EP Lab Digest - October 2007 - (Page 12)

12 SPOTLIGHT INTERVIEW OCTOBER 2007 SPOTLIGHT Continued from page 11 How are new employees oriented and trained at your facility? The most successful component of orientation for most employees has been the on-the-job training received in the department. Our physicians are excellent instructors and assist in the orientation process. New employees start in the clinic setting, progress to the basic procedures and then proceed on to full responsibility for the patients undergoing complex procedures. medicine and family practice. Our EP physicians are very good at communicating any patient interaction back to the referring physician. The relationship is good because each specialty recognizes and respects the other.The EP physicians deal with the arrhythmia issues only and return the patient to cardiology/internal medicine for any other issues. It is an excellent collaborative environment. What measures has your EP lab implemented in order to cut or contain costs? We do bulk buys on a regular basis for some of the more expensive items utilized in the departments (e.g., devices, leads, specialty catheters). In addition, because of the standardized stock at all three facilities, there is no need to have unused quantities of supplies at any facility. Staff carries equipment/supplies to other facilities if needed. We constantly evaluate contracts with our device and catheter vendors. What types of continuing education opportunities are provided to staff members? Our device and catheter vendors are very good at providing clinical education. In addition, utilization of online education is encouraged. Figure 5. Raghuram Dasari, MD (left) and Kathy Helms, RN (right) take a closer look at information from a recent CARTO case. How is staff competency evaluated? Staff are evaluated yearly for general hospital and safety competencies. In addition, competencies are evaluated with the initiation of each new procedure in the department. are made in collaboration with the lab/physician scheduled. We have contracts with device vendors as well as the catheter companies. These are done in collaboration with the EP manager and the Materials Management Department. Does your lab utilize any alternative therapies? No. In what ways have you improved efficiencies in patient through-put? Our main efficiency is the standardization of supplies, protocols and staff between the three facilities. We have well-trained staff that has no other focus other than EP-related issues. Our staff are well-trained, very competent and efficient because of the standardization. How do burnout? you prevent staff Does your EP lab compete for patients? Has your institution formed an alliance with others in the area? Yes. There are programs at every hospital in Northwest Indiana. Our labs always have been in the forefront when it comes to new technologies and procedures. Our physicians trust our staff to undertake new endeavors, which then benefit our other labs. We are on a first-name basis with most of the labs in the area. We will never let competition interfere with patient safety. However, we must always remember that we are in a very competitive environment and we want to retain our market share. Because of the small number of staff in the department, we try to maintain a close relationship with each other. We often spend more time with each other than we do our own families! We’ve all learned to deal with the different personalities and respect each individual. We attempt to have at least one social occasion per month in order for the staff to maintain a good relationship. In addition, by periodically changing our routine, we have been successful in keeping positive attitudes on the job. The addition of new technology and procedures keep staff updated and interested in what they are doing. Please describe one of the more interesting or unusual cases that have come through your EP lab. A “30-ish” registered nurse familiar to the department complained of symptomatic palpitations post partum. An EKG revealed an isthmus atrial flutter.This was ablated successfully utilizing an irrigated tip catheter. Six months later, she began to complain of symptomatic palpitations again. During an EP study, it was found that she had an atrial tachycardia located in the area of the crista terminalis; it was CARTO mapped and successfully ablated. Again, approximately six months later, she again reported symptomatic palpitations. This time, atypical AVNRT was found and a curative ablation was done. In addition to the mentioned arrhythmias, this patient also had a right bundle branch block and a PFO. She has been arrhythmia-free for over approximately two years now. 1,000+ patients in the clinic, the RN provides phone triage for patients after hours and on weekends/holidays. Because of the numerous clinics at three facilities, we increased the call pay to encompass the responsibility. The nurses are on call one week at a time — from Monday to Monday. They rotate call every 4–5 weeks, depending on specific schedules. Only RN are needed for the call teams; our Rad techs do not take call. Staff rarely has to come in for any patient issue. In 2006-2007, we had only to respond four times to needs after hours and on weekends. Does your lab use a third party for reprocessing? No. Approximately what percentage of your ablation procedures are done with cryo? What percentage is done with radiofrequency? Cryo is not utilized in our labs. Radiofrequency is used 100% of the time. What committees, if any, are staff members asked to serve on in your lab? We have recently initiated the Studer principles into our work environment as part of our healthcare system’s “Operation Excellence” goals. Our staff participates in the Outpatient Satisfaction and Ambulatory Patient Satisfaction teams. Do you perform only adult EP procedures or do you also do pediatric cases? We care for patients aged 12 and above. Anyone younger than that is referred to a pediatric cardiac electrophysiologist elsewhere. What procedures do you perform on an outpatient basis? All patients are admitted as outpatients; their status is evaluated post-procedure as to whether they will be discharged same day or be admitted for further observation. How do you handle vendor visits to your department? Do you contract with vendors? Our vendors are aware of the times that are busy in the department and make every attempt not to disturb staff and physicians during those busy times. Appointments for meetings/inservices How does your lab handle call time for staff members? How often is each staff member on call? How frequently do they have to come in, on average? Is there a particular mix of credentials needed for each call team? We have one RN on call for emergencies. We studied the need for emergency procedures after hours, and the occurrence is very rare. However, with Do your nurses/techs participate in the follow up of pacemakers and ICDs? If so, how many device visits per week do they handle? Do you use any particular software for follow up? How many of your ICD/pacemaker patients require a doctor for their visits? Our RNs work in the clinic under

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

Finally! The New Registered Cardiac Electrophysiology Specialist (RCES) Credential: Interview with Christopher M. Nelson, RN, RCIS, FSICP ECG 101: Closing the Gap Phenomenon Contents Letter from the Editor ICD Patient Support Group: St. Peter’s Hospital Spotlight Interview: Community Healthcare System Use of Magnetic Catheter Navigation for Ablation of Focal Tachycardias Echocardiography: The Preeminent Front Line Screening and Diagnostic Tool for Cardiovascular Imaging and Physiological Assessment First Annual EP Lab Digest Salary Survey: Last Chance! Clinical Trial Update: 2007 Email Discussion Group Adopting and Implementing the AF Ablation Consensus Statement Electrophysiology in the West Summit Events Calendar The Sustained Treatment of Paroxysmal Atrial Fibrillation (STOP AF) Clinical Trial: Interview with Kevin Wheelan, MD Industry News and Products

EP Lab Digest - October 2007

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