Abstract No. 169 The Implementation of a Nurse Navigator on Reduction of Unreimbursed Drain Exchange Cases Performed in the Interventional Radiology Suite

To investigate the impact of implementing a drain management liaison service on unreimbursed expenses for patients with indwelling abscess drains. This project analyzes the impact of a nurse navigator on decreasing abscess drain checks, typically a low-reimbursing case performed in the interventional radiology (IR) suite. A retrospective chart review was conducted of indwelling abscess drain evaluation exams performed by IR at a single institution between March 2019 and April 2023, with specific investigation into the economic impact of the implementation of a drain management nurse. The patients were divided into two groups: Group 1: Patients who underwent drain evaluation between March 2019 and February 2022, prior to implementation of drain management liaison, which consisted of fluoroscopic drain evaluation by institutional protocol every two weeks. Group 2: Patients who underwent directed drain evaluation between March 2022 and April 2023, after implementation of nurse liaison service, which consisted of weekly virtual visits evaluating output, site-related issues, and changes in clinical status. These visits resulted in subsequent directed CT or drain exchange/upsize/removal as clinically indicated. Hospital charges and average reimbursement figures were obtained. Primary outcomes were the included differences in hospital charges, and unreimbursed charges per month incurred by each group. A total of 1674 drain evaluations were performed on 734 patients. Patients with greater than 10 encounters were excluded from analysis, resulting in a working total of 1485 evaluations on 723 patients. Estimated hospital charge and reimbursement values per procedure are listed in Table 169.1. By reducing the number of drain changes, Group 2 demonstrates a monthly decrease in unreimbursed charges. Our findings indicate clinically directed drain changes that resulted in substantial savings in unreimbursed expenses when compared to routine previously established protocol. These results demonstrate the potential for drain management services to reduce cost in the IR department while making space for higher revenue-generating cases.