Creating a State-of-the-Art EP Program at Charleston Area Medical Center

Leslie Carpenter, Charleston Area Medical Center (CAMC), Charleston, West Virginia
Leslie Carpenter, Charleston Area Medical Center (CAMC), Charleston, West Virginia
The new, state-of-the-art CAMC Heart & Vascular Center opened in January 2009. The $72 million, 210,000 square foot building includes two new electrophysiology labs. Read on to learn more about the new center’s innovative design. Charleston Area Medical Center (CAMC) is the flagship of the CAMC Health System, a non-profit, 838-bed, regional referral center with more than 5,000 employees. CAMC is made up of three hospitals, General Hospital, Memorial Hospital and Women and Children's Hospital, which each provide very distinct services. Southern West Virginia's largest teaching hospital, CAMC is also home to one of the top heart programs in the United States, the highest-level trauma center and many other top-notch services. Construction and Design Patients who receive cardiac and vascular services at CAMC do so in the state-of-the-art CAMC Heart & Vascular Center. Construction began in 2006, and the center opened at CAMC Memorial Hospital in early 2009. The CAMC Robert C. Byrd Clinical Teaching Center, which is part of the new building, is comprised of the behavioral medicine, outpatient care, family medicine and vascular medicine centers, opened in July 2008. Through its educational partnership with West Virginia University - Charleston Division, the teaching centers provide increased educational opportunities for medical residents and other health professional students, as well as more convenient and efficient access to health care for thousands in the region. Some 100 faculty and 400 clinical faculty provide training and educational oversight to both medical student clerkships and to the CAMC residency programs at the CAMC-WVU Charleston campus. Each year more than 80 medical students and 150 residents choose to come to the WVU-CAMC Charleston campus programs to further their education. The Vascular Center of Excellence, cardiac catheterization labs and recovery areas also moved to this newer, larger area. An increase in space and capacity in both departments has benefited patients and staff. The facility also houses an outpatient laboratory and testing area, registration area, lobby and café. The second floor, where cardiac catheterizations are performed, opened with seven catheterization labs and two electrophysiology labs. This floor is also designed with efficiency in mind, as patients enter from the perimeter of the labs and supplies are located in the center, allowing quicker access to supplies needed for procedures. The unit has direct access to the surgery suite at Memorial Hospital for emergency situations. The new labs also house new and advanced cath lab technologies. The pre- and post-cardiac catheterization patient rooms on the third floor encourage increased time for nurses at each patient’s bedside through their well-organized design. “The computers and supplies that the nurses need are stationed in each patient’s room, so the nurses can spend more time at the patient’s bedside,” said Lisa Hoffman, RN, director of the cardiac cath/EP lab and PCCU. “We wanted to create a sense of openness with the location of the nurses’ stations, so they wouldn’t have to go as far to get what they need.” The spacious private rooms on this floor include special family areas. Focus on Electrophysiology CAMC’s electrophysiology program began in 1989 under the direction of Ronald McCowan, MD, FACC. At that time, there were two dedicated RNs and one dedicated CVT. The lab itself functioned on a floor separate from other cardiac services until it was integrated into the new facility in 2009. Shawn Allen, RN has worked in the EP lab since its inception. “Our EP program is very unique in that it started without much guidance from the outside,” she said. “It was put together through much dedication and education.” “What is most unique about this lab is that Dr. McCowan, Shawn Allen and Cliff Thorpe, who were the pioneer staff, have remained here,” said Lorena Landrum, MD, associate partner of Arrhythmia Treatment Associates, PLLC. “To have EP lab personnel in the same lab for 18 to 20 years is almost unheard of. That experience is unparalleled and is an extraordinary benefit to our EP lab and this hospital.” The primary goal of the EP lab was, and still remains, to provide specialized diagnostic and interventional treatment for arrhythmias and dysrhythmia problems. Approximately 1,500 EP cases per year are performed in the lab at CAMC and include pacemaker and ICD implantations, electrophysiology studies and complex ablations, including pulmonary vein isolation (PVI) for patients with atrial fibrillation. There are now two full-time EP labs, which are each 690 square feet, as well as one lab that is shared with cath staff. CAMC has three full-time electrophysiologists, two cardiologists who perform implant procedures, four dedicated EP nurses, three float nurses, five dedicated RTs and one float RT. Many of the EP staff are also trained to assist in the catheterization labs. Nurses cross-train on monitoring and mapping systems, and all staff can scrub in and assist on implants. All EP staff is required to be certified in both advanced cardiac and basic life support. Nationally, EP procedures continue to rise, and there is no exception locally. “In Charleston we’ve seen a significant growth in electrophysiology,” said McCowan, who is an Associate Professor of Medicine at West Virginia University – Charleston Division and CEO of Arrhythmia Treatment Associates, PLLC. “There has been a progressive increase in EP interventional procedural management of tachyarrhythmias and heart failure. The added expertise of Drs. Landrum and Faulknier has allowed us to be viewed as a full-service EP provider.” “With atrial fibrillation becoming so prevalent in our aging population, there is definitely a need for more ablation to be performed in West Virginia,” said Brett A. Faulknier, DO, Associate Professor of Medicine, Department of Cardiology and Electrophysiology, WVU Physicians of Charleston. “Further tools need to be developed that will make the ablation lesions more uniform and deliverable.” Obtaining and maintaining the tools needed to perform these cases can sometimes be a challenge. The newest equipment obtained when the new building opened was the cardio mapping system that is currently in use. However, the lab at CAMC is working to upgrade the current mapping systems to the most up-to-date software and also to bring in more highly-trained and motivated support staff, including the forthcoming addition of another EP physician, to allow for increased volumes and the ability to handle more complex cases. CAMC continues to grow and has remained in the top 20 hospitals nationally in heart procedure volumes for many years. For more information, please visit: www.camc.org