Page 153 - Simplicity is Key in CRT

or death during follow-up. All measurements were mapped for each step of the pathway. The analysis was structured so that similarities and disparities between the current practice CRT care and the “model care pathway” could be mapped and measured when possible. Conclusions drawn from this analysis are presented in table 1.
Table 1. Current process bottlenecks, per process stage
Finally, a workshop with all stakeholders was conducted to define the “Maastricht Operational pathway”, based on both the “Model care pathway” and the detailed assessment of the current local practices and processes. The local multidisciplinary team was challenged to evaluate the newly designed pathway for feasibility in practice and to control whether any identified ‘waste’ (according to the assessment) could indeed be removed. This phase lasted 4 months and required 30 consulting days, as well as 2 workshops for local stakeholders. A high level view of the “Operational pathway” for MUMC is shown in figure 3.
Referral and Pre-assessment
Implantation procedure
Follow-up management
Heterogeneous referral
No structural case identification Many contacts pre-implant Long referral-to-treatment time
Long length of stay
Heterogeneous follow-up
Many contacts post-implant
No structural CRT optimization
No integration of HF/device care Long referral time in non-response
Figure 3. High level “Operational pathway” in MUMC.
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