What is the size of your EP lab facility and number of staff members? What is the mix of credentials at your lab?
This is a 230-bed facility. We have one EP lab with a staff of three: two RN, BSNs, and our manager is an RT(R), CV, RCIS.

When was the EP lab started at your institution?
Our EP program started in 1989.

What types of procedures are performed at your facility?
Procedures include diagnostic EPs, ablations, pacers and ICDs, Bi-V devices, Reveal ® (Medtronic, Inc.) implants, tilt studies, 3D cardiac mapping, and Wolf mini-maze; the staff also assists with these procedures in the OR.

Approximately how many are performed each week? What complications do you find during these procedures?
We perform 35 procedures a week. We have very few complications.

Who manages your EP lab?
Alan Saye, RT(R), CV, RCIS is the EP Lab Manager.

Is the EP lab separate from the cath lab? Are employees cross-trained?
For the most part, yes. The staff in the EP lab are full-time EP, but on occasion, work in the cath lab. There are several nurses that will rotate through the EP lab from the cath lab on the occasion when EP lab staff are out. Yes, employees are cross-trained.

Do you have cross training inside the EP lab? What are the regulations in your state?
Yes, all staff can do each other s jobs. There are no state regulations.

What are some of the new equipment, devices, and products introduced at your lab lately? How has this changed the way you perform those procedures?
New products include 8 mm ablation catheters and CARTO (Biosense Webster, Inc., a Johnson & Johnson company) 3D mapping. This reduces time of ablation procedures. Also, Alan created a new implant drape sheet that is now being manufactured by Microtek, and he helped design a coronary sinus access catheter now being marketed by Bard.

Who handles your procedure scheduling? Do you use a particular software? How do you handle physician timeliness?
Procedure scheduling is handled by a mix between Central Scheduling and the Lab Manager. The software used is hospital-based MEDITECH.
Physician timeliness is not a problem. The physicians make themselves available within 10 minutes until case-ready page.

How is inventory managed at your EP lab? Who handles the purchasing of equipment and supplies?
We have one central supply person, Susan Lovell, who is responsible for keeping our supplies reordered and stocked, and assists with billing and tracking of implanted devices and leads. Special orders are handled by the EP manager.

Has your EP lab recently expanded in size and patient volume, or will it be in the near future?
Patient levels have been stable for several years. We are expecting patient load to steadily increase over the next few years.

How has managed care affected your EP lab and the care it provides patients?
There is no change in patient care, as patient safety and care are a major priority.

What measures has your EP lab implemented in order to cut or contain costs?
Waste is kept to a minimum through routines set up by the manager that emphasize waste reduction. The contents of pre-made trays was recently assessed and excess items removed.
The hospital has an active administration team, SMAT, which analyzes cost as a group and decides on cost-saving matters throughout the hospital. The EP Lab Manager is a part of this team. This team has been extremely successful at saving money and cutting costs.

How are new employees oriented and trained at your facility?
A 90-day training program is implemented when a new staff member arrives.

What types of continuing education opportunities are provided to staff members?
Annual Heart Rhythm Society (formerly NASPE) trips and monthly continuing education opportunities are supplied by the hospital.

How is staff competency evaluated?
A physical and written annual competency is given to the staff.

How does your lab handle call time for staff members?
No call is expected of the staff.

Does your lab use a third party for reprocessing?
No; due to large bulk purchases we are able to save money and time over reprocessing.

Approximately what percentage of your ablation procedures are done with cryo? What percentage is done with radiofrequency?
None of our procedures are done with cryo. Radiofrequency is utilized 100%.

What trends do you see emerging in the practice of electrophysiology?
More ICDs will be implanted, and atrial fibrillation ablations will become routine.

Does your lab provide any educational or support programs for patients?
Our facility maintains a brilliant education team that teaches patients about pre and post procedure.

Describe your city or general regional area. How does it differ from the rest of the U.S.?
We are located in the NW corner of Georgia between Chattanooga and Atlanta. Our patients use our facility due to its ease of access, low traffic, and its specialty in cardiac services. We have a reputation as being one of the best medical centers in Georgia. This is a large, progressive, cardiac center with five cath labs and offers all modern cardiac diagnostics to our patients. We are one of the top five cardiac centers in the HCA system, which we were awarded this year.

Please tell our readers what you consider unique or innovative about your EP lab and its staff?
Our staff recognizes the quality of our care, and actively promotes the EP lab and its services in the community and the surrounding area. As a team, the care that is given is evident through a zero infection rate over a three-year period.

For more information about Redmond Regional Medical Center, please visit their website:
www.redmondregional.com