Implementation of a Highly-Performing Electrophysiology Device Implant Program: Is There a Role for Niche Hospitals?
- 2 Aug 10
- Posted on: 8/2/10
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Good Samaritan Hospital (GSH) and Lebanon Cardiology Associates (LCA) recently partnered to create a community hospital EP program caring for elderly, ill patients, and experienced lower overall implant complications compared to available national trials and single academic centers. Find out more information here.
After approximately two years of planning, Good Samaritan’s invasive cardiac EP lab was opened on July 1, 2008. There are two full-time technologists (David Lugg, BS, RCIS and Douglas Hollis, RCIS) and one full-time nurse (Robert Gray, BSN, RN). In addition, we have one part-time technologist, Michelle Stoner, BS, CVT, who still participates in traditional coronary and peripheral interventional cardiology procedures.
Jeffrey L. Williams, MD, MS, FACC is the Director of Cardiac Electrophysiology and is board-certified in Internal Medicine, Cardiovascular Disease and Clinical Cardiac Electrophysiology. In July 2009, he was joined by Co-Director of Electrophysiology Robert Stevenson, MD, who is board-certified in Internal Medicine, Cardiovascular Disease, and Nuclear Cardiology. Julie Miksit, RN, BSN, MBA is the Assistant VP of Cardiovascular Services at Good Samaritan. Alicia Wike, RN, is the Cardiac Catheterization and EP Lab Supervisor, and the manager of the Cardiac Catheterization and EP Labs is Jennifer Hemperly, RN.
The implementation of the GSH EP device implant program is best described using key premises outlined by the Baldrige National Quality Program: leadership, strategic planning, customer focus, workforce focus, process management, measurement/analysis/knowledge management, and results (Figure 1).1 Of note, GSH also utilizes Lean Six SigmaSM principles for certain process improvements.
We routinely perform ablations for supraventricular tachycardia, ventricular tachycardia, and atrial fibrillation in our state-of-the-art procedure room; however, our device implant program is the focus of this report.
Leadership and Planning
The implementation of the Good Samaritan EP program began 18 months prior to program inception in July 2008. Dr. Williams and Mrs. Miksit began a systematic planning strategy for lab implementation with the full support of Good Samaritan and Lebanon Cardiology Associates. The demographics of the area, especially serving Health Professional Shortage Areas, necessitated the Good Samaritan EP lab have capabilities to perform all aspects of device implantation. Electrophysiology equipment acquisition was based upon the desire of Good Samaritan Hospital and Lebanon Cardiology Associates to offer state-of-the-art cardiovascular care to the Lebanon Valley community. The Good Samaritan Hospital’s invasive cardiac electrophysiology laboratory is 800 square feet and fully-equipped to function as a cardiothoracic surgical suite. We have our own anesthesia equipment that consists of a traditional ventilation machine and full anesthesia cart (Dräger Fabius® Tiro compact anesthesia system, Draeger Medical, Inc., Telford, PA) and the Monsoon Jet Ventilator (ACUTRONIC Medical Systems AG, Switzerland). The fluoroscopy system is a GE Innova 2100 single-plane unit (GE Healthcare, United Kingdom).
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