Cath Lab Digest - November 2007 - (Page 16)

16 SPOTLIGHT NOVEMBER 2007 Recovery/Holding Area. Tenia Hewitt, RN Daniel Cutcher, RN, Manager, Cardiac Catheterization/Electrophy siology Laboratories during adenosine-induced hyperemia reflecting the blood flow through the artery. The distal pressure/proximal pressure ratio during hyperemia is called the fractional flow reserve (FFR). We utilize intravascular ultrasound (IVUS) in special situations (i.e., left main coronary artery disease). We occasionally perform CFR, coronary flow reserve, using the Doppler FloWire (Volcano Corporation, Rancho Cordova, CA) to measure coronary flow through the use of pulsed sound waves and measurement of the returning signal reflecting off moving red blood cells. Quantitative angiographic measurements are also available quickly using our Siemens Axiom or Angiostar Systems. What measures has your cath lab implemented in order to cut or contain costs? One substantial move that has helped cut costs has been having a dedicated materials management coordinator to manage all inventories with in our cath lab. Twice annually, physical inventory is performed to evaluate “no movement” and expired products. Aggressive contracting with our vendors is also implemented annually in order to cut or contain costs. What type of quality control/quality assurance measures are practiced in your cath lab? Daily quality controls are performed on specific equipment including the Avoximeter, Accucheck, ACT and temperaturecontrolled equipment, as well as our crash carts and defibrillators in the cath lab. We also monitor room utilization, finish times, contrast usage, patient procedure flouro times, final time out, patient occurrences such as contrast allergy, contrast-induced nephropathy and documentation compliance. We track all complications and outcomes as identified by the American College of Cardiology (ACC) guidelines. We also participate in the Blue Cross Blue Shield of Steve Gellman MD, Helen Constan RN. Steve Gellman MD, Helen Constan RN. Michigan Cardiovascular 2 Consortium (BMC ). BMC2 is a collaborative consortium of health care providers in Michigan, created in 1997. The goals of the consortium are to maintain a prospective, longitudinal multi-center registry of consecutive percutaneous coronary interventions (PCI), to develop and validate risk-adjustment models for fatal and non-fatal outcomes of PCI, to identify risk factors and process of care variables related to adverse outcomes of PCI and to improve the quality of care for patients undergoing PCI through the development of a continuous quality improvement program. This program involves information sharing, the use of riskadjusted data and benchmarking. In 2003, Henry Ford, in a collaborative effort between the cardiac catheterization lab, the emergency department and the cardiac intensive care units, developed a process where every patient presenting to the ER and an outlying hospital ER with an acute MI would receive PTCA within 90 minutes of presentation, thereby minimizing heart damage and improving patient prognosis. As a result, we monitor and track our door-to-balloon times and participate in an interdepartmental AMI committee. Our systems administrator, Joann Alfonsi, gathers data and is very helpful in assessing and assuring that the quality of care is above standard. The data is analyzed by Christine Swanson MSN, NP and presented at interdepartmental meetings. Patient satisfaction is measured through Press Ganey Surveys. Today, the cath lab distributes patient/family education folders which include a cardiac catheterization or electrophysiology survey along with a selfaddressed stamped envelope, general hospital instructions and information, pre and post catheterization instructions including discharge information, a self-care guide, including medical information sheet, appointment and “questions for your doctor” manual, and a referral form for cardiac rehabilitation, “Working on Wellness,” and weight management programs. As well as education folders, Henry Ford Heart and Vascular (HFH) gift bags containing hearthealthy popcorn, sugar-free mints, playing cards, a notepad and pencil, and pill box are given at discharge. These gift bags have become quite popular with our patients and their families. At Henry Ford Health System, we put EACH PATIENT FIRST… A focus on service and performance excellence has become a Henry Ford Hospital-wide initiative. Creating “The Henry Ford Experience” is the foundation of all that we do, bringing together the seven pillars that represent our system’s priorities: People, Service, Quality & Safety, Growth, Research & Education, Community and Finance. How does your cath lab compete for patients? Has your institution formed an alliance with others in the area? We have cultivated a strong connection with many of the outlying facilities and do receive many of our patients from these facilities. A majority of our ST-elevation myocardial infarct (STEMI) patients are transferred to our facility. We market our health system by letting the community know that we are the hospital that specializes in cardiac care. Our outstanding performance in our treatment of STEMI patients has been a useful marketing tool. Our motto is: We’re Henry Ford — when others can’t, WE CAN! How are new employees oriented and trained at your facility? New employees are assigned to a preceptor. We have an orientation manual containing a checklist for multiple competencies that must be completed for each new employee. Orientation length is usually 3 months and evaluated on an individual basis with consideration of previous employment experience. Nurses are required to have RN licensure. Cardiovascular technologists (CVTs) do not have specific licensure but must have an extensive cardiac background. All of our staff technologists and nurses are required to maintain ACLS and Basic Life Support (BLS) certification. What type of continuing education opportunities are provided to staff members? Educational opportunities are fortunately abundant within our department. BLS and ACLS courses are provided by Henry Ford Health System (HFHS). HFHS also offers classes and seminars available to staff hospitalwide. We have scheduled in-services

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

Henry Ford Heart and Vascular Institute Treating Patients with Complex Vascular Disease with a Multi-Disciplinary Approach Improving Patient Compliance with Antiplatelet Medications Clinical Editor’s Corner Cath Lab Nurse/Tech Vascular Access and Closure Using the StarClose® Device The Clinical and Economic Impact of Measuring Fractional Flow Reserve FFR and Choosing an Optimal Revascularization Strategy Finally! The New Registered Cardiac Electrophysiology Specialist (RCES) Credential Use of a Mobile Lab to ‘Test the Waters’ at a Rural Hospital Remembering a Cardiac Cath Lab History ACVP• Membership Page What Do You Think? The Ten-Minute Interview with… Ernie Livingston, RN, BSN SICP* Chapter Updates Who’s in Charge? Working to Eliminate Bottlenecks: Florida Hospital’s Cardiac Cath Lab Achieves Greater Efficiency and Higher Satisfaction Preserving Left Ventricular Function during Percutaneous Coronary Intervention Ask the Clinical Instructor: A Q&A Column for Those New to the Cath Lab Making the Most of Your First Impression: Interviewing Tips and Techniques CEU Education Center Clinical & Industry News Meetings Calendar

Cath Lab Digest - November 2007

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