Cath Lab Team Building @ RMH

In part one of our profile of Sentara Rockingham Memorial Hospital's cardiac team, we discussed how team members stepped up to to continue activating STEMI from the field and reduce the rate of false calls by educating local EMS. In this post, we'll look at Sentara RMH as an example of excellent cath lab team building from a management perspective.

How do you go about cath lab team building? You could start by getting the team out of the lab, as cardiac operations manager Linwood Williams argues.

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Working in the Cath Lab Causes Heart Disease

Radiation Safety (Still) Matters

In February, ACVP blog reported on a survey that showed non-physician Cath Lab employees, ACVP members, reporting higher levels of musculoskeletal pain due to radiation exposure and lead apron use.

In April, SCAI released a membership survey with almost 50 percent of responders reporting orthopedic injuries, and there has been "no discernible improvement" since a similar survey was collected in 2004.

There's more bad news. A new study published this week links radiation in the Cath Lab to subclinical atherosclerosis. That's right, working in the Cath Lab can cause cardiovascular disease.

The study calculated a radiological risk score based on proximity to radiation source, caseload, and the length of employment, and there was a significant correlation between this measure and carotid intima-media thickness on the left side, not on the right, which provides "further support for a causal connection."

What's being done?

Continue reading Working in the Cath Lab Causes Heart Disease

One simple procedural change reduces mortality in the cath lab

An international study published mid-March in the Lancet showed that using the wrist as an access point for heart catheterization reduced bleeding and lowered mortality rates as opposed to using the groin as an access point.

While previous studies have demonstrated that wrist access reduces incidents of bleeding, this is the first to demonstrate the connection with incidents of mortality.

The change lowers mortality at no additional cost beyond necessary additional training and expertise---insertion through the wrist is more technically demanding than insertion through the groin, as the artery is smaller.

Special Report (4): Robotics improve efficiency and reduce radiation exposure

In 2011, the Society of Cardiovascular Angiography and Interventions published new guidelines for a Radiation Safety Program for the Cardiac Catheterization Laboratory.

With regards to procedures, they recommended limiting exposure duration, reducing dosage, limiting high-dose high contrast use, reducing magnification, and increasing distance from the x-ray beam to name a few.

Mayo Clinic reduced doses by 40 percent over a 3-year period in a case study released in 2012, where researchers noted that "the physician's expectations [had to] change from a desire for excellent image quality to a desire for low radiation dose and acceptance of clinically adequate image quality."

Technology itself might not be able to change culture, but it can significantly improve many relevant factors, as demonstrated by trials and testimonials of Corindus's CorPath system.

Continue reading Special Report (4): Robotics improve efficiency and reduce radiation exposure