Regent's Park Mobile Cardiac Cath Lab - Exeter

Mobile Cardiac Cath Labs: Achieving Maximum Efficiency

Most staff feel there is never enough space within a cath lab or that productivity could be improved, but imagine how that is magnified for those working in a high-intensity mobile lab, with a preset time frame and a high number of procedures in which to complete them. Over the past weeks we have been two members of a highly specialised cardiac team working on one of Regent’s Parks’ Mobile Cardiac Catheter Labs based at the Wonford Hospital, Exeter. This mobile lab was brought in as part of a waiting list initiative to reduce patient waiting numbers by approximately 400 over a seven-week period.

In this article we describe the lessons we have learnt and some of the processes that were implemented.  We hope that by sharing our experience it may open up some interesting areas for discussion within your department.

Service overview

The facility
The mobile cath lab was delivered to site in advance of the go-live date to allow for the integration of incoming services e.g. Power, Water, IT & Telephony. The facility itself consists of the cath lab (procedure) area, a control area (physiologist workstation), an office area and a plant room (X-ray cabinets, switches etc).

The mobile lab was set-up alongside a dedicated day-ward with a temporary protective cover installed to protect staff and patients from the outside elements.  All patients were transported to and from the lab using a transport trolley.

The staff
The Regent’s Park cath lab team comprised of 4 members: 2 nurses, 1 physiologist, and 1 radiographer. In addition, the operator was provided by the Trust. Over the seven-week period several Regent’s Park team members rotated through, however there was always at least one member each week that knew the operational processes to ensure a smooth transition. It was essential that all members of the Regent’s Park team were able to demonstrate the ability to work well under pressure and to function as part of a team while maintaining the ability to problem solve and create solutions to the unique challenges that this environment requires.

The Hospital
The hospital provided a dedicated six-bed day ward, with ‘ring-fenced’ beds. This was located within a building directly alongside the mobile lab. Although located in a different part of the hospital from their main department it allowed access to/from the mobile lab via one external door thereby keeping patient transit times to an absolute minimum. The day ward was staffed by the Trust and consisted of two nurses and a ward clerk.

Start of Day: Patient Arrival
Patient appointment times were sent out several weeks prior to the arrival of the mobile lab. In addition, on the Friday before their procedure, the ward clerk would call each patient to remind them of their appointment time, as well as explaining their arrival location. Each day was booked for single sex patient lists in line with local and national guidelines. The patients were scheduled to arrive at intervals and would be received by the ward clerk allowing the nurses to concentrate on preparing each patient. The consultant cardiologist would ensure  the first three patients had been consented by 9am to ensure a prompt start time.

During Day
Teamwork is essential in any cath lab environment. Whilst everybody had their primary role, each member was prepared to assist others when the need arose. During the day, a runner nurse and radiographer would collect the patient whilst the scrub nurse set-up for their arrival with the assistance of the physiologist. At the end of a case, the radiographer and the scrub-nurse from the case would take the patient back to the day-ward for handover, and the system was then repeated, the 2 nurses exchanging roles. Handover at the bedside, both on collection and arrival established clinical details, approach and plan. The physiologist would ensure the lab was clean and prepare the table. In between cases the cardiologist would report the case and consent any remaining patients.

Mobile Lab Post Case
All patients (unless contraindicated or if the patient was to have a TAVI/other procedure requiring an 8F sheath in the near future) received an Angioseal. Except where contra-indicated, Angiosealed patients included patients who were to have a PCI in the next few days within just a few days of their angiogram also received them. Radial approach was also used and provided the opportunity to recover patients in a chair freeing up valuable bed space.

Day Ward Post Case
Patients had a three-hour stay post procedure. The first hour consisted of bed rest, with the following two hours spent in a chair. The chairs were arranged at the end of the ward alongside each other and proved popular with patients who were able to chat with other making for a very sociable environment, whilst allowing the nurses to prepare beds for subsequent patients. Patients relatives were given a contact card with a number to call after three hours to check on the progress and estimated collection time. This helped to ensure they did not attend the department until necessary.

Ultimately we are all working in healthcare with the same goals. This includes providing the highest possible standard of care and improving the experience of our patients during their hospital admission.

We hope that you have enjoyed hearing our experiences of working within a mobile cath lab service. It was truly a wonderful experience with an excellent team, and we look forward to all working together again soon.

 

Special thanks to Dr Andrew Sharp (RD&E Consultant Cardiologist), Ms Justine Davenport (RD&E Ward Clerk), & Mr Bryn Webber (Regent’s Park Cardiac Services Director) for their assistance with this article.

 

About Regent’s Park Cardiovascular Solutions

Regent’s Park Cardiovascular Solutions (RPCVS) has been providing a range of high quality cardiovascular solutions to the healthcare services industry since 2002. Our supply of healthcare equipment and buildings include modular cardiac catheterisation labs, hybrid operating theatres with surgical and imaging capabilities, vascular labs, as well as major radiology equipment such as MRI and CT. Bringing together all of our solutions, we provide the infrastructure to design, build, finance and operate cardiology centres, cardiothoracic hospitals, as well as diagnostic and imaging centres for cardiovascular disease in both the traditional hospital setting as well as in the community alongside GP’s. See www.rpcvs.co.uk for more information.

RPCVS has a sister company, called Regent’s Park Heart Clinics (RPHC), that develops strategic partnerships with groups of cardiologists, hospitals and primary care organisations. See www.rphc.co.uk for more information.

RPCVS and RPHC are part of the Regent’s Park Healthcare group – a consolidation of visionary healthcare companies focused on providing world class standards of healthcare.
See www.regentsparkhealthcare.com for more information.

To discuss the requirements of your organisation or to find out more about working for Regent’s Park please contact:

Mr. Bryn Webber
Cardiac Services Director
bryn.webber@rpcvs.co.uk
+44 (0)7966 987712


Regent's Park Mobile Cardiac Cath Lab - Exeter

Regent's Park Mobile Cardiac Cath Lab - Exeter

Regent's Park Mobile Cardiac Cath Lab - Exeter

Regent's Park Mobile Cardiac Cath Lab - Exeter

Regent's Park Mobile Cardiac Cath Lab - Exeter

Regent's Park Mobile Cardiac Cath Lab - Exeter

Regent's Park Mobile Cardiac Cath Lab - Exeter

Regent's Park Mobile Cardiac Cath Lab - Exeter

Regent's Park Mobile Cardiac Cath Lab - Exeter

Regent's Park Mobile Cardiac Cath Lab - Exeter


Author:

Tim Larner

CEO & Senior Cardiac Radiographer
Coronary Heart Publishing Ltd
UK

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