Cath Lab Digest - February 2008 - (Page 30)

30 CATH LAB MANAGEMENT FEBRUARY 2008 uses to identify the turnaround timeframe, the crucial aspect is what activities take place during that specific phase. Activity components of this time period usually involve tasks such as transferring the patient off the procedure table, transporting them to a recovery bed or an inpatient room, sheath removal and groin management, and cleaning and preparing the procedure room to accept the next patient. In order to determine your cath lab’s turnaround time, you need to identify the key processes involved in preparing to accept the next patient and determine their effectiveness. Begin by performing an in-depth review of each step of the process, outlining all the activities involved and monitoring the time it takes to complete each of the steps. Identify what takes place at the end of a procedure. List all the steps necessary to discharge the current patient from the procedure room and prepare the room for the next patient, up to when the next patient enters the room. This may be done by documenting the processes in a workflow diagram. A workflow diagram will provide a detailed overview of the activities associated with each step in the turnaround process. It will allow you to perform the review, scrutinizing each step to determine if it can be performed differently, performed in a more timely fashion or if it can be eliminated. Every institution has specific barriers that may prevent them from achieving ultimate procedure room turnaround times; however, there are some aspects that are universal and may apply to all Figure 2. American Heart Association/The Institute for Healthcare Improvement Plan-Do-Study-Act Worksheet. This worksheet allows you to document and evaluate each step of the Plan-Do-Study-Act Cycle and can be adapted to meet the needs of a cath lab turnaround time analysis. Reprinted with permission from The Institute for Healthcare Improvement. Available for download at the American Heart Association website: http://www.americanheart.org/presenter.jhtml?identifier=3015074 institutions. For instance, at the end of a diagnostic procedure, is the patient moved to a recovery area where the sheath is pulled or is this done in the procedure room immediately after the case? Who is responsible to pull the sheath? If your patient remains in the procedure room to have their sheath pulled, this could add, at minimum, 15 to 20 minutes to your turnaround timeframe. If sheath pulling is the responsibility of the cath lab staff, even when the patient is in the recovery area, that staff member will be unavailable to assist with room preparation for the next patient. Who is responsible for transporting the patient to the recovery area or inpatient unit? Is this the responsibility of the cath lab staff or is there an escort service available that can transport stable patients? If a member of the cath lab team has to leave the suite to transport a patient to the recovery area, they will be unavailable to help set up the room for the next patient. Utilizing the entire team to prepare the procedure room can slash minutes from your turnaround time. Another area to review with the aim of eliminating minutes from turnaround time is procedure room cleaning. Who is responsible for cleaning the procedure room between cases? Is this the responsibility of the cath lab staff or is there a dedicated environmental service employee assigned to the cath lab suite? Although the cleaning procedure between cases may be rapid, this task does require a cath lab staff member if your cath lab is not using environmental services. Analyzing what happens at the end of a procedure until the beginning of the next is only one aspect in the evaluation of the throughput process in the cardiac catheterization lab. In order to gain a complete picture of what must take place during your turnaround time, you can flowchart the entire process using formal or informal diagramming techniques. Figure 1 demonstrates one method of informal flowcharting of procedure room turnaround activities. There are other ways that turn around activity can be outlined, such as documenting the roles and responsibilities of each team member in a flow diagram. Another popular method that can be utilized when analyzing the throughput process is the quality improvement model, Plan-Do-StudyAct (PDSA) cycle. This model has been http://www.americanheart.org/presenter.jhtml?identifier=3015074 http://www.americanheart.org/presenter.jhtml?identifier=3015074

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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