Cardiovascular Business - March/April 2008 - (Page 8) CATH LAB ExPOSé: WHAT IT TAKES TO KEEP PATIENTS, PROFITS, AND REFERRING DOCS IN TODAy’S CHANGING LANDSCAPE Victoria Hollingsworth, administrative director of heart and vascular services at Beaumont Hospital, says the hybrid cath lab model provides a number of advantages over the traditional single lab model including flexibility, scalability, and improved patient care. equipment. Finally, the multipurpose cameras and related software cost more than their single function counterparts. Florida Hospital strives for balance; two of its cardiac labs are equipped for peripheral vascular procedures, and one lab is a dedicated vascular center. The remaining three labs are dedicated to cardiac procedures. The vascular center is outfitted with a 16-inch image intensifier to accommodate vascular procedures and a wider array of stents, grafts and coils than cardiac cath peers. Still, Hollingsworth says hybrid labs are the wave of the future. “Don’t box yourself in. If current volume is 500 cardiac and 500 vascular procedures annually, don’t build two dedicated rooms. Outfit one or two combination labs.” crease in cath lab volume in the last three years. The main campus houses seven cardiac cath labs and four electrophysiology labs equipped with a variety of GE Healthcare Innova x-ray imaging systems, and the vascular center uses Siemens Medical Solutions Axiom Artis. Sandler attributes the decline to multiple factors. “Better living through chemicals is keeping patients out of the cath lab. Patients are benefiting from statins, drug-eluting stents and healthier lifestyles. Plus, physicians who previously turned to the cath lab as the first intervention are opting for other first-line treatments.” The final insult? Every cardiology practice in the area has opened an outpatient cath lab, which carries a double whammy. Competition for patients is intense, and patients referred to Florida Hospital tend to be sicker, translating into longer hospital stays, more stents per procedures and Handling the competition longer case times. “All of these factors cut into our profit marCompetition is growing increasingly fierce in the cath lab market. gin,” states Sandler. Private practices are offering everything from echocardiography Florida Hospital has adopted a multi-pronged approach to the and noninvasive testing to cardiac CT and MR. In many locations, competitive challenges. It maintains a strong focus on the patient the stage is set for turf wars over patients, referring docs and staff. and physician experience, striving to ensure efficient case flow to Unfortunately, there is no magic bullet to cure competitive woes. optimize physician time. For example, the hospital tries to arrange The answers include both continued investments in clinical and the schedule so each physician’s procedures are back to back, even IT resources and slow but essential relationship-building. with add-on cases. Another focus is reducing room turnaround Florida Hospital operates one of the largest cardiology protime; Lumedx Apollo Advance ClinDoc provides time-saving grams in the country, yet the mega-enterprise admits to a detemplates to minimize dictation and support real-time reporting. “If we’re wasting physicians’ time, we’re costing them money,” says › treating Cardiac Disease on south long island Sandler. Cost containment is another arrow South Nassau Communities Hospital recently opened in the quiver. The cath lab keeps a lid on costs a $17 million Center for Cardiovascular Health. The by partnering with interventional radiology; center is the cornerstone of South Nassau’s cardiac the specialties achieve economies of scale as care initiative to meet the pressing need for advanced, they negotiate with vendors to stock stents, interventional cardiology services in Nassau County. grafts and coils. Florida Hospital also uses The 21,000 square-foot center includes two statethe data from ClinDoc to drive a marketing of-the-art digital cardiac catheterization rooms, 18 program that focuses on quality rather than dedicated preparation/recovery spaces, decentralized specific physicians, sharing data like its subnursing stations, doctor’s offices, examination rooms, 90 minutes door-to-balloon time with the family waiting areas and conference rooms. area patients and physicians. > Jason Freeman, MD, Director of Interventional Cardiology Similarly, Beaumont Hospital faces mounting competitive pressure. This year, Cardiovascular Business March/April 2008
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