Cath Lab Digest - November 2007 - (Page 26)

26 CATH LAB MANAGEMENT NOVEMBER 2007 Use of a Mobile Lab to ‘Test the Waters’ at a Rural Hospital Cath Lab Digest talks with John Walker, CEO, Western Plains Medical Complex, Dodge City, Kansas A mobile cath lab from Cardiac Services, Inc. Inside the mobile cath lab. W estern Plains Medical Complex partnered with mobile solutions company Cardiac Services, Inc. (CSI) for nearly two years. After recruiting an interventionalist, the hospital brought in a mobile cardiac catheterization laboratory to test volumes while planning and building a permanent cath lab. Can you describe your hospital and the type of population you serve? We are a 99-bed acute care hospital located in Dodge City, Kansas, which is in southwest Kansas. Western Plains Medical Complex is a rural hospital; we are 150 miles west of Wichita, which is the closest major metropolitan area. We serve a population of around 200,000 between our primary and secondary markets. Our market goes all the way to Wichita in the central part of the state, north up to Nebraska, over and even into Colorado in the west, as well as down into northwest Oklahoma. It’s quite a diverse area. Why did your hospital decide to begin a cath lab program? Our population was underserved in cardiology. What we had were what I referred to as “part-time cardiologists.” Cardiologists, primarily out of Wichita, 150 miles away, came to do day clinics once every two weeks or so. If someone needed cardiac care, they had to wait to get an appointment from one of these cardiologists. This was just for those people who were looking to get a cardiology appointment, which in most cases would have been a referral from a primary care physician. It didn’t include people who had an urgent need, such as a myocardial infarction (MI), chest pains or other symptoms. Prior to our cath lab (mobile) opening, patients were administered thrombolytics and then transferred to other hospitals in Wichita. In effect, once you left Wichita, you had no full-time cardiologist in almost half the state of Kansas. That was the impetus behind our bringing in a full-time cardiologist. Of course, once you have an interventional cardiologist, they will need the technology to support their practice, which is why we got involved with CSI and began using a mobile cath lab. What requirements does the state of Kansas have to begin a cath lab program? We do not have a Certificate of Need (CON) in the state of Kansas, so it was up to the hospital to prove the need. In our case, LifePoint Hospitals, Inc. is our parent corporation out of Brentwood, Tennessee. Gaining the funding to both recruit cardiologists and to begin with the mobile cath lab was a matter of putting all the financial projections together. It was not a difficult task, because there was all kinds of data showing that patients were leaving the area and driving somewhere else for cardiac care, be that Wichita, 150 miles away, or Hays, Kansas, a little more than 100 miles away. That data was openly available through the Kansas Hospital Association and other organizations. Why incorporate a mobile cath lab? We were fortunate to have recruited an interventional cardiologist, Dr. Muhammad Khan. Yet we knew we couldn’t build a cardiac cath lab overnight. We had a need for a mobile service to come in and help us out so we could be up and running quickly. This led us to contract with CSI, who also offered us clinical and technical support. CSI provided extensive on-site clinical applications for staff upon installation. CSI’s clinical specialists also returned several times during the lease to re-train, following staffing turnovers.They brought in the startup mobile lab, which in our case was a GE Advantx LCV+ combination lab. It has a 12” image intensifier with spin, bolus chase and digital subtraction. Where was the lab located and how was it attached? We poured a cement pad and located it right behind our emergency room. Working with our local electrical supplier, we ran a special power source for the lab, so that it would have its own power source and not be dependent on the hospital for power. We also built an enclosed area between the mobile lab and the ER, which served a dual purpose: one part was storage space for the supplies and the other worked as a passageway, to go from the hospital to the lab and to keep the patients out of the weather. We do have our share of seasonal weather in Kansas. CSI had the very good option of a lab with what I would refer to as “side entry,” with a lift for the stretcher. You could roll the stretcher directly to the mobile cath lab, put the patient on the lift, raise them up three or four feet and then slide them right into the mobile cath lab and on the table very quickly. How long did it take to get the mobile lab set up and ready to go, and how long until you had your first patient? Once the delivery took place with the mobile lab, it was a very quick process. Once it was delivered to the site, within 4-5 hours, it was up and running. After In effect, once you left Wichita, you had no full-time cardiologist in almost half the state of Kansas. That was the impetus behind our bringing in a full-time cardiologist.

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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