Cath Lab Digest - February 2008 - (Page 28)

28 CATH LAB MANAGEMENT FEBRUARY 2008 An Evaluation of Cath Lab Turnaround Time Rose Czarnecki, RN, BSN, MPM Senior Cardiovascular Consultant Health Care Visions, Ltd. Pittsburgh, Pennsylvania W ith the rising cost of health care and decreasing reimbursements from third-party payers, health care organizations must find a way to protect their bottom line. One area frequently reviewed is supply utilization and costs. Although supply cost reduction is still a very attractive goal when looking at trimming the budget, it is no longer at the forefront of cost reduction initiatives. Most health care organizations have negotiated price reductions to a point where continued discounts may not be possible. Hospital administrators are challenged to look beyond dollars and cents and be creative when looking for solutions. In the cardiac catheterization laboratory, realizing a return on investment is increasingly difficult, especially with the limitations in reimbursement predicted for the future. Over the next several years, cardiovascular programs will be faced with payment reductions from CMS and other insurers, particularly in the historically profitable cardiac DRGs. Cardiac cath lab administrators and managers must scrutinize how they can offset this decline in reimbursement to be able to realize a profit. Historically, this has been accomplished by either looking at staff and/or supply reductions. However, administrators have negotiated and renegotiated pricing with their vendors to the point where they may be getting the “best” deal and there may not be opportunities for more discounts. Over the years, cath labs have also learned how to work “smarter” by cross-training employees to perform multiple tasks, thereby reducing the number of staff members needed to accomplish most patient care activities. Where can administrators turn for the next opportunity to cut costs and increase profits? In the cardiac cath lab, one area that may provide an opportunity for cost savings is maximizing patient throughput. Having a well-defined throughput process can optimize lab utilization. Getting each patient into and out of the procedure room in a timely manner can add minutes and maybe even hours to the daily schedules, allowing for the accommodation of a greater number of cases. Increasing the number of procedures performed per day or week can add to overall income. Even though a cath lab manager may believe their throughput process is the best that it can be, it is always of benefit to examine it closely, in order to be absolutely certain there is no room for improvement. One way this can be accomplished is by conducting an indepth review of all activities that must take place in order to get the patient in and out of the procedure room. There is no better way to identify problem areas within the process. By identifying roadblocks and determining if there are opportunities to expedite the process, turnover time can be reduced. Many factors affect the patient throughput process in the cardiac cath lab. What occurs pre-, intra- and postprocedure is very important to the process. Did the patient arrive in the suite on time? Was all the appropriate documentation available, i.e., blood work results? Were all the appropriate supplies needed for the procedure available? Was the patient on the table at the scheduled time? A negative response to any of these questions can delay the current procedure and definitely delays the start of the next case. Achieving optimal throughput time is also very dependent on procedure room turnaround time. What is procedure room turnaround? Turnaround time is defined and measured in several different ways. Some labs define turnaround time as the time that one patient leaves the procedure room until the time the next patient enters the same room. Another may measure it as the time one patient leaves the procedure room until the room is ready for the next case. No matter what definition your institution Figure 1. Sample Informal Flow Chart for the Evaluation of Cardiac Cath Lab Turnaround Times There are many steps in the turnaround process of a cardiac catheterization lab. Every lab has their own way of completing each step. By documenting and analyzing what is involved in completing each step, you may discover ways to improve your processes and save time and money. This sample flow diagram outlines a few of those processes and can get you started outlining your own processes.

Table of Contents Feed for the Digital Edition of Cath Lab Digest - February 2008

Cath Lab Digest - February 2008 Bay Regional Medical Center ENDEAVOR IV: A Zotarolimus-Eluting Stent Versus a Paclitaxel-Eluting Stent in a Randomized Clinical Trial A 3D CT Vessel “Roadmap” Over Live Fluoroscopy for Chronic Total Occlusions Contents Clinical Editor’s Corner An Evaluation of Cath Lab Turnaround Time Commentary: An Evaluation of Cath Lab Turnaround Time Excerpts from Chapter 19. STEMI Interventions – Future Perspectives The Potential Clinical Utility of Intravascular Ultrasound Guidance in Patients Undergoing Percutaneous Coronary Intervention With Drug-Eluting Stents The Ten-Minute Interview with…Debbie Charlton, RN The Society of Invasive Cardiovascular Professionals (SICP) at Transcatheter Cardiovascular Therapeutics (TCT) 2007 The Cath Lab is a Business: Do You Have the Knowledge to Stay Afloat? Incidence and Predictors of Vascular Complications after Invasive Coronary Procedures: A Prospective Analysis Ask the Clinical Instructor: A Q&A Column for those New to the Cath Lab Volunteer Survey SICP* Section Meetings Calendar What Do You Think? CEU Education Center Clinical & Industry News Classifieds Advertisers Index

Cath Lab Digest - February 2008

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