CRT: Todays cath labs need to be run 'like a business'

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WASHINGTON, D.C.—Cath lab managers are increasingly facing more pressure – both from within the hospital and externally from new federal initiatives such as healthcare reform and decreasing Medicare reimbursements – which require increased flexibility and ever-evolving process plans, according to Steven Simms, RN, director of the cardiac cath lab at Washington Hospital Center in Washington, D.C., during his Feb. 27 presentation at the annual Cardiovascular Research Technologies (CRT) meeting.
He suggested that cath labs have to adopt a “survival of the fittest” attitude. We have a lot of things that crop up throughout each day that complicate our daily lives.”

Certain burdens of cath lab managers include fielding requests from upper management to decrease overtime, managing a staff that is trying to do the bare minimum, dealing with declining volumes and the increase in product dollars. Simms also noted the challenge of keeping up with new procedures to help a lab stay competitive with other cath labs.

“On any given day, we can add on a case rate of 42 percent or more cases, leading to unpredictable, stressful and hectic times,” he said.

For external pressures, “we are facing healthcare reform, declining reimbursements, the impact of patient satisfaction scores on the internet, quality initiatives and the economy, leading to the acquisition trend of physician practices, and staff changes with a reduction in workforce,” he explained.

“Healthcare reform is changing the landscape of the cath lab, a decrease of reimbursement rates by 30 percent,” Simms said. “The economy plays a huge part in our lives, as loss of jobs means less people with healthcare coverage; therefore, increasingly, accounts are not paid because we have fewer insured patients.”

However, Simms sees a positive side. “Even with all of these distractions, getting the team together and running as a close-knit unit make it fun and can decrease the stress levels a lot. Also, the unknown makes a good training environment because you need to be able to think quickly on your feet, as you do not know what is going to come through those doors or what may happen to that person that just walked from the prep area to your table.

"Today, we have to run cath labs like a business,” he added. “We have to work leaner because of reduction of staff due to declining volumes. Patients are still sick, but they are not getting treated because they can’t afford it.”

Decreasing volumes have led providers to opt for employee cutbacks, which means more on-call times for the remaining staff. As a result, cath lab managers “get creative with scheduling, so people don’t get burnt out.”

He encouraged cath lab managers and staff to remain focused on the mission, such as patient-centered quality care, maintaining core values professionally and personally, applying adult learning principles and employing effective interpersonal skills.

“With this changing culture, we really need to facilitate a team environment, in which the staff members are empowered to perform their duties,” Simms concluded. “It is important to maintain one common goal of improving patient care.”