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There’s always a moment of hesitation in making the jump from what’s old but comfortable into what’s new but unknown. Yet recent technology upgrades for cardiac catheterization labs at a pair of Mississippi hospitals are proving worth the risk — boosting safety, cutting redundancy and making daily work more efficient.

At Central Mississippi Medical Center (CMMC), the time was ripe in 2007 to upgrade the 11-year-old hemodynamic monitoring system, which keeps tabs on a patient’s blood pressure, electrocardiogram and other vital signs during cath-lab procedures. The system had been in place since the cath lab opened in 1996.

“The system we had was running fine and there was really nothing wrong with it,” said Bryan Williamson, manager of cath lab and cardiac services at CMMC.

“But we were still running Windows 1995, and wouldn’t have been able to get support for that if we ever had a problem. In addition, some of the components they didn’t make any more, and we were just keeping our fingers crossed that we could locate one if we needed it.”

Sticking with an upgraded version of the same system the lab already used — Calysto by Witt Biomedical Corp. under Philips Medical Systems — eased the transition and translated into a $150,000 investment for the hospital. According to its maker, the system’s advantages include its ability to integrate into a hospital’s IT infrastructure and to record and document an entire cath-lab procedure.

For CMMC, the process of bringing the system up to its full capacity has been about taking small, incremental steps rather than trying to make all the changes at once.

The cath lab was set to go paperless around the first of this year and will be able to interface directly with the hospital’s electronic medical records system — instead of sending each report to another office to be scanned in and loaded into the system. As part of technology upgrade, the chore of double-documenting has been one Williamson hoped to eliminate for the cath lab’s nurses since he took his post a just over a year ago.

Interfacing with the EMR system will make it easier for physicians and staff to remotely access patient information. The system also has the capability to generate administrative reports, track inventory and communicate directly with national registries.

The cath lab is used by about 10 staff physicians, performing procedures including cardiac catheterization, balloon angioplasty, open-heart surgery, stent placements, rotational atherectomies, pericardial centesis, inferior vena cava filter placements and catheter retrievals.

In the lab, the addition of a nursing station has called for another change in practice, but also allows nurses to be closer to the procedure. For the physicians who utilize the hospital’s two labs, the recent changes have been mostly “cosmetic,” Williamson said, with the arrival of new flat-screen monitors and hardware.

“Eventually the technology will help increase our customer loyalty as well as patient and physician satisfaction,” he said. “Anything you do that’s going to make things easier and faster is a good investment.”

That was the finding, too, at Ocean Springs Hospital (OSH), where the addition of a new imaging system with flat-panel technology allowed the scope of its second cath lab to be broadened for the use beyond just cardiology.

“When my staff goes in in the morning, they may work with a cardiologist for two hours, then a vascular surgeon, then they very well could be working with a radiologist later that same day,” said Terri Harris, nurse manager for cardiovascular services at OSH and its sister hospital, Singing River in Pascagoula.

Both hospitals completed the process of upgrading their cath labs’ imaging systems in the spring of 2007, with the Toshiba Infinix CC-i system at Singing River and a GE system at Ocean Springs.

The flat-panel technology improves visualization for cardiologists to see intricate blood vessels as they guide catheters through the heart and blood vessels. The Toshiba system allows real-time digital imaging and links to the cardiology PACS (Picture Archiving and Communications Systems). This allows images to be sent to other cardiologists from the cath lab.

Another benefit of the new systems has been in reducing radiation exposure for both patients and staff in the cath lab, requiring less radiation and less contrast media injected into blood vessels.

At Ocean Springs, the new imaging system also has the camera capability to be widened for peripheral vascular procedures or dialed down for smaller heart procedures, Harris said.

“We can do both types of procedures at the same time,” she said. “If a patient needs a heart cath and also has abnormal renal artery signs, we can go ahead and do both procedures and the patient only has to go through it once.”

To express that multi-use aspect, the combo space is called a “vascular procedures room” rather than a cath lab. For the hospital’s radiologists, the room works as a backup to their primary space when its equipment is down for maintenance.

The same sharing relationship doesn’t go on at Singing River, where each department enjoys newer equipment. But it has enabled the smaller Ocean Springs Hospital to grow in a more-efficient way.

“It allows us to not waste space, because it’s not a room that only certain people can come in,” Harris said.

“It’s been great for us. We’ve had people from other hospitals come in and say, ‘Gee, how’d you get them all to work together?’ But it really wasn’t that difficult.”

The move has also provided a chance to centralize the management of the space, its inventory and staffing. Harris is able to negotiate contracts for supplies for the entire system, providing greater leverage with vendors to reduce prices.



February 2008

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