What it takes to keep patients, profits, and referring docs in today’s changing landscape
Cardiac cath labs operate in an increasingly challenging environment, contending with a variety of clinical, demographic, regulatory and competitive factors. Patients are growing older, leading to more comorbidities, and, at the same time, new hospitals and private practices are diving into the cath lab market, which can make it more difficult to maintain patient volume and referring physician relationships.
Despite the challenges, cath labs across the country are surviving, and in some cases, thriving. Many are fine-tuning their business to stay ahead of the game. Others are re-inventing themselves, turning to technology and new business models to deliver profitability.
Some secrets to success include collaboration (think shared, multi-discipline labs) and old-fashioned common sense. In other words, offer high-quality service and build and maintain relationships with key players—referring physicians and staff.
Read on to learn more about how a few labs are making it work in the current environment.
The single-discipline cardiac cath lab may soon be extinct. The advent of multipurpose imaging equipment able to accommodate peripheral vascular procedures has led to a new paradigm. Beaumont Hospital (Royal Oak, Mich.) sits on the leading edge of the hybrid model. The hospital has embraced the multipurpose heart and vascular concept in its cardiac cath labs, which are equipped with Siemens Medical Solutions Axiom Artis and Philips Healthcare Allura Xper FD 20 imaging systems and handle cardiac cath, peripheral vascular and neuro-
The shared lab provides a number of advantages over the traditional single lab model, says Victoria Hollingsworth, administrative director of heart and vascular services. The concept offers flexibility and scalability and facilitates improved patient care. Although one specialty like interventional radiology may be the primary user of a given room, each lab can handle vascular surgery or cardiac cath procedures. As volume among the various specialties ebbs and flows, procedures can be shunted to other suites, enabling the hospital to maximize real estate, equipment and staff. In addition, patients don’t need to be moved if they require both cardiac and vascular procedures or if a cardiac event occurs during a neuroradiology procedure; however, only one room meets OR specification for vascular surgery.
Washington Hospital Center (Washington, DC) also uses the multipurpose approach. The center’s 11 labs are outfitted with Philips Healthcare Allura Xper FD 10 and FD 20 imaging equipment. Most systems are the FD 20, a larger field of view system sized to accommodate peripheral vascular work. The cath labs offer comprehensive services including stents, peripheral vascular procedures, brachytherapy, patent foramen ovale (PFO) and atrial septal defect (ASD) closure and percutaneous valve replacement. The primary advantage of the hybrid approach, says Vice President of Heart and Vascular Services Elizabeth Wykpisz, is flexibility. Patients and physicians can stay in a single room for multiple types of procedures. In fact, the hybrid model contributes to Washington Hospital Center’s highly efficient patient throughput, with the labs completing an average of 50 cases daily and effectively handling up to 80 cases a day.
Peripheral pros (and cons)
Many cath labs are open for peripheral vascular business as well as conventional cardiac cath procedures. The rationale for accommodating peripheral vascular procedures is clear. It offers an additional business line and can help sites maximize their investments.
What does it take to accommodate peripheral procedures? The key differences are the competency of the staff, imaging equipment and supplies such as stents, lasers and software applications. Peripheral rooms require a larger field of view x-ray system and different stents and grafts than traditional cardiac cath rooms. Due to the complex supply management associated with peripheral vascular procedures and the different types of procedures (i.e. carotid, renal), a dedicated inventory area is available at Washington Hospital Center.
It is important to remember, however, that there are downsides to the combination approach. A multipurpose lab requires a larger camera, which can get bulky especially during pediatric and cardiac procedures, says Joel Sandler, administrative director