Cath Lab Digest - October 2007 - (Page 18)

18 SPOTLIGHT OCTOBER 2007 Saints Cardiac Cath Team working together. Dr. James Waters, Medical Director, Cardiac Cath Lab, shows procedure results to his patient. FemoStop. Patients go to our 4-bed holding area if they are being discharged or waiting for a bed. If they are being admitted they most often go to the IMC unit (Intermediate Care) or if needed, the ICU. Does your lab have a hematoma management policy? Yes we do. It is both a departmental and hospital-wide policy. How is coding and coding education handled in your lab? We do our own interdepartmental billing and coding. We work with finance and our supply chain department for pricing and procedural coding. Our coding is updated yearly or as new procedures are instrumented in our lab. How is inventory managed at your cath lab? Currently we do not have an automated inventory system. All inventory, consignment and nonconsignment, is managed by all staff but, with one staff member (an RT) overseeing ordering and par levels. We order through our Materials Management department. For our peripheral equipment, the RT who manages equipment and products met with the interventional physicians to review desired equipment. She then met with a special procedure technologist to review common equipment so as to not “over order,” and set par levels. We brought in consignment product for almost all of our needs but still have some direct purchases. Has your cath lab recently expanded in size and patient volume? Our interventional volume has increased exponentially since our elective angioplasty program began in July 2006, under the MASS COMM study. In the near future, we are expanding to a full cardiovascular center offering peripheral angiography and intervention including renal, subclavian, and iliac stenting. We are also considering adding an electrophysiology (EP) program, but will start by offering implantable cardioverter defibrillators (ICDs). We also presently perform cardioversions and TEEs, along with single and dual chamber pacemakers. What other modalities do you use to verify stenosis? Are you using physiology for lesion assessment? We are currently in the process of purchasing IVUS from Boston Scientific (the iLab system). We do not use physiological assessment. What measures has your cath lab implemented in order to cut or contain costs? Due to the size of our lab, we are able to contain costs by having the majority of our most costly products on consignment, i.e, pacers, stents, balloons, guides, guide wires, and peripheral equipment. We are also a member of the Premier Buying group and Yankee Alliance. What type of quality control/quality assurance measures are practiced in your cath lab? A few of the quality indicators we monitor are the door-to-balloon times, bleeding, groin complications and patient satisfaction. We also flag our patient population through admitting, so if any patient is readmitted, our staff can follow them for any potential adverse outcomes. All PCI study patients are followed internally and externally with the state for quality. We meet monthly with our hospital Quality Nurse and the Medical Neil Archambault, RN, ASN, Clinical Leader-Cardiology, takes a quick moment out of his busy morning to say “cheese.” Back, l-r) Omar Ali, MD, interventional cardiologist, Dave Green, RN, EMT-P, Rich Snyder, RN, Jeff Peters, RTR (Front, l-r) Erin Boutin, RN, Nurse Manager, Cardiac Cath Lab, Stacey Cayer, RN, Rosany Rosario, CVT-RCIS, Kathleen Poirier, Unit Assistant . Assistant. Inc., Minneapolis, MN) to our inventory. We are in the process of purchasing intravascular ultrasound (IVUS). In addition, we are now performing cardiac cath via the radial approach and have added some different sheaths and wires to optimize this technique. How does your lab handle hemostasis? We currently stock Perclose (Abbott Vascular, Redwood City, CA), AngioSeal™ (St. Jude Medical, Minnetonka, MN), D-Stat Radial hemostat bands (Vascular Solutions, Inc., Minneapolis, MN), FemoStop® (Radi Medical Systems, Inc., Wilmington, MA) and the D-Stat Dry (Vascular Solutions) patch. Approximately 95% of our patient population receives an AngioSeal, 2% receive a Perclose, 2% receive manual pressure alone, and 1% receive a combination of either manual pressure with hemostasis patches, D-Stat radial band and

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

Saints Medical Center Fibromuscular Dysplasia in Children and Adolescents Cerebral Vascular Accident Following a Pulmonary Embolism: Search for the Hidden Patent Foramen Ovale Contents Clinical Editor’s Corner Meetings Calendar CEU Education Center Radiation Tracking in the Cardiac Catheterization Lab Letter to the Editor Carotid Stenting: An update Release from Stent-jail: Beneficial Snow-Plowing? Patient Management Guidelines Searching for a Cardiovascular Position? Tips for Creating a ‘Stand-Out’ Resume Long-Term Implications of Short-Term Closure Decisions – The Evolution to Vascular Access Management and the Boomerang Catalyst System The Ten-Minute Interview with… Angie Bowles, RN, CCRN CMS Issues Final FY 2008 IPPS Rule ACVP• Membership Page Experience with a New Workhorse Guidewire Ask the Clinical Instructor: Q&A for Those New to Cath Lab A Glimpse of the Future of Clinical Education: Boston Scientific’s SimSuite Bus Visits Carnegie Institute 2007 Educational Fair Held at the Washington Hospital Center Research Update: Original Contribution Abstracts from The Journal of Invasive Cardiology What Do You Think? A Virtual Cath Lab Viewer (VCL): The Development of an Online 3D C-arm Simulator and Coronary Anatomy Viewer Clinical & Industry News Cost-Effectiveness of the Radial versus Femoral Artery Approach to Diagnostic Cardiac Catheterization

Cath Lab Digest - October 2007

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