by
Lauren Dubinsky, Senior Reporter | March 02, 2015
From the March 2015 issue of HealthCare Business News magazine
Fluoroscopy, for example, has always been a challenge in the cath lab because of the radiation dose it exposes patients to. “We’re constantly looking for ways to minimize radiation exposure for the patient and for the lab staff, and for the attending physician who is doing the cases,” says Atwater.
To solve that, Duke University Hospital started using non-fluoroscopy 3-D cardiac mapping systems developed by Biosense Webster, St. Jude Medical, and Boston Scientific. Since then, the hospital has seen a dramatic reduction in fluoroscopy exposure and fluoroscopy related complications.
In addition, interventional cardiologists must now have a good understanding of valve disease, cardiac anatomy and physiology and imaging. They are no longer just angioplasty specialists, although it’s still an important bread-and-butter skill.
“The integration of imaging in the cath lab and in the OR is crucial and unless you have trained in it, that is probably one of the biggest limitations,” says Singh. Cardiologists must learn CT, MR, echocardiography, 3-D reconstructions and also holographic imaging to perform better procedures in the cath lab, he added.
Providing that top quality of care
Not every hospital can afford a state-of-theart cath lab or operating room, but there are still ways they can provide top-quality care. “I think it’s fair to say that whether it’s surgery or interventional cardiology, there is a movement to really create these centers of excellence in each specific niche within a specialty,” says Singh. He recommends that instead of trying to do everything that is new and upcoming, hospitals should focus on creating one type of program first and work on the infrastructure.
But these structural procedures are resource intensive and the hospitals need support from the administration, nursing staff, radiology department and surgeons to have a successful program. Cleveland Clinic has an affiliates program that provides consulting services to other hospitals to help them develop their clinical services, including nursing workflows and quality and safety measurements.
Cleveland Clinic produces a recommendations report for all of the hospitals it works with in order to help them improve their cardiovascular program. At the hospitals’ request, Cleveland Clinic can also help them implement the recommendations. “The idea is that we go out to these hospitals, we evaluate their programs, we give them very constructive feedback about their processes and workflow, and safety measures and quality initiatives, and we help them to get better,” says Cantillon.
