St. Antonius TAVI Pathway Optimization Case Study - Integrated Health Solutions

Increasing daily TAVI capacity

St. Antonius increased the TAVI procedures by 24%

Key facts

partner

St. Antonius Hospital Utrecht/Nieuwegein, the Netherlands

CHALLENGE

St. Antonius Hospital wanted to become a leading TAVI center but faced major operational bottlenecks. Planning was inconsistent, patient prep processes weren’t aligned, Cath Lab workflows suffered delays, and post‑procedure steps — like pacemaker scheduling and discharge — created long lengths of stay (LOS) and peak‑load pressure. The hospital needed to increase TAVI volume without adding staff, budget, or infrastructure.

SOLUTION

St. Antonius partnered with Medtronic IHS to implement the TAVI Pathway Accelerator with the goal to raise daily TAVI volume from three to four without extra resources. A multidisciplinary team optimized planning, streamlined pre‑procedure workflows, improved communication, and standardized team routines. They reduced changeover times, increased use of local anesthesia, improved pacemaker decision protocols, and introduced length-of-stay dashboards and clearer discharge criteria.

33%

Daily TAVI procedure increase

27%

LOS reduction

24%

TAVI increase (6-8 months)

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Challenge

The hospital aimed to become the primary center of reference in transcatheter aortic valve implantations (TAVIs). To do this, the hospital wanted to increase the number of procedures without increasing their budget, staffing, or infrastructure. However a number of operational challenges were standing in the way, including:

The hospital & heart centre

St. Antonius Hospital has multiple locations in and around Utrecht, and is one of the leading hospitals and heart centers in the Netherlands.

Its heart centre is a leader in cardiology and cardiothoracic surgery, performing more than 7,000 Cath Lab interventions (in five Cath Labs) and more than 2,800 operating room procedures annually.

Medtronic Integrated Health Solutions (IHS) has worked in strategic partnership with the hospital on various efficiency and optimization solutions over the last seven years. It is in this context that St. Antonius Hospital engaged IHS to help them accelerate patient access to TAVI, improving their resource and capacity utilization in a cost-effective way, and ensuring good clinical outcomes and a positive patient experience.

Planning and scheduling issues

that included last-minute changes, lack of staff awareness of key patient preparation processes, and inadequate case prioritization

Procedural issues

including delays in patient transport from ward to Cath Lab, inadequate TAVI team preparation and cooperation, and a high number of general anesthetics procedures

Post-procedural issues

including poor slot reservation for pacemaker implantation, relatively long lengths of stay (LOS), poor visibility into LOS, and high peak load for the ward

Solution

St. Antonius Hospital engaged Medtronic IHS to implement the TAVI Pathway Accelerator Solution with these objectives in mind:

Increase the number of daily TAVI procedures from three to four procedures within six months using the same or fewer resources
Maintain clinical outcomes and patient satisfaction

A multidisciplinary hospital team, including cardiologists, surgeons, Cath Lab and clinical nurses, and planning staff worked together with the Medtronic IHS team to increase daily TAVI capacity. Working together, they successfully:

Optimized procedure planning by:

Clustering patients with similar clinical profiles to aid prioritization
Adjusting the procedure schedule to minimize peak demand
Streamlining and redesigning the pre-procedure checklist and gaining Heart Team buy-in to improve patient preparation
Improving communication between Planning, Cath Lab and Ward

Increased daily production levels by:

Employing several improvement initiatives to increase on-time starts and reduce changeover time
Implementing a TAVI team routine to establish roles and schedules at the start of the day
Filming procedures and evaluating with the team to establish better cooperation
Increasing number of local anesthesia and light sedation procedures to reduce procedure time and length of stay

Reduced LOS and freed up ward capacity by:

Adjusting pacemaker protocol to enable earlier decision for implantation
Redefining target LOS and discharge criteria and improving communication and discharge preparation
Building an LOS dashboard and introducing a management system to improve awareness and performance

Pathway Accelerator solution

Pathway Accelerator is a comprehensive and integrated approach to helping providers implement, run, and sustain evidence-based, best-practice-informed, and patient-centric care pathways. Capitalizing on hundreds of care pathway optimization projects across a broad array of medical conditions, Pathway Accelerator can quickly transform your pathway and deliver sustainable results.

Impact

Within six to eight months, the hospital increased the total number of procedures by 24 percent without adding resources or capacity by:

Increasing daily procedures by

33%

(from 3 to 4 TAVI procedures)

Reducing avarage LOS by

27%

In addition, patients are experiencing a smoother admission process, less time spent anxiously awaiting the procedure in the pre-procedure area, and shorter hospital stays — with comparable clinical outcomes and complication rates.

What the hospital is saying:

Due to Medtronic IHS’ expertise and structured and multidisciplinary approach, we were able to increase production levels and realize our growth ambitions.”
— Heart Center Manager

The different interventions, fact-based analysis, and best-practice sharing helped us to make informed choices for a new way of working.”
— Interventional Cardiologist

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