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A Workflow Revolution in Cath Lab Reporting
Can you tell us about the cath lab at Children’s Hospital of Michigan?
Children’s Hospital of Michigan is a part of the Detroit Medical Center. We have two Siemens bi-plane cath labs and 8 staff: 4 technologists and 4 nurses, with 13 full-time physicians. We do approximately 620-650 patients per year in 2 labs. In 2007, we did 620 patients, while in 2006, we did 650 patients.
What are the average age ranges you tend to see?
The average age of our patients is probably somewhere in the teens, but we do everybody from one hour old to what has been our oldest patient so far, 86 years old.
How long have you had the syngo Dynamics system?
We’ve had syngo Dynamics for about a year now. We started as the beta site for Siemens with their 6.0 version. The system has helped us tremendously for physicians’ reporting. Typically, when a procedure is over, the physician goes to the syngo Dynamics unit to complete the report, which takes about 10-15 minutes. Much of the information put into the report is already templated information. For example, when we do an angiogram of the pulmonary artery, the relevant information is templated, so you just have to point and click. There’s also additional information the physicians can edit and type in themselves. When the procedure is over, the physician does his report and it is faxed out to the referring physician immediately. Prior to implementing syngo Dynamics, it was a back-and-forth process. The physician would dictate the report and send it to the secretary. The secretary would then type it out and send it back to the physician. He would make corrections and send it back to the secretary, who would then send it out to the referring physician. That process usually took about 10 days. Now we have about a 1- to 2-day turnover in getting our reports into the medical records and out to the referring physicians.
You mentioned that there is a workstation in the lab. Where else can the physicians access the reports?
One of our physicians chose to have a workstation in his office. We actually have two workstations available in the cath lab.
Can you explain the structured reporting offered by the system?
We have our cardiac cath report as a template, and we have information in template format. As I mentioned, if we do a pulmonary artery angiogram, we have a statement that says a pulmonary artery angiogram was performed, and if it is normal or abnormal. Typically we have all the normal versions of the typical things that we do already templated in syngo Dynamics, so when the physician looks at the dictionary (where we have templated information pertaining to the injection site, the patient, or any other information pertaining to the procedure), they basically just click on that statement and it drops into the report, versus repeating that statement over and over again in the dictaphone or typing it out. Some of the more common abnormalities are in the system as well. It’s a simple point-and-click: physicians click on basic information and it drops right into the report.
As a result, this has freed up a lot of time for various members of the cath lab. First, our secretary’s time. When she’s looking for a report, the physicians will just fax it right down to her from the system. She is now free to do other things rather than just transcribe reports into the hospital system. The system has also freed up staff time. We do not have to constantly check to see if a patient has been archived or if the physician faxed the report where it needed to go. Most importantly, it has freed up physician time, which is very valuable. Now the report is done one time, versus it being done, reviewed, and reviewed again. It’s now completed in one effort.
How have the patients and their families been affected?
I don’t get to see the direct effects, but the statements I’ve gotten back from our referring physicians are that they are pleased to have this information quickly. It is important, because if they need to bring these patients back to their office, they can do so a lot sooner. As far as patient care, I think that says a lot for the referring physician to have a copy of the report in their hands hours after the procedure is done, which is phenomenal — how many places can actually say that?
What about the integration between the hemodynamics, imaging and the reporting system?
It’s very simple. We actually have all Siemens equipment. Our hemodynamic recording system is the Sensis unit. Hemodynamics is updated in real-time. As we record a pressure, it updates in the reports. If I pull up the report template of the patient we have on the table, I can watch the report template update as whoever is recording the information in the Sensis puts it in.
What were some of the changes in workflow implemented after syngo Dynamics was brought into the lab?
Nothing too drastic. We as staff didn’t have to worry about the reporting aspect anymore. It’s just made things easier because now we are not receiving 50,000 phone calls from referring physicians, saying hey, where’s the report at? It’s been faxed out to the physician, so they have it. Sometimes physicians would take the report and supposedly fax it and sometimes it would fax and sometimes it wouldn’t. So that burden has been removed from our staff.
Has the greater speed and organization in reporting helped in tracking complications?
As far as tracking complications go, that information is put into our Sensis portion of our lab. Having this information located there means we can do a search and assess our complications. We are also keeping a database of all of our complications.
