Susquehanna Heart Center

Susquehanna Heart Center
Susquehanna Heart Center
Susquehanna Heart Center
Susquehanna Heart Center
Susquehanna Heart Center

David R. Rothrock, BS, RCIS

Williamsport is located in a relatively rural area in north central Pennsylvania and therefore, geographically, competition is limited. The closest full-service adult lab is located approximately 45 minutes away. We differentiate ourselves from other healthcare providers by exceeding our customers’ expectations and following our system’s simple creed: Courtesy, Attentiveness, Responsiveness, and Empathy (CARE).

Susquehanna Health System was formed in 1994 with the alliance of three hospitals. The alliance was created to contain costs and to limit duplication of services across the region. It is important to understand that this was (and is) a voluntary alliance and not a merger. We agreed to function as one institution, but still exist separately. Because of our success as an alliance, we frequently entertain interviews and visits from other hospitals from across the country. Our stated mission is to improve the health status of the communities we serve through high-quality, compassionate, accessible and cost-effective care.

How are new employees oriented and trained at your facility? What licensure is required for all professionals who work in your lab?

The orientation plan is individualized to meet new employees’ educational needs. New employees hired without prior experience receive an intensive, full-time, 3-6 month orientation. Each orientee is paired with an experienced team member who precepts them clinically, provides didactic material, mentors them in system/ departmental expectations and is available for questions. These employees document their procedures and accomplishments, and are given daily feedback on their performance, both verbally and in writing. Frequent meetings occur with the orientee, preceptor and Cardiovascular Service Line educator to review progress and address outstanding items. The cath lab management team participates in these meetings as needed. Experienced new employees have a similar but accelerated orientation. All nurses are required to have a valid license in the state of Pennsylvania. The Cardiovascular Technologists are required to have successfully passed the RCIS certification. The RNs are also required to pass the RCIS certification within three years of hire. All clinical staff is BLS- and ACLS-certified.

What types of continuing education opportunities are provided to staff?

There are multiple opportunities for education, and the staff has not found it difficult to obtain enough educational hours to meet the requirements for a RCIS or RN. Within the lab, there is a monthly education hour. This is supplemented periodically by vendor inservices for new devices or drugs. System-wide education also occurs for global topics affecting all staff. On a rotating basis, two of the clinical staff have the opportunity to attend the TCT (Transcatheter Cardiovascular Therapeutics) meeting in September/October. Multiple staff members have also attended the Cath Lab Digest Regional Seminars when they are held in Philadelphia.

How do you handle vendor visits?

System policy specifies that vendor/drug representatives check in with Purchasing before entering the department. In addition, they are required to schedule an appointment with the cath lab manager and present at the schedule office upon arrival. New representatives are required to have a Life Safety orientation to the lab, as well as HIPAA education/review. Vendors have signed Business Partner HIPAA contracts with the Health System. They are required wear to a badge with their name and company and are restricted to the office area, unless providing staff and/or physician education.

How is staff competency evaluated?

The Cardiovascular Services Educator coordinates annual competency for high-risk or low-volume procedures. He/she uses various techniques for the assessment, such as individual demonstration of the skill, self-learning packets, group discussions and written tests. The cardiologists and cath lab leadership team also observe staff daily to assess their individual skills.

Does your lab utilize any alternative therapies?

At present, we are not utilizing any alternative therapy in the cath lab.

How does your lab handle call time for staff members? Is there a particular mix of credentials needed for each call team? Do you have flextime or multiple shifts?

All clinical staff is required to take call on a rotating basis. One of the staff RN currently is responsible for building the call schedule. She has been able to coordinate everyone’s needs into a workable schedule. Currently call time is usually broken into 2 or 3-day increments and ends when staff arrives for scheduled or unscheduled cases. We have four people on call at all times, typically two RNs and two RCISs. There are multiple staggered start times, with the non-call staff arriving at 07:00 or 07:30 and the call staff between 08:00 and 10:00.

What trends do you see emerging in the practice of invasive cardiology?

Catheter-based interventional devices will continue to improve. This will lead to an increase in the number and complexity of interventional procedures. The age and acuity of patients will also continue to increase. There will be economic pressure from CMS and insurance companies to control cost and decrease the average length of stay. It is likely that one of the emerging modalities in either MRI or CT scan will replace at least a portion of the diagnostic cases. This will be more than offset by the increase in interventional cases.

Has your lab undergone a JCAHO inspection in the past three years?

Our hospital and Health System has been accredited by JCAHO for many years. We were inspected in 2001 and 2004, and received a 3-year accreditation status. The cath lab passed without any deficiencies both times.

Where is your cath lab located in relation to the OR department, ER, & radiology departments?

The cath labs are located directly between our medical ICU and the Cardiovascular Surgical Unit (CVSU). The OR is at the end of the hallway. The ER is located three floors below, with Radiology one floor above the ER. The heliport is on the roof, two floors above. We believe that we have an ideal central location.

Please share with readers what you consider unique or innovative about your cath lab and its staff.

The entire staff is one big family. We will do anything for each other, including covering shifts and call. We joke and poke fun with each other like brothers and sisters, but we have a lot of fun doing it and the time passes quickly. Our patients sense the familiarity of staff and comment frequently about it.

Is there a problem or challenge your lab has faced? How was it addressed?

Maintaining full staffing is an ongoing challenge; the demands of on-call responsibilities are significant with a small staff. This is compounded by the employment opportunities outside the cath lab for RNs and the local and national shortage of Cardiovascular Technologists and RNs. Educational support for two of our Cardiovascular Technologists is an example of a tool used to retain valuable staff members. It also reflects one of many staff retention and recruitment initiatives that contributed to Susquehanna Health System’s designation as an Employer of Choice in March 2005. This prestigious honor is presented only to organizations dedicated to a higher level of employee relations that results in increased employee satisfaction and workforce stability. Only one percent of hospitals in the nation operate at the level required for this designation. SHS was honored because 92.5% of employees surveyed find that patient care services are never postponed due to insufficient staffing. For this same question, the average of the six other hospitals and Health Systems that are designated as an Employer of Choice scored 68.3%, while all other healthcare organizations average only 58.6%. Numbers such as this signify the emphasis SHS employees place on patient care.

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?

Williamsport is located in the Susquehanna Valley on the bank of the Susquehanna River in north central Pennsylvania. It is beautiful country, with many wonderful opportunities for outdoor sports and recreation. The nine-county referral area that we serve consists of mostly farms, woodland and scattered small towns. In many of our referral counties, white tail deer outnumber the residents! Williamsport is by far the largest city within 50 miles. Each summer, Williamsport reaches the international news media as the site and home of Little League Baseball World Series. During the two weeks of the Series, the population in our area triples.


Do you require your clinical staff members to take the registry exam for Registered Cardiovascular Invasive Specialist (RCIS)? Does staff receive an incentive bonus or raise upon passing the exam?

The cardiovascular technologists are required to pass the RCIS examination before they are hired. The RN clinical staff is required to pass the test within three years of employment in the lab. Currently there is no monetary inventive in place to pass the exam.

Are your clinical and/or managerial team members involved with any professional organizations that support the invasive cardiology service line, such as the SICP, ACVP, or regional organizations?

The manager is a SICP fellow and the RN Resource Clinician is a member of SICP and ACVP.

David Rothrock can be contacted at [email protected]

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