Lehigh Valley Hospital ranked first in 2008 and second in 2010 in lowest mortality for heart attack care in the U.S., according to U.S. Centers for Medicare and Medicaid Services “Hospital Compare” data (www.hospitalcompare.hhs.gov). The hospital, with an already successful STEMI program, decided to try and lower its door-to-balloon times still further.

Lehigh Valley Health Network is composed of three hospital facilities — two in Allentown and one in Bethlehem, Pennsylvania. Seeking to improve an already well-established ST-elevation myocardial infarction (STEMI) system of care, Lehigh Valley Health Network initiated a real-time feedback process. Our goal was to improve clinical outcomes by reducing door-to-balloon times. We also believed real-time feedback would strengthen our relationship with emergency medical services, and improve the way we support our local STEMI staff and that of our transferring hospitals.

Using proven methods for D2B time reduction

Growth trends over the past decade reveal that many hospitals across the United States have expanded upon their existing services — whether from a diagnostic cardiac center to offering therapeutic cardiac catheterizations or PCI; from general vascular surgery to peripheral and/or endovascular care; from basic electrophysiology (such as device implants) to offering ablative treatments; or even expanding from an established open heart surgery program to offering a less-invasive approach to valve repair.

Through these service advances, many key components must be considered, analyzed and implemented seamlessly, which takes diligent effort and clear focus. But, in most cases, a state regulatory board defines the level of service to which a hospital can advance. Such regulations can delay, or even completely derail, a planned expansion, regardless of its clinical, financial, or strategic merit.

What is the size of your cath lab facility and number of staff members?

Saint Vincent Healthcare, employing approximately 2,300 employees, is a 300-bed faith-based facility, one of twelve hospitals in the Sisters of Charity of Leavenworth Health System.

Our cath lab has three cardiac suites, one interventional radiology suite, and one bi-plane neuro-interventional suite. We have ten registered nurses (RNs), ten radiologic technologists (RTs), an RN manager, and three support personnel. We provide services for two cardiovascular interventionalists, six cardiologists, five interventional radiologists, and one neurosurgeon, who does cerebral diagnostics and interventions.

What procedures are performed at your facility?

Diagnostic angiograms: We do heart caths, renal angiograms, aortograms, runoffs, carotid angiograms, cerebral angiograms, fistulograms, and upper extremities angiograms.

Is the development of hybrid labs a meaningful trend?

Patient need will drive both suite implementation and long-term success. If minimally invasive therapies that combine aspects of cardiovascular surgery, interventional cardiology and most importantly, sophisticated imaging, are helpful in treating patients, then hybrid labs will be here to stay. The entire field is moving towards a convergence between imaging, interventions, and surgery, with the PARTNER (Placement of AoRTic TraNscathetER Valve) trial as one excellent example.

There are some hospitals that may end up installing a hybrid lab just to get on the bandwagon. If they have not figured out exactly how the lab will be used, who is going to use it and for what types of procedures, then in those instances, the room may end up being underutilized.

What has been your experience at Mayo Clinic?