Cardiovascular Business - March/April 2008 - (Page 10) CATH LAB ExPOSé: WHAT IT TAKES TO KEEP PATIENTS, PROFITS, AND REFERRING DOCS IN TODAy’S CHANGING LANDSCAPE spatial Considerations: A Cardiac Lab requires about 500 square feet as does a combination cardiac/endovascular suite. A third model, the Surgical Lab, requires about 700 square feet to accomodate anesthesia and other additional equipment. Efficiency is the operative word for all cath labs. Best practices dictate a comprehensive approach. Take Washington Hospital Center. Intravascular ultrasound (IVUS) is in high demand during cath procedures. Rather than sharing systems between rooms and asking physicians to wait, the hospital provides a flexible approach to supporting physicians that require the use of IVUS. This includes dedicated, fixed IVUS units in many of the labs as well as portable ones. Senior technologists are trained in multiple procedures (including use of IVUS technology) to provide staffing flexibility and efficiency as the case load and procedure type fluctuate. Reporting is streamlined and user-friendly, too. Technologists begin data input as patients arrive, and physicians can complete the case via either voice recognition software or a clinical documentation system. Conventional dictation remains an option for the physicians who prefer that model. Staying ahead in the cath lab business is a challenge, but not an insurmountable one. Smart labs can turn a profit even during tough time. It requires multiple strateWilliam Beaumont Hospital Cath Lab Statistics gies fine-tuned to the particular needs of the local marketplace. Common themes Coronary/Peripheral include hybrid labs and a strong focus Year Average Age Patient Volume Diagnostic Volume Intervention Volume on clinical quality. Staff retention and 2002 65.18 10748 5797 5505 physician satisfaction are essential, too. 2003 65.50 10509 5166 5909 Cross train and reward staff, and assess 2004 65.35 9387 4745 5442 physicians’ needs to keep them satisfied. 2005 65.47 11879 4670 5830 Think workflow, efficiency and sim2006 66.45 11572 3951 6388 plicity. Don’t forget about cutting costs. Consider buying collaboratively with 2007 66.72 10668 3814 5775 another department and an RFID inAt the William Beaumont Hospital cath labs, the average patient age has increased from 2002 to 2007, ventory management tool to better track while the number of diagnostic caths has decreased. The number of patients and interventions (coronary stock and prevent loss. and peripheral) have fluctuated, with both experiencing a decrease from 2006 to 2007. chases include a system’s ability to help the lab leverage patient data for effective and efficient workflow and clinical improvements. Beaumont Hospital, for example, aims to deploy new software to facilitate data collection, structured reporting and outcomes research. The new software will be integrated with Epic Systems Corporation EpicCare EMR; the project will enable physicians completing procedures in the cath lab to view data from all imaging modalities on the same platform. That is, a cardiologist can view CT, MR, echo and cardiac cath data concurrently. In addition, techs will input data into the report during the procedure with physicians adding information after the procedure. Patient reports will be faxed to the referring physician, and specialty areas like nursing and inventory management will receive relevant reports and data following each cath procedure. “The new software will increase throughput and reduce errors,” predicts Hollingsworth. That’s because the software can be configured to leave a case open until the tech populates all variables necessary for regulatory compliance. And the system can be integrated to American College of Cardiology (ACC), American Heart Association (AHA) and Centers for Medicare & Medicaid Services (CMS) databases to streamline reporting processes. Florida Hospital also turns to software to trim costs. “Lumedx Apollo ClinDoc system is our best tool,” shares Sandler. The software puts a variety of information at users’ fingertips, tracking outcomes, utilization and case length. “We need to know if we’re using 1.6 rather than 1.5 stents per case because we aren’t reimbursed for each stent,” states Sandler. The next step is a pilot of WaveMark CIMS RFID tracking system. The goal, says Sandler, is to better match inventory to caseload. Sandler hopes to integrate the RFID and clinical documentation systems to gains efficiencies. Chasing efficiency 10 Cardiovascular Business March/April 2008
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