Background
La Porte Regional Health System (LRHS), a Clarian Health Partner, is comprised of La Porte Hospital, a 227-bed community hospital; La Porte Regional Physician Network, made up of 19 physician practices; and La Porte Hospital Foundation, a philanthropic arm that supports the health system. La Porte Hospital was the first hospital in northern Indiana to achieve Magnet™ recognition, an award that is given to an elite group of hospitals for exemplary nursing leadership and quality patient care.
The facility has experienced significant growth over the past few years. The cardiology program has grown to include a successful interventional program as well as cardiothoracic surgery. In an unprecedented spirit of partnership, physicians are working together in ways that are unique and creative for extraordinary patient care. Doctors and clinicians from a broad spectrum of specialties have come together to form the Heart & Vascular Institute in order to screen and treat patients, as well as educate the community about heart disease.
In the past, La Porte Hospital was able to provide care to all cardiovascular patients except for those needing cardiac electrophysiology (EP) services. Patients in need of EP services had to be transferred to hospitals in surrounding areas for treatment. It was decided that every effort would be made to obtain EP services for the patients in our community. Cardiac electrophysiologists would be recruited, as well as a director of electrophysiology services (at which time I was hired). Dr. Mark Dixon and his partners, Drs. Scott Kaufman and Raghuram Dasari, joined the medical staff in order to provide EP services.

The Options
The decision to provide EP services was an easy one. Where those services were going to be provided was not quite as simple. There were three alternatives for this relatively land-locked facility: shared space with the cath lab, new construction, or utilization of a temporary building.
Sharing space with the cath lab would not be ideal, as there was only one cath lab in the facility. The current lab was already very busy — doing multiple interventions and diagnostic cases per day. To add multiple EP cases to this already busy lab would not be a satisfactory solution. The full compliment of services added would include electrophysiology studies, catheter ablations, and implantation of pacemakers, defibrillators, and biventricular devices. Besides the obvious problem with routine scheduling, there would be issues of what to do with emergent cases requiring intervention when the lab was already being utilized. Patient safety would be a prominent factor in the evaluation of this option. In addition, in order to share space, a new hemodynamic monitoring system would have to be purchased and the lab would have to be shut down during installation. This would require the facility to go on bypass for any cardiovascular emergency and on hold for the scheduling of elective cases during the installation period.