instruction in the performance of bedside procedures has dramatically decreased in residency programs and medical schools across the nation and on our own campus. This highlighted a great need for learners of all levels at VUMC, and lead to the creation of a bedside procedure consultation service with the following goals:

To improve confidence and competence amongst medical students, residents, and faculty in the performance of standard bedside medical procedures.

To improve procedural-related patient outcomes and satisfaction by increasing the percentage of procedures successfully completed, decreasing the number of attempts per each procedure, and decreasing the frequency of minor and major procedure-related complications.

To create a comprehensive curriculum that standardizes the teaching and performance of bedside procedures through on-line modules, Center for Experiential Learning and Assessment (CELA) simulations, and hands-on elective rotations that emphasize the procedure process from onset to termination including medical decision making, consent, technical skills, management of common complications, diagnostic test ordering as well as the interpretation of their results.

At this point we have successfully launched our pilot program, and we have opened up our bedside procedure service for consultation on procedures including paracentesis, lumbar puncture, thoracentesis, DHT placement, US-guided PIV placement and I&D of abscesses. The consultation service is led by Dr. L. Tyson Heller and consists of a group of 12 trained and credentialed hospitalist physicians in the division of hospital medicine who have been through special training. Up to this point we are a little more than three months into our pilot program and the service has been well received by our Riven Hospitalist teams. We plan to expand our service on July 1st, 2017 from the current pilot program that only serves a small group of Riven patients to an expanded service that can fulfill consultation requests from the entire hospital at large including our resident teaching teams. We hope to become an elective rotation for residents and medical students with a comprehensive multi-modal curriculum on July 1st, 2018.