;Identify additional space requirements in addition to the required
footprint of the equipment under
;Consider placement of additional
equipment required for the expanded patient population; for
instance, anesthesia cart, neuro-monitoring equipment, adequate
access to head, back and side, by the
operator, and clearance by the gantry arc for all staff and equipment
;Minimize floor hazards through exploration of the tunneling of cables
;Understand the specific nuances
of the care required by the new
patient population. Placement of
a bi-plane suite into many existing cath labs without consideration for expanded space needs
to ensure full functionality results
in wasted money and frustrated
For organizations that have already taken
the first step in delivering best practice
care to stroke patients through the implementation of a primary stroke center,
the transition to offering interventional
services through a comprehensive stroke
center is a natural progression. This evolution to a higher level of services can be
eased significantly through the existing
infrastructure and experienced leadership
present in a well-established cath lab.
By incorporating lessons learned, and
through the use of experienced cath lab
staff, the normal learning curve associated
with the treatment of complex stroke
patients through neuro-intervention can
be lessened considerably.
The implementation of a dual-use
lab likewise brings challenges associated
with the prioritization of cases. Combin-
ing two emergent patient populations,
STEMI and acute ischemic stroke for
example, is not possible for organiza-
tions with only one interventional suite.
A combination of elective and emer-
gent cases is, however, completely fea-
sible when coupled with well established
bumping protocols and the availability of
well trained, competent staff.
The introduction of neuro-endovascular
capabilities into an existing cath lab
setting brings with it very significant
operational challenges. This approach is
not recommended in a facility with only
one cath lab, due to the difficulty in com-
bining two emergent patient populations
and the likelihood of the need to divert
when a single room is in use.
Although the idea of integrating neuro-interventional capabilities into a fully
functional cath lab may be received
with initial skepticism by some, a careful review of the opportunity and of the
similarities of patient need will illustrate
the opportunity. With proper planning,
quality dual purpose equipment, appropriately trained staff, capable physicians,
and strong leadership, an organization
willing to embrace the challenge can
build a truly extraordinary service.
As the incidence of stroke continues
to rise, hospitals will need to consider
new strategies for treatment—ones that
are clinically and financially right for
both the organization and its patients.
While making the decision to move forward with an expansion effort can be
daunting, with proper planning and a
solid foundation of existing services, the
traditional cath lab setting can seamlessly
evolve into a new model for care.
Stacey Lang is a vice president with Corazon, a
national leader in consulting, recruitment, and
interim management for the heart, vascular,
neuroscience, and orthopedic specialties. To learn
more, visit www.corazoninc.com or call 412-364-8200.
Stacey can be contacted at firstname.lastname@example.org.