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

South Carolina Heart Center is a freestanding outpatient facility, privately owned by our physician partners. We have 24 cardiologists; six are interventionalists. South Carolina Heart Center has 3 cath labs, one of which is a dual lab for both peripheral and cardiac procedures. We have 15 private and family-friendly patient rooms where pre and post procedures occur. We employ 11 full-time staff and 3 part-time staff: 2 full-time registered nurses (RNs), 2 medical assistants, 4 cardiovascular technologists (CVTs), 3 part-time RNs, and 1 administrative assistant. Years of service range from 1 to 14 years, with 8 years being the average time spent working in the cath lab.
Our facility also houses a 64-slice CT scanner, nuclear medicine department, clinical research, as well as a clinical area for physician office visits.

What types of procedures are performed at your facility?

Abstract:

9:30 am. September 1st, a day I will never forget. It was Labor Day. It started as a very windy day with a lot of cloud cover. The sun was nowhere to be seen.

I had just started my rounds. Standing next to a patient in the ICU, I called Jason, our cath lab director. I was apprehensive, having just seen the news on television that Hurricane Gustav (Figure 1) was about to make landfall. My patient was a 41-year-old male with ongoing chest pain and ST-segment elevations in lateral leads just admitted to the ICU. After Jason answered the phone, I explained to him the need to open the cath lab before the hurricane. Most of the cath lab crew lives within 30 minutes of the hospital. I was confident that we could do the PCI and have just enough time to get the crew back home before the hurricane hit. Jason agreed, so we sent the call out.

Utilization of laser ablation and intragraft glycoprotein IIb/IIIa inhibitors via ClearWay therapeutic infusion catheter to improve procedural safety

We describe a complex thrombotic saphenous vein graft (SVG) percutaneous coronary intervention (PCI) case resolved with the aid of laser atherectomy and ClearWay™ (Atrium Medical Corporation, Hudson, NH) local abciximab delivery.

LUMEN takes place February 26-28, 2009, at the Loews Hotel in Miami Beach, Florida. More information is available online at www.LumenAMI.com

Cath Lab Digest talks with meeting director Sameer Mehta, MD, FACC, and LUMEN’s four co-directors, each managing a crucial topic: Emergency Medicine, Door-to-Balloon Processes, Interventional Cardiology and Cardiovascular Nursing.

Director, LUMEN:
Sameer Mehta, MD, FACC

Why have a meeting focusing solely on STEMI interventions?

Managed care has heightened health care professionals’ awareness of the need to provide cost-effective care without compromising quality, a goal that is typically accomplished by providing evidence-based best practice(s). Management of the arterial access site represents a fundamental component of every procedure performed in the cath lab, and has substantial cost and patient care implications. In most laboratories, the two predominant methods to attain hemostasis following femoral artery sheath removal are 1) application of direct manual pressure, or 2) use of a mechanical closure device. These competing techniques involve a variety of potential tradeoffs related to cost, safety, patient comfort, resource utilization and patient flow through the laboratory (Table 1), and their relative use varies among cath labs.

Multi-Device Strategies Using Guide Catheters, Distal Vascular Protection Devices and Aspiration Catheters

ABSTRACT: Resurrection Medical Center implemented an initiative to address patients presenting with an ST-elevation myocardial infarction (STEMI). This facility followed their performance improvement process using evidence-based strategies in order to comply with standards set by accrediting bodies. Quality improvement staff nurses take an active role in this practice. Because of this quality initiative, there has been a positive effect on the quality of care on this specific patient population.

Quality Today

Quality initiatives are a hot topic in today’s healthcare arena. Healthcare consumers now can pick and choose where they receive healthcare services. Consumers want and expect the best treatment and care when they walk into a healthcare facility. Yet patients do not always receive the best in quality.1 Because of consumers’ interest in excellence and compliance with quality indicators, healthcare facilities are looking to improve their quality scores.

Sameer Mehta, MD, FACC, MBA, is studying ST-elevation myocardial infarction interventions in his work with short door-to-balloon time primary PCI and the Single INdividual Community Experience REgistry for Primary PCI (SINCERE) database at 5 community hospitals in Miami, Florida, now over 365 patients. A past chief of interventional cardiology and director of the cardiovascular laboratory at Cedars Medical Center in Miami, as well as former President of the American Heart Association (Miami Dade Division), Dr. Mehta is a Voluntary Associate Clinical Professor of Medicine at the University of Miami-School of Medicine. Dr. Mehta is also president of the Indo-American Society of Interventional Cardiologists (ISIC) and a course director for LUMEN 2009: The Symposium on Optimal Treatments for Acute MI (www.lumenAMI.com). He has recently published the Textbook of STEMI Interventions (available through HMP Communications at http://www. stemiinterventions.com).

This monthly column in Cath Lab Digest reviews important points of distinction in drug-eluting stents, from characteristics to techniques, to provide valuable and relevant information about this technology.