Cardiovascular Rounds

News, resources, and analysis from the Cardiovascular Roundtable

Filtered by: Cardiac Cath Hide

Why the hype surrounding renal denervation?

January 30, 2013

Nicole MacMillan, Cardiovascular Roundtable 

Recently, a new treatment for drug-resistant hypertension known as renal denervation (RDN) has been a hot topic in the CV world. Also known as renal nerve ablation, the procedure has enormous potential to improve treatment for a large portion of the more than 68 million hypertensive patients in the United States, and may have a similarly dramatic impact for CV programs once it's approved by the FDA.

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How can CV programs optimize cath lab scheduling to match demand and lower costs?

January 17, 2013

Jeffrey Rakover, Cardiovascular Roundtable

The Roundtable has received a number of questions recently regarding cath lab scheduling given today’s unpredictable volumes. We have identified several scheduling strategies that can reap rewards both in enhanced efficiency and reduced costs, addressing concerns ranging from decreasing volumes to excessive overtime costs and staff morale.  

While our research finds no scheduling approach fits every institution, some promising practices are worth considering such as flexing labs and staggering staff shifts.

Below, you will find links to additional resources touching on numerous other scheduling questions — from whether to implement block scheduling to how best to delegate scheduling responsibility.

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So you're not a TAVR program—Now what?

January 14, 2013

Megan Tooley, Cardiovascular Roundtable

There is no question the emergence of transcatheter valve technologies—specifically transcatheter aortic valve replacement (TAVR)—has elicited unprecedented excitement from the cardiovascular community in recent years. However, despite this enthusiasm, the reality is only a portion of hospitals will meet the strict resource and volume requirements necessary to become TAVR sites in the near future.

This may leave many of you wondering, “So what if we’re not a TAVR program? Is there still a place for us in the valve market?” You’re not alone, and as we explore in our national meeting series, your options for treating valve disease and disorders do not end at TAVR.

Learn how one Roundtable member is ensuring their patients have access to a full range of valve services—even if they’re not the TAVR program.

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Informed consent for cardiovascular procedures: Resources for your program

January 10, 2013

Nicole MacMillan, Cardiovascular Roundtable

With the recent release of the Society for Cardiovascular Angiography and Interventions’ (SCAI) consensus statement on ad hoc PCI, the discussion around informed consent for cardiac procedures has again risen to the forefront of our members’ topics of interest.

One study we discussed previously suggests that patient education surrounding elective PCI decisions is often infrequent and ripe for improvement. This dialogue with patients will become increasingly critical as providers seek to activate patients in their care to secure both loyalty and engagement throughout the treatment process.

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SYNTAX trial confirms surgery best for most patients

November 1, 2012

Final results of the five-year SYNTAX trial find CABG surgery delivers better outcomes than PCI for intermediate-high risk patients.

This trend was surprisingly apparent for patients with three-vessel disease and at high risk for surgical complication. However, patients who underwent CABG or PCI that had left main disease with fewer than three vessels affected had equivalent rates of major adverse cardiac and cerebrovascular events (MACCE).

Nevertheless, researchers note that nearly 80% of patients with three-vessel disease have a 79% improved survival rate with surgery over PCI. These results suggest that for high-risk patients, surgery may be the best treatment pathway, demonstrating fewer downstream complications.

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Should you pursue a PCI program without surgical backup?

September 14, 2012

Megan Tooley, Cardiovascular Roundtable

The Roundtable recently received a number of member requests regarding the viability of percutaneous coronary intervention (PCI) programs without on-site cardiac surgery. In addition to the latest literature comparing clinical outcomes between programs with and without surgical backup, there are number of other important factors CV leaders must take into account before pursuing this strategy.

Members of the Roundtable may access a summary below of the most recent clinical findings on PCI without surgical backup, as well as other programmatic implications to consider before starting a PCI program.

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Appropriately staff the cath lab

Dana Pfenninger Khan August 30, 2012

We've recently fielded a number of questions related to cath lab staffing ratios and skill mix. These questions arise as a result of several key market dynamics that impact procedure suites, including softening PCI volumes, tightening margins, and procedures shifting to the outpatient setting.

Given these pressures, CV programs are strengthening efforts to adjust staffing in high-cost areas such as interventional suites, or redeploying the workforce according to areas of greatest need.

Roundtable members can access a suite of resources to benchmark cath lab staffing ratios and learn how to optimize the workforce.

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Cardiovascular AUC at your fingertips

August 13, 2012

Megan Tooley, Cardiovascular Roundtable

The CV service line faces increasing scrutiny over the appropriateness of diagnostic tests and procedures, as well as pressure to contain costs while improving quality during the transition to value-based care. These forces create urgency for CV administrators to develop strategies to right-size utilization and ensure patients receive the most appropriate care for their respective condition.

Professional societies, such as the American College of Cardiology, have created appropriate use criteria (AUC) for a variety of procedures and tests to support programs in meeting this mandate of appropriate CV care.

We've compiled links to the latest AUC, as well as a few additional resources regarding the use of these criteria, to make them more accessible for Roundtable members.

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