875 - Assessing the Accuracy of Physician Extender Procedural Selection of Fluoroscopic-Guided Spinal Injections

Objectives: To determine the proportion of procedural orders by physician extenders (NP, PA) that need to be altered day-of by the performing physician. This will help characterize the success of utilizing physician extenders for procedural planning. Inefficiencies contribute to various delays in fluoroscopy suite workflow, costing time and financial resources, and wasting medical equipment. These same-day alterations, which often requiring re-consenting, may be alarming and stress-inducing for patients.

Design: Study will be performed via retrospective chart review. Primary outcome measure will be the proportion of time that a physician extender orders a procedure that is consistent with the procedure selected as appropriate by the performing physician on the day of procedure. Additional data for evaluation and characterization includes patient age, procedure laterality, procedure region (C/T/L-spine), spinal level, time from office-visit to procedure, and primary and secondary pain diagnoses to further delineate mechanisms and contributors to delayed fluoroscopy-suite time.



Results: We will evaluate the proportion of time that a physician extender orders a procedure that is consistent with the procedure performed by the physician. Preliminary data suggests physician extenders, while not completely accurate, correctly plan procedures a substantial proportion of the time. Further analysis will determine if accuracy can be based on procedure type and location.



Conclusions: Use of physician extenders to supplement interventional pain clinics has increased in popularity over the past several years. The accuracy with which extenders can place procedural orders contributes to delay prevention on the day of the procedure. Efficient utilization of fluoroscopy suite time is a vital metric that directly impacts physicians and facilities. To date, no studies have investigated the use of physician extenders ordering fluoroscopic procedures. Results of this study will benefit institutions and physicians by identifying and characterizing potential improvements in procedural workflow of fluoroscopic-guided clinics in addition to improving the patient experience.