Cath Lab Digest

We have established a fund in the hospital foundation that we use primarily for education. As in most hospitals, the education budgets have been eliminated and the fund allows for us to have some dedicated money. This money may be tax-deductible donations from the staff, physicians or philanthropists. Some money is brought in by surveys completed by staff that is deposited into this fund. Most recently, we have brought in speakers to help prepare staff to sit for the registered cardiovascular invasive specialist (RCIS) exam and for continuing education points in early January. This was actually supported by our physician group (Ferrel Duncan Clinic), which graciously donated money to our Foundation Fund. This money helps send staff to conferences and helps with any expenses associated with education.

How do you handle vendor visits to your lab?

Vendors are allowed to visit monthly, with scheduled visits. They must adhere to our hospital policy guiding vendor access, which requires registration with our purchasing department.

How is staff competency evaluated?

Staff has an annual evaluation and competency is evaluated at that point in time.  Evaluations are performed by the director of the cath lab. Recertification of core compentencies is completed annually.

Does your lab have a clinical ladder?

Our nursing co-workers can be recognized by participating in our STAR clinical ladder. It rewards nursing staff for participation in areas of education and research, community involvement, clinical excellence, and nursing leadership. Our radiologic technologists also have a clinical ladder that operates in a very similar way.

Within what time period are call team members expected to arrive to the lab after being paged?

We have a dedicated night crew four nights during the week that assist with emergent cases, in addition to performing stocking, clerical, and data collection duties. Additionally, we recently implemented a weekend team to provide cath lab coverage during daytime hours on Saturdays and Sundays, working 12-hour shifts. A back-up call team is available during off-weekend hours and nights for cases of concurrent emergency procedures.

Do you have flextime or multiple shifts?

Yes, we have team members who work 8-hour, 10-hour, and 12-hour shifts, starting at multiple times to help with better utilization of work time.

Has your lab recently undergone a national accrediting agency inspection?

Over the last 12 months, we have been surveyed by the Joint Commission, as well as state and federal health agencies.  

Where is your cath lab located in relation to the operating room (OR) and ED?

Our cath lab suite is located on the fourth floor of the main tower on our campus. The operating suite is located on the lower level of the same building, accessible from the cath lab by an adjacent bank of patient care-only elevators.

In October of 2010, we opened a new, state-of-the art emergency department, attached to the south side of our main building. The ED is on the lower level and connects to the main building on that level, as well as via a patient-only-hallway on the second floor.  

What trends have you seen in your procedures and/or patient population? 

Over the past four years, all procedure volume has shown a net 20% increase, with electrophysiology and ICD procedures leading growth.  

What is unique or innovative about your cath lab and staff?   

Having a night team and weekend option team helps set us apart. This is beneficial for many reasons. There is no delay caused by waiting for the call team to arrive for acute patients. Stocking and cleaning of the procedure rooms can be completed much more easily and consistently, without accruing overtime. The call burden has been reduced dramatically. Even though staff still takes what we call “back-up call,” the odds of being called in are very minimal. The most important point is the safety aspect it brings. In the past, we have expected our staff to be fully competent immediately after working a full day shift, and being called into the hospital in the middle of the night, sometimes multiple times. Yes, our staff is very competent, but the biggest chance of making a mistake is while being sleep deprived. By rearranging our duties (ACC registry data collection, etc.) to these off hours, it can be done effectively and still be within productivity standards.

Is there a problem or challenge your lab has faced?

Call once was the biggest problem, but has been resolved with the night and weekend option teams. Communication is and probably will always be an ongoing challenge.   

What’s special about your city or general regional area in comparison to the rest of the U.S.?  How does it affect your “cath lab culture”?