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Right Heart Catheterizations by the Pulmonary Vascular Disease Program: A Comprehensive Team Approach from the Viewpoint of the Nurse Practitioner

Arlene Schiro

Barbara Cockrill

Aaron Waxman


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Conference: 2009 PH Resource Network Symposium

Release Date: 09.24.2009

Presentation Type: Abstracts

Arlene Schiro, RN, ACNS, BC, ACNP; Barbara Cockrill, MD; Aaron Waxman MD, PhD
Massachusetts General Hospital, Boston, MA 

BACKGROUNDThe Pulmonary Vascular Disease Program is committed to providing comprehensive care through the diagnosis and treatment phase of our patients with Pulmonary Arterial Hypertension. The Nurse Practitioner played an integral role in developing a program for providing Right Heart Cathetizations (RHC) within the Pulmonary Vascular Disease Program. Right Heart Catheterizations are required for the diagnosis of Pulmonary Vascular Disease. 


  • Expedite Scheduling
  • Build a relationship between team members and the patient 
  • Offer immediate feedback to patients during procedure   
  • Decrease time to treatment initiation 
  •  Develop RHC training for the Pulmonary and Critical Care Fellowship Program 

IMPLEMENTATIONDevelop a Steering Committee for the RHC Program that would:

  • Identify roles 
  • Standardize equipment and supplies  
  • Develop Policies and Procedures for best practice 
  • Provide a standardized billing and scheduling program 
  • Design a Quality Monitoring Program and Patient Satisfaction Survey 
  • Analyze data that would evaluate a comparison of elapsed time from RHC procedure to time to treatment initiation

IMPLICATIONS OF PROGRAM: Patients have reported increased satisfaction in having a consistent group of caregivers who will support them during the continuum of their disease. It also offers the NP an opportunity to build expertise and implement role expectations.


  • Quality Monitoring must be continued quarterly 
  • RHC Steering Committee should meet to discuss "best practice" standards 
  • Plan to compare standards of care with those implemented by the Cardiology's RHC Program