Implementing an Endocarditis Interdisciplinary Pathway in a Large Academic Medical Center: A Quality Improvement Project

Infective endocarditis (IE) is an infection and or inflammation of the heart valves and endocardium and a potentially life threatening illness. Dependent on the infecting organism, the cardiac damage caused by IE can be indolent or very aggressive. Hospitalized patients with IE require management by an interdisciplinary team, including cardiologists, cardiac surgeons, infectious disease specialists, registered nurses, nurse practitioners, physician assistants, pharmacists, and social workers. Treatment is complex and patients often present with various comorbidities. Standardized interdisciplinary care protocols have been shown to reduce patient mortality and hospital length of stay. The development of the pathway guidelines was informed by stakeholder meetings and recommendations from the American Heart Association, American Association for Thoracic Surgery, and European Society of Cardiology. One IE-related pathway was published in the institution’s intranet with two subsections: IE Diagnosis and IE Management and Discharge Processes. Education sessions on pathway access were conducted for interdisciplinary staff across three cardiac care units. The frequency of pathway online views was measured over three months, accumulating a total of 191 views. The median number of daily views was 2.5 [IQR 2, 4]. Analysis of these initial measures will help guide future efforts to streamline and enhance interdisciplinary collaboration amongst staff that care for patients with IE.