Student Dissertation

Agency : Cardiac catheterization lab, Patient turnaround time, Utilization, Cathlab key metrics

Objective : • To study the workload and trends of Cath lab since inception. • To study Cath lab time utilization, identify bottlenecks and recommend optimum utilization.

Background : Cardiac catheterization labs (Cath lab) represent a significant capital investment for many hospitals. Realizing a return on this investment is increasingly challenging, given the introduction of advanced technologies and limitations in reimbursement. To meet the challenges and maintain fiscal health, hospitals are pursuing strategies to improve throughput, maximize equipment utilization and increase efficiency. Inefficient use of this limited resource increases costs and can compromise patient care.

Methodology : A two phase descriptive - observational study was conducted at Cath lab, Paras hospitals, Gurgaon. The data collection technique was based on review of records and observation. Analysis of the data collected was perused so as to obtain an overview of workload and utilization of Cath lab. Secondary research- Phase I In the first phase, Cath lab records related to work load, process flow, and policies were methodically studied with following specific objectives. 1. To identify workload of Cath lab over the years since inception. 2. To assess patient profile in terms of elective/emergency, route of catheterization, mode of payment. 3. To study overall process flow of Cath lab patients and different phases involved in Cath Lab from “Patient In to Patient out” Primary research – Phase II In the second phase, Time motion study was done in Cath lab for the study period (Cath lab Utilization Study) with following specific objectives. 1. To analyze patient turnaround time in Cath lab. 2. To assess the functional bottlenecks in optimum utilization of Cath lab. 3. To evaluate Cath lab in terms of quality assurance i.e. patient safety, employee safety, documentation. 4. To propose key metrics for Cath lab

Findings : Major underutilization of Cathlab was observed at studied hospital in terms of both elective and emergency time allotted to Cathlab in hospital. The bottlenecks for efficient utilization were unnoticed due to absence of key metrics for performance evaluation of Cathlab. There was a significant gap with respect to patient safety and radiation safety protocols

Recommendations : Decreased number of cases, inefficient scheduling, late starts and delays between cases are the main factors that account for inefficient utilization of Cath lab. Accurate records, weekly analysis of recorded data, better financial counseling before procedure, and strict adherence to and enforcement of approved policies and procedures are essential ingredients for an efficient operation of Cath lab. The correction of above mentioned factors would increase the available operating time in Cath lab.