Mount Carmel Health System

What is the size of your EP lab facility and number of staff members? What is the mix of credentials at your lab? The EP lab at Mount Carmel Health System is a system-based department that has responsibility for five labs at three facilities: Mount Carmel East in Columbus, Ohio, Mount Carmel West in Columbus, Ohio, and Mount Carmel St. Ann’s in Westerville, Ohio. We have 19 RNs: Ryan Bailey, RN, BS; Teri Balser, RN; Katrina Bratton, RN, BSN; Laurie Bussey, RN; Jody Cain, RN; Rhonda Edwards, RN, BSN; Lori Fravel-Petruska, RN, BSN; Jennifer Harvey, RN, BSN; Stephanie Henery, RN; Molly Hoover, RN; Sonya Kennedy, RN; Lois Kozlowski, RN; Mariann Menter, RN; Brian Reymond, RN, BSN; Anne Rorapaugh, RN; Elizabeth Siferd, RN; Meggan Stiltner, RN, MSN; Doris Will, RN; and Joey Young, RN, BSN. We have three RTs: Lee Crum, RT, BA, Jean DiDonato, RT, and Kevin Odle, RT. There are seven electrophysiologists: Dr. F. Kevin Hackett, Dr. Ken Lee, Dr. Kamel Addo, Dr. Shaialesh Patel, Dr. Charles Noble, Dr. Jiang Cui, and Dr. Christopher Frank. We also have three interventional cardiologists who implant devices: Dr. Jack Stanko, Dr. Tyrus Frerking, and Dr. Keith Pattison. When was the EP lab started at your institution? The EP lab at Mount Carmel West opened in the early 1990s. A dedicated EP lab at Mount Carmel East opened its doors in November 2003. The newest addition to the EP labs is at Mount Carmel St. Ann’s, which opened in April 2010. What types of procedures are performed at your facility? Approximately how many are performed each week? The EP program at Mount Carmel Health System is fully comprehensive. We implant pacemakers, bi-ventricular pacemakers, defibrillators, bi-ventricular defibrillators, and loop recorders. We perform diagnostic EP procedures and ablations, including atrial fibrillation and VT ablations. We use 3D mapping for some procedures, as well as cryotherapy. We also have recently initiated a laser lead extraction program. We do on average between 60–80 procedures per week between all three sites. What is the primary goal of your program? The primary goal of our program is to provide fully comprehensive, high-quality electrophysiology services to Central Ohio. Who manages your EP lab? The Director of the EP lab is Taryn Vierling, RN, MSN. The Medical Director of the EP lab is Dr. F. Kevin Hackett, and the System Director for Cardiovascular Services is Deb Thompson, RN, BSN. Is the EP lab separate from the cath lab? Are employees cross-trained? The EP lab is separate from the cath lab. The employees are not cross-trained to work between departments. Who handles your procedure scheduling? Do you use particular software? We have a dedicated scheduler for our department, Joann Moore. Joann uses Witt Biomedical to schedule cases for all five labs. What type of quality control/quality assurance measures are practiced in your EP lab? We partner with our quality management department to monitor our quality control measures. We have numerous indicators that the staff collects. The data is then compiled and reported on our department scorecard. We also have an EP QA committee that has representation from physicians, department leadership and risk management. How is inventory managed at your EP lab? Who handles the purchasing of equipment and supplies? We have two inventory coordinators, Tim Money and Judy Grubb, who are responsible for inventory management at all three hospitals. We work in partnership with the physicians to assure that we are being diligent in the purchasing and use of our supplies. We also have a supply chain department that assists with this task. There is a quarterly meeting with physicians, supply chain, and department leadership to review new products that are available. Has your EP lab recently expanded in size and patient volume, or will it be in the near future? In addition, is your EP lab part of a separate “heart hospital”? In the past year, we have grown from a department that spanned two labs to five. We started with 13 staff members and now have 23. We had responsibility for two hospitals and now we are at three. We have added three physicians to our service providers. That being said, we have grown tremendously over the past year. How are new employees oriented and trained at your facility? Our orientation process is approximately three months in length. The new staff member spends one month at each role: medicator/circulator, scrubbing, and monitoring of cases. However, this orientation period is completely dependent on the individual and can be modified accordingly. What types of continuing education opportunities are provided to staff members? We have frequent in-services provided to staff by vendors during our monthly staff meeting. The staff also will do in-services for each other on requested topics. There is an online continuing education site that our staff can access as well. The EP physicians will also provide education for staff as needed. How is staff competency evaluated? We have annual education days, at which we have our annual competencies. What committees, if any, are staff members asked to serve on in your lab? We have a shared governance model, so the majority of our staff are involved in one of three committees: Employee Engagement Council, Leadership Council, and Clinical Excellence Council. We also have representation on the system-wide professional practice committee. How do you handle vendor visits to your department? Do you contract with vendors? Vendors are required to check into Reptrax upon their arrival to our facility. Vendors are only permitted to be present during cases in which their services are needed. How does your lab handle call time for staff members? We do not have call in the EP lab. Our nurses will carry a beeper over the weekend to schedule cases for the upcoming week. Does your lab use a third party for reprocessing? How has it impacted your lab? We send our used catheters to SterilMed for reprocessing. It supports our ongoing initiative to cut costs without impacting patient care. Approximately what percentage of your ablation procedures are done with cryo? What percentage is done with radiofrequency? Approximately 95% of our ablation procedures are done with radiofrequency; the other 5% are done with cryotherapy. Do you perform only adult EP procedures or do you also do pediatric cases? We only perform EP procedures on patients over the age of 18. What about device recalls? How has your lab handled these? We work in conjunction with the vendors to monitor and manage device recalls. We track the number of cases that we have monthly. Does your lab provide any educational or support programs for patients who may have additional questions or those who may be interested in support groups? Our staff do education with patients both pre-operatively and post-operatively. They provide written materials for patients and family members. We do not currently have a device support group, but have as a goal for the upcoming year to evaluate the need to implement one. Please tell our readers what you consider unique or innovative about your EP lab and staff. What we consider to be unique about our lab is our “systemness.” We have fully functional labs at all three facilities, and the staff travel between hospitals. Their site assignments are based on the skill mix needed for the cases at that site. The staff have adapted to transitioning between hospitals very well. They work with different pre/post-op areas, pharmacies, transport, and other ancillary departments. It has taken a lot of flexibility and an extremely professional and positive approach for the staff to be so successful at all three hospitals. It has provided for great physician satisfaction knowing that the staff between sites will be consistent in their practice. With the extreme growth that we have experienced over the past year, the staff in the EP lab at Mount Carmel Health System must be commended because they have accepted change with open arms and smiles. For more information, please visit www.mountcarmelhealth.com