Conversations with the editor: optimizing patient pathways through the activation of an aortic valve outpatient day service

Throughout a medical technology's life cycle, stakeholders may play different roles of varying significance. National agencies (eg, the US Food and Drug Administration, European Union Competent Authorities) are the key actors in regulatory approval (eg, US Food and Drug Administration approval, CE Mark), whereas national/regional policy makers determine coverage and reimbursement of innovative technologies. For mature, already adopted technologies, the hospital level has a pivotal role in the rational and appropriate use of resources. Dr. Sergio Berti has implemented a pilot project for TAVI patient pathway optimization at the Ospedale del Cuore G. Pasquinucci–G. Monasterio Foundation, Massa, Italy, based on the activation of a dedicated day service ambulatory program to perform advance imaging tests and examinations. This project has resulted in facilitating patient referrals to the most appropriate therapeutic option, faster patient recovery due to earlier patient mobilization and shorter length of stay, and better capacity to plan operating room activity. This experience shows how organizational innovations might help hospitals improve patient care and gain efficiency.