Cath Lab Digest

We agreed, as we were both part time, and thought the extra cash would be nice. I had expertise with the equipment side, including networked systems and the cath database. Denise knew the supplies and purchasing side inside out. Between the two of us, there was over 20 years of cath lab experience. After working on this project for a couple of months, we began taking ownership, and the thought of turning it over to someone else was not very appetizing. After much discussion, we put together a proposal to job-share the position. Our first proposal was turned down flat, with the reason given that they only wanted one person to manage the cath lab. After another month, they were still having no luck finding a manager, we tried again, going directly to the Medical Director. Our proposal was immediately accepted. We continued to work part-time in the hospital cath lab another three months until June of 2000, when we started job-sharing the management position at HCOR.

Creating a Schedule

During the previous six months, we had gotten the equipment ordered, policies written, staff hired, lists of supplies completed, and visited the site on numerous occasions. We had negotiated our jobs so that I worked two 10-hour shifts a week and Denise three 10-hour shifts. Since we were going to be salaried, we built in an extra 4 hours a week into my position so I could cover Denise’s vacations and other emergent staffing needs. Denise had 2 hours extra a week built in for the same reason. The total hours and cost came to a 1.3 FTE, but because we were also staffing in the cath lab, it decreased other staff needs. We would cover each other and perform the administrative duties with the extra time we got by working the 10-hour days.

HCOR Facilities & Daily Life

HCOR facilities are a joy to work in we have 13 bays, which we use for patient prep and recovery, a small kitchen area, and a procedure room where we perform DSEs, TEEs, and cardioversions. The cath lab is large and has a storeroom. There is also a dictation/viewing room for the physicians. Denise and I have a large built-in desk in the break room, which has worked out, as the staff are usually only in the break room for lunch, during which time we are relieving them. The best part of our break room office is the windows on both sides of our desk, which look out onto the majestic Rocky Mountains.

We do 60-75 angiographic procedures a month, and 15-20 procedures in the procedure room. We staff daily with 2 RNs and one unit assistant in addition to Denise or myself. On most days, the cases are done by 10 A.M. and the patients gone by 3 P.M. at the latest. The last staff member leaves by 3 P.M. or when the last patient is able to leave. If we do more then 4 patients on a day, we have relief people that we can call to help out. The physician’s office is in the same building, so there is always a doctor close by.

Our documentation is paperless, as most of our charting is done on a computer. The few papers we do have to fill out are scanned into the system. We hope to be completely paperless in another year. HCOR is linked by a fiber network to the hospital, and we continue to communicate frequently. Though we work for the joint venture cath lab and are under the physician’s administrative control, we are still employees of the hospital, which bills the joint venture.

Our Job Sharing Preparations & Maintenance

A key point in putting our job-sharing position together was sorting out the expectations of the other person. Denise and I had many discussions about how we would handle various things. One big issue was the schedule.

Scheduling. Though I can see how this could be a major stumbling block in the job sharing situation, for us, it has not been so. We usually do 2-3 months of our schedule at a time, both agreeing that if something comes up, we would be willing to flex. If we schedule appointments on our days off, we try to do it in the afternoons, so if needed we could work the busy times in the mornings. We both realized from the beginning that there would be times when we would both have to attend important meetings. Thus far, we feel being salaried is an advantage in flexing our time for meetings, staff coverage, etc.

Sharing Information. Communication was going to be our biggest issue, as we would see each other infrequently. We solved this by having a filing system where we can track items, such as what has been ordered, leaving notes, and talking on the phone frequently, either during the day, or in the evenings or on weekends. To keep communication going, email is sent to a cath lab manager address that includes both our names. Our system has worked out well, and we have not had any complaints from physicians, staff, or vendors. Knowing there is a potential for problems in this area, we are very diligent about checking our email.

Duties. Each of us continue to have areas where we are taking more responsibility. I do more of the equipment work, such as service contracts, keeping up on the changes and updates, the network and our database, statistical reporting, and QA. Denise has done most of the vendor work, ordering, bill-paying, contracts, and product tracking. In a pinch, we both know enough about what the other does to accomplish what is needed.

At first, for any decisions we would communicate with the other; but now, after two years, we fill in for each other, move forward with decisions, and communicate these decisions to the other.