Femoral arterial access is performed in approximately 2 million patients every year as part of cardiac catheterization procedures. Vascular complications occur in approximately 3% of patients undergoing coronary intervention and are associated with significant morbidity and mortality. There is an increase in vascular complications that corresponds with the beginning of the academic cycle and trainees have more complications in their first few procedures than later when they are more experienced. Methods: To help improve patient safety we propose a three step process to use simulation to teach femoral arterial access. This involves the development of a valid simulation model that provides realistic training for obtaining femoral arterial access, a program to incorporate the simulation model in the education curricula of cardiology fellowships at four major training institutions and follow up collection of data to assess for change in complication rates across these institutions. In the final phase, this simulation model would be made available to all the cardiac catheterization laboratories in the state of Michigan for training of any member of the catheterization laboratory who might be involved in obtaining arterial access. The program leverages the ongoing collaborative network of interventional cardiologists unique to the Blue Cross Blue Shield of Michigan cardiovascular collaborative (BMC2). Impact: The introduction of simulation system to teach femoral arterial access across a number of hospitals connected in a learning network will ensure rapid dissemination and early reduction in procedural complications.

Public Health Relevance

The goal of the proposal is to create a user friendly life like simulator for teaching femoral access. This simulator will be initially validated at four teaching hospitals and then introduced as a learning tool in all hospitals performing PCI in the state of Michigan.

Agency
National Institute of Health (NIH)
Institute
Agency for Healthcare Research and Quality (AHRQ)
Type
Research Demonstration and Dissemination Projects (R18)
Project #
5R18HS020447-03
Application #
8465228
Study Section
Special Emphasis Panel (ZHS1-HSR-Y (02))
Program Officer
Gray, Darryl T
Project Start
2011-06-01
Project End
2014-05-31
Budget Start
2013-06-01
Budget End
2014-05-31
Support Year
3
Fiscal Year
2013
Total Cost
Indirect Cost
Name
University of Michigan Ann Arbor
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
073133571
City
Ann Arbor
State
MI
Country
United States
Zip Code
48109
Miller, Scott F; Sanz-Guerrero, Jorge; Dodde, Robert E et al. (2013) A pulsatile blood vessel system for a femoral arterial access clinical simulation model. Med Eng Phys 35:1518-24
Sandhu, Amneet; Moscucci, Mauro; Dixon, Simon et al. (2013) Differences in the outcome of patients undergoing percutaneous coronary interventions at teaching versus non-teaching hospitals. Am Heart J 166:401-8