Spotlight Interview: North Cypress Medical Center

Debbie Rockoff, RN, BSN, RCIS, Director of the Cardiac Cath Lab Cypress, Texas
Debbie Rockoff, RN, BSN, RCIS, Director of the Cardiac Cath Lab Cypress, Texas

North Cypress Medical Center is a 175-bed physician-owned, general acute care hospital, founded by local physicians who wanted to create a sophisticated, upscale, patient-friendly healthcare environment for their community. Our services include the latest, state-of-the-art medical technology and equipment, well-respected area physicians, and an upscale 5-star hotel-like ambience. Designed with patients and physicians in mind, North Cypress aims to be the hospital of choice for the Northwest corridor of Houston, Texas.

Dr. Robert A. Behar is the founder, Chairman of the Board and Chief Executive Officer of North Cypress Medical Center. A true visionary, Dr. Behar wanted to develop a hospital with state-of-the-art equipment and amenities that truly put patients and physicians first.

In this capacity, he oversaw the development of the hospital and professional buildings. He also chairs the Central Committee for Operational Review and coordinates all operations at North Cypress Medical Center.

When was the EP lab started at your institution? What is the size of your EP lab facility and number of staff members? 

The hospital opened in 2007 and has become one of the fastest growing facilities in the area. We have two combination cath lab suites utilizing Philips FD20 imaging equipment and an 8-bed pre/post holding area. 

Who manages your EP lab? What is the mix of credentials at your lab?

The lab is managed by our director, Debbie Rockoff, RN, BSN, RCIS. She is under the direction of Robert Martel, CFO and Dr. Mobeen Mazhar, Chief of Cardiology. The staff consists of 10 RNs, 5 RTRs and 1 scheduler. Our physicians are comprised of 16 cardiologists, 5 electrophysiologists, 6 interventional radiologists, and 1 neurointerventional radiologist.

What types of procedures are performed at your facility? 

Device implants were performed within the first year of opening. In 2009, we acquired Bard and Biosense Webster Carto® equipment to begin radiofrequency ablations. We started with diagnostic and simple ablations and progressed to PVI and complex atrial fibrillation ablations. 

Approximately how many are performed each week? Do you perform only adult EP procedures or do you also do pediatric cases?

We focus exclusively on adult ablations with approximately 5 ablation procedures performed weekly. 

Are employees cross-trained?

We have a dedicated EP staff to assist in the procedures. The staff is cross trained to do other procedures as well.

What new equipment, devices and/or products have been introduced at your lab lately? How has this changed the way you perform those procedures?

We recently acquired Hansen Medical’s Sensei® X Robotic System for complex ablations. We have seen a tremendous decrease in fluoroscopy, anesthesia, and procedure time, which directly benefits our patients’ recovery times. In addition, we have seen our staff decrease their own fluoro time to less than 5 minutes per case and remove their lead aprons for the remainder of a procedure. It is incredibly rewarding to offer technology that improves both staff and patient care.

How are new employees oriented and trained at your facility?

Our EP physicians train the staff and convey their expectations before beginning procedures. Our industry partners assist as well by offering bi-monthly EP in-service training. In addition, we recently had a half-day training where all participants dissected a pig heart to better understand the cardiac anatomy as well as areas that are commonly ablated.

What types of continuing education opportunities are available to staff members?

The staff is encouraged to attend educational seminars and symposiums to stay current with cutting-edge technology. 

How is staff competency evaluated?

Competencies are done frequently and evaluated on a yearly basis. 

How is inventory managed at your EP lab? Who handles the purchasing of equipment and supplies?

Two staff members handle inventory, utilizing a Philips/Witt hemodynamic system and Meditech software. They identify and inform the director regarding trends in procedures and volume so the hospital is always prepared. The purchasing of equipment and contract negotiations are discussed in a committee comprised of the director of the cath lab, CFO, chief of cardiology, and David Renneker, Controller. Final approval is obtained from the CEO.

Who handles your procedure scheduling? Do they use particular software? Does your staff provide any educational materials for patients who may have additional questions about their condition/procedure? In addition, does your hospital or lab staff have a device support group?

The scheduler posts cases using Meditech software and then informs the EP team of an upcoming case. Our nurses phone all patients the day prior to the procedure to give instruction and answer questions relating to the procedure to help reduce anxiety. Families are encouraged to stay with the patient prior to the procedure. Post procedure, we offer a teaching folder to the family with brochures related to the procedure. The nurses will also perform a follow-up phone call the day after the procedure. 

Is your lab doing web-based/transtelephonic device follow-up?

The web-based/transtelephonic device follow-up is done in the physician offices.

How does your lab handle call time for staff members? How do you prevent staff burnout?

The cath/EP lab is rewarding, demanding, fast-paced, sometimes hectic, and constantly requiring critical thinking skills for patient care. The turnaround time in rooms is approximately 15-20 minutes. The on-call staff consists of 2 RNs and 1 RTR. The hospital is an accredited Chest Pain/Stroke Center and call outs can be frequent. In an attempt to prevent staff burnout, everyone on staff takes call. The nurses that work the procedure rooms also rotate through the holding area, and we stagger shifts in the holding area to account for recovering patients. By implementing this system, on-call time was decreased to one week per month and allowed a combination of 8- or 10-hour shifts per day. Some days are physically and emotionally draining, but due to the team effort, the department runs like a well-oiled machine.

For more information, please visit NCMC Hospital's website.

North Cypress Medical Center is a Doctor-Owned, Patient-Centered Healthcare Institution.