Cath Lab Digest - September 2007 - (Page 21)

21 Front row: Edith Humphries, CVL Tech; Beth Ward, RN; Mandy Sullivan RT; Gina Myers RN; Brittany Wade, CVL Tech; Karen Mallette RN. Back row: Terrance Alford, CVL Tech; Jack Douglas RN. X-ray technologists Margaret West, Mandy Sullivan, Bobby Fortenberry, Suzette McCall (Chief Tech) and Amy Hollingsworth. Dr. Clay Hays, Cath Lab Medical Director. Director decisions. We’re fortunate in that we have a low hematoma rate. How is inventory managed at your cath lab? Who handles the purchasing of equipment and supplies? Our nurse manager is primarily responsible for inventory. One of our RTs handles most of the interventional inventory, and our EP nurse specialists take care of the EP lab supplies. Orders are done through software program called Pathways Material Management software (McKesson, San Francisco, CA). How is coding handled in your lab? I build the charges, which of course involves assigning CPT4 codes. Assigning medical necessity and DRG codes is done in our Health Information Department. We have a program called Compliance Advisor™ (McKesson) which edits the bills. If a bill is rejected, it is reassigned to the department that charged the procedure. If it is one of ours, I review the charges and the medical record to determine if the charges are correct, and if the code is correct. Is your lab involved in clinical research? Yes, we are currently enrolled in the ACCESS Registry for PFO closures in patients who had a stroke while on anticoagulation therapy. Have you had any cath lab-related complications in the past year requiring emergent cardiac surgery? No. What other modalities do you use to verify stenosis? When we use another modality to verify stenosis, it is usually intravascular ultrasound (IVUS). We do have a fractional flow reserve (FFR) wire, but rarely use it, as our physicians prefer IVUS to verify stenosis. What measures has your cath lab implemented in order to cut or contain costs? It seems that we are constantly negotiating with vendors to reduce the cost of their products. Our Materials Management Department is also very active in assisting us with negotiations to reduce supply costs. In 2006, the hospital began a physician-led Materials, Supply and Device Committee. All new products are reviewed and approved by that committee before use. What type of quality control/quality assurance measures are practiced in your cath lab? Quality controls are run each morning on the x-ray equipment, activated clotting time (ACT) machines, and on the co-oximeters. We review all our complications and submit results each quarter. Deaths are reviewed in the physician morbidity and mortality (M&M) meetings. How does your cath lab compete for patients? Has your institution formed an alliance with others in the area? We go out of our way to have the equipment and supplies that the physicians need, and try very hard to accommodate their schedules. We do not have an alliance with another hospital. Do you monitor patient satisfaction? Yes, we use Press Ganey (South Bend, IN). Results of this national benchmark are very important to our department. Did your facility need to make any changes to the imaging equipment to accommodate peripheral procedures? Yes. We’re currently in the process of purchasing the imaging equipment. What are some of the new equipment, devices and products introduced at your lab lately? ASD and PFO closure, alcohol septal ablation, and valvuloplasty are our newest procedures. We have purchased the St. Jude EnSite® 3-D mapping system and we will soon be doing more complex ablation procedures. Our staff members really enjoy being involved in new procedures. The FilterWire (Boston Scientific, Natick, MA) and Proxis (St. Jude Medical, Minnetonka, MN) are some of the newer distal protection devices we are using. Does your cath lab do electives on weekends and or holidays? Thankfully, we don’t do elective procedures on weekends or holidays, although we do seem to have a lot of emergency procedures that often have to be done on holidays or long weekends. How does your lab handle hemostasis? Several of our physicians use a closure device, and if we pull the sheath, we usually use a compression device (CompressAR®, Advanced Vascular Dynamics, Portland, OR). We sometimes use a variety of closure pads, including SyvekPatch® (Marine Polymer Technologies, Inc., Danvers, MA), D-Stat™ Dry (Vascular Solutions, Inc., Minneapolis, MN) and SafeSeal™ (Possis Medical, Minneapolis, MN) in conjunction with the CompressAR. If the physicians close the artery, they use either Angio-Seal™ (St. Jude Medical) or StarClose™ (Abbott Vascular, Redwood City, CA), whichever is their preference. If patients are outpatients, they are returned to the cardiovascular holding department where they were first prepped for the procedure. Patients are recovered and discharged from this department. If the patient is admitted, they are sent to a telemetry unit. Does your lab have a hematoma management policy? No. Hematomas are handled by nursing judgment and physician

Table of Contents Feed for the Digital Edition of Cath Lab Digest - September 2007

St. Dominic Hospital The Genous Bio-engineered R Stent Percutaneous Treatment of Peripheral Arterial Chronic Total Occlusions: Device Options and Clinical Outcomes Contents Clinical Editor’s Corner Percutaneous Revascularization of Peripheral Chronic Total Occlusion — Which Patients, Why, and How? Myocardial Infarction and Syncope: A Manifestation of the “Raynaud-Prinzmetal Syndrome”? Essential Technical Components of the Transradial Approach If You Build It, Will They Come? Evidence-Based Medicine with Drug-Eluting Stents Back to School: The Value of Education in Cardiovascular Services The ACVP Standards and Competencies: Are You Using Them Effectively? What Do You Think? My Experience with Fibromuscular Dysplasia and Stroke A Brief Review of Fibromuscular Dysplasia Letter to the Editor A Look at On-the-Job Training: Perceptions, Reality and Our Profession Doing the Wave: Inventory Management with RFID The Ten-Minute Interview with… Paul Pinsker, RCIS CLD’s Annual Salary Survey Harrisburg Area Community College Volunteer Survey CEU Education Center SICP* Section Ask the Clinical Instructor: A Q&A Column for Those New to the Cath Lab Clinical & Industry News

Cath Lab Digest - September 2007

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