Spotlight Interview: Coliseum Medical Center

What is the size of your EP lab facility and number of staff members? What is the mix of credentials at your lab? Also, when was the EP lab started at your institution? We are a new EP lab facility, having opened in October 2006. At the present time, we have one dedicated EP lab. This includes one full-time Registered Nurse who has 28 years of experience in Critical Care, as well as one traveling nurse who has EP experience. We also have one full-time Registered Radiology Technologist. What types of procedures are performed at your facility? Since we are a new EP lab, our electrophysiologists Dr. Joseph Poku, Dr. Carmine Oddis, and Dr. Felix Sogade are starting with simpler procedures. To date, the majority of our cases have been AICDs, BiV ICDs, dual-chamber pacemakers, EP studies, atrial flutter and supraventricular ablations, and tilt table studies. What are the primary goals of your program? Our #1 goal will always be to maintain a safe and comfortable environment for our patients. With hands-on training, practical experience, and educationally-focused EP physicians, we have been increasing our confidence, competency, and efficiency as well. Another goal is to increase the number and complexity of procedures performed on a monthly basis. We also hope that by the fall of 2007, we will be doing atrial fibrillation and ventricular ablations. Lastly, we will continue to educate the hospital staff about EP procedures and their role in the proper care of an EP patient. Who manages your EP lab? The Clinical Manager of our EP lab is Debbie Ellis, RN. Since our EP program has a relatively small volume at this time, she handles the day-to-day responsibilities. Does your EP lab compete for patients? Has your institution formed an alliance with others in the area? We are the new kids on the block. There is a much larger hospital in the area that has three EP labs; therefore, we both work with the same three electrophysiologists. Our expectation is to expand the market, making care to patients in our health care system more accessible and convenient. By creating an environment of enthusiasm, efficiency, competence, kindness, and convenience, we hope to make our EP lab a place they can look forward to coming to. Since we do not have the experience to do the more difficult left-sided ablations at this time, we have to transfer patients to the other facility. What are your thoughts about non-EPs implanting ICDs? Do you train such individuals? At this time, our lab is only open to electrophysiologists. We are still in our training phase, so even though we are becoming very efficient at what procedures we currently do, our Medical Director is very protective of our staff; he wants to continue to teach, guide, and train us during our first year of service before letting non-EPs be trained and use our lab facilities. What types of continuing education opportunities are provided to staff members? We recently had the opportunity to attend Cardiovascular Solutions, which was a three-day conference sponsored by the two hospital systems located in Macon, Georgia. At this seminar, information regarding the history and future of electrophysiology was one of the many subjects discussed. We had the opportunity to observe a live demonstration of an open cryoablation procedure performed by a cardiovascular surgeon. Medtronic also sponsored a virtual set-up so that we could experience what it felt like to try threading a lead into the coronary sinus and around the lateral wall of the left ventricle. It was not an easy thing to do! We have had excellent in-service support from our product representatives at Boston Scientific, Medtronic, St. Jude Medical, and Guidant. They understand we are a new lab, so they are constantly giving us helpful information and tips to make us a better and more knowledgeable lab. In addition, Boston Scientific recently brought a sheep heart lab to our facility, allowing us to see what an ablation catheter does to the heart tissue. We were also able to compare the catheter sizes relative to the actual heart structures. We plan on attending the SASEAP conference this summer in Myrtle Beach, South Carolina. We hope to see all of you there! Please describe one of the more unusual cases that have come through your EP lab. Although we do not yet have an unusual case study to include here, we do have a funny story that we would like to share. A nurse from one of the medical floors called us and asked if Dr. Poku was going to do an obliteration on one of the patients. As a result, we now call Dr. Poku The Obliterator! Obviously we still have a lot of teaching to do regarding explaining ablations and other procedures to hospital staff. Is there a nationally recognized Electrophysiology Lab week? If so, that would be a good time to educate the hospital staff about what we do! How does your lab handle call time for staff members? In addition, how do you prevent staff burnout? At the present time, we do not take call. We have established hours from 7:30am to 4:00pm, Monday through Friday. Of course, we do have great flexibility in our schedule. In order to accommodate our electrophysiologists’ schedules, we may start earlier, sometimes beginning a procedure at 7:00am. Of course, if a procedure runs long (as many of them do!), we stay until the case is complete, sometimes until 10:30pm. There will always be those who are dissatisfied with our hours, but since there are just three of us, it is the only practical way for us to operate at this time. In the future, as our case volume grows, we can add staff so that extended hours can be accommodated. There is no faster way to burn out a staff than to have them working eight hours or more a day and then have them be on call as well this would not be a safe situation. I know of other labs working their staff to exhaustion, to the point that mistakes were made. As patient advocates, it is our duty to protect our patients from unsafe conditions. Describe your city or general regional area. How does it differ from the rest of the U.S.? Macon, Georgia is located in the heart of Georgia, which is the central portion of the state. It is about one hour south of Atlanta. Macon has the advantages of being close to Atlanta with all the interesting things to do there, without having to live in the constant traffic jams! If we want to visit the beach, Savannah is only a three-hour drive. We are surrounded by many rural communities. Macon (as well as central Georgia) is facing the same problems that many of our cities across this country are facing today: that is, we have an increasing amount of patients who eat too much and exercise too little. This, in turn, increases the incidence of problems associated with obesity, such as diabetes, hypertension, kidney failure, and cardiomyopathy. In addition, despite the great amount of publicity about the health hazards of cigarette smoking, we still have many citizens, young and old, who continue to smoke. As a non-Southerner, I was also intrigued to find that in this part of Georgia, the older citizens used to chew on chalk (Kaolin is mined in this area). In fact, you can still find people in the rural areas who don’t consider this an unusual thing to do. Evidently, a long time ago, someone thought it was a good remedy for people who were anemic. Unfortunately, the micron-size particles clog the renal tubules; the end result is dialysis. Unfortunately, the noncompliant portion of the population will always be present. This is good for the health care industry, but it is such a shame for those who suffer with the effects of bad choices. For more information about Coliseum Medical Center, please visit: www.coliseumhealthsystem.com