Cath Lab Operational Efficiencies: Expert Advice

Getting After Cost Efficiency Opportunities

Terumo Business Edge reached out to a recent customer who had requested our services. Below, we talk to Vico Marziale, Director of the Cardiology Service Line at Ochsner Medical Center.  Vico describes what we believe are fairly typical challenges for today’s cardiology programs and how Terumo Business Edge was able to help him regarding process improvement plans that were under consideration. Today’s programs face a myriad of challenges that can be better understood, and the options for addressing those challenges, once they are quantified and qualified. Please consider reading how Vico describes the benefits he gained from Terumo Business Edge.

—  Gary Clifton, Vice President, Terumo Business Edge

What is your role at Ochsner?    

I am the Director of the Cardiology Service Line, Cath Lab/Electrophysiology (EP) Lab. I have operational, financial and quality oversight of the Ochsner Main Campus Cath Labs and EP labs. In addition, I have a consultative/coordination relationship with all eight Ochsner facilities that offer interventional cardiology services.

Tell us about your facility and cath lab.

At OMC, we have six cath labs that perform vascular and structural heart procedures, which includes transcatheter aortic valve replacement (TAVR), left atrial appendage occlusion (LAAO), mitral valve repair and pediatric congenital heart procedures. The cath labs provide care for approximately 5,000 patients per year. In the cath labs, we support 17 physicians that specialize in coronary and vascular interventions, including coronary and peripheral chronic total occlusions (CTO), brachytherapy, heart failure, and pediatrics. In addition, we have 4 dedicated EP labs that perform cardiac rhythm management (CRM) device implants, ablations, and lead extractions. The EP labs have 6 adult electrophysiologists and two pediatric electrophysiologists. The EP labs provide services for approximately 3,000 patients per year.

What is your strategy for handling the growing cost pressures on the cath lab?

Cost containment is a constant battle in healthcare and especially in high cost procedural areas. The focus tends to be on supply cost and labor. We do focus on both of those, but we also look at process improvements such as same-day discharge (SDD), radial access utilization, lab efficiencies (first case start times/room turnover time) and variation in procedure cost per providers, as well as maximizing our revenue by improving documentation, coding and our procedure authorization processes.

What led you to bring in Terumo Business Edge?

After considering our areas offering opportunities for improvement, we established action plans and goals for improvement. When Terumo Business Edge came into the picture offering their services to evaluate our current processes and offer feedback on our process improvement plans, the timing was perfect. We were already deep into looking at our data on radial access utilization and SDD, as well as cath lab operational opportunities. Having a fresh, outside perspective had incredible value when performing an assessment. The Terumo Business Edge team has seen and lived these processes many times from around the entire country and bring with them a diverse perspective.

Can you share your experience with the assessment?

After meeting the Terumo Business Edge evaluation team, I quickly learned the depth and breadth of their knowledge and experience. This gave me immediate confidence that this team would be able to deliver accurate and actionable data for me to work with. They were able to validate our best practices and show us where opportunity for improvement existed. The whole process took two days and they were not disruptive to the lab, which was important to me. They truly understood the world I live in.   

Did you find value in the assessment? How do you plan to use the findings at the hospital?

Once we received the final report, I reviewed it with my team and focused on strategies that would give us some quick wins while we continued to work on some of the more long-term strategies. One of the quick wins was to move some of our non value-added processes that were taking place in the cath and EP labs to the preop area. This allowed for us to increase our available lab time to accommodate more procedures and/or reduce labor hours and overtime.

Any final thoughts?

I would highly recommend that anyone looking for ways to improve operational efficiencies and initiatives to improve the bottom line, as well as opportunities to improve quality, should engage the Terumo Business Edge team. The wealth of knowledge and experience is extremely valuable, and they are a great team to work with.