Enhancing efficiency in length of stay for ventricular assist device patients during routine right heart catheterization

Background: Left ventricular assist device (LVAD) patients undergoing right heart catheterization (RHC) were traditionally admitted pre- and post-procedure for inpatient anticoagulation bridging. From 2021 to 2025, transition to outpatient RHC and eliminate length of stay (LOS) using an IACT-PDCA initiative enhanced with virtual ventricular assist device (VAD) clinic reminders. Methods: In 2021-2024, patients were instructed to complete international normalized ratio (INR) testing 3 days before RHC. In early 2025, a retrospective review revealed cancellations due to missed INR testing. Consequently, we integrated a virtual VAD clinic in 2025, with reminders initiated 7 days prior to ensure timely INR testing. Results: LOS was reduced to zero days; INR-related cancellations were nearly eliminated. Estimated cost savings totaled ~875,744 SAR. Conclusions: A staged quality improvement approach using IACT-PDCA and virtual care effectively transformed RHC workflow into a sustainable outpatient model.