Successful Institutional Development of a Pediatric Exercise Stress Testing Program after the Establishment of a Dedicated Exercise Team

Orr, WB, Roberts B, Dalal A, Silva JNA, Van Hare GF. Successful Institutional Development of a Pediatric Exercise Stress Testing Program after the Establishment of a Dedicated Exercise Team. JEPonline 2020;23(3):38-45. Despite being appropriately equipped, the exercise laboratory was not being used to its full capability. This was due to a combination of factors that included inexperienced providers, unfamiliarity of different ergometers parameters, and poor education regarding indications for pediatric exercise testing. Recognizing this, the institution focused on revitalizing and scaling the pediatric exercise stress testing program to use multiple ergometers and metabolic analyzers to enhance clinically relevant and actionable data in managing congenital heart failure and channelopathy patients. The exercise testing data were reviewed over a 24-month period looking specifically at the total number of tests performed during a given month, the percent of the tests performed on the treadmill versus the cycle ergometer, the number performed as ECG-only versus a cardiopulmonary exercise test, and the total work Relative Value Units (wRVUs) generated. Implemented programmatic changes were reviewed and assessed for impact against the testing metrics. Our experience highlighted the most impactful factor for program growth, which was the implementation of a dedicated exercise team. This resulted in the improvement in standardized and thorough reports with relevant clinical data for managing patients. Lastly, there was a demonstrable financial value.