Student Dissertation

Agency : Cardiac Catheterization; Catheterization Lab; JCI Standards; AHA Guidelines; Cath Lab

Objective : • To review and understand the current standards of the procedures and process of the hospital to avoid any delay or gap in the functioning of the department. • To analyze JCI (Joint commission international), DHA (Dubai Health Authority) and AHA (American heart association) guidelines to implement and design the process mapping, policies and procedure manual for Cath lab.

Background : Thumbay hospital, Dubai has come up with a new advance cardiac care unit; therefore, to achieve well-organized and efficient implementation of the cardiac catheterization unit in the hospital and maintaining smooth and effective management of the cath lab to ensure the quality of care in the hospital.

Methodology : It is a descriptive study performed at Thumbay hospital, in study duration of 3 months (February to April 2018). Data collection is done by the discussion with the concerned staff, specialist and expertise opinions were considered. JCI, DHA and ACC/AHA guidelines are also considered to formulate all the policies and manuals. The study includes three phases: Phase I include Process mapping for the cath lab in relation to the other departments in the hospital and mapping the cross-functional flow for the smooth and effective functioning of the department without any delays to deliver service and quality of care to the patient. Phase II includes Designing of the cath lab service manual for the hospital it is created to serve both as a reference document and a training resource. The manual touches upon the structural and functional aspects of the department. It covers the procedures integral to the effective and efficient delivery of services. It also summaries the quality indicators, forms in use and reporting formats. This manual is designed as a living document in line with on-going business direction and growth Phase III Include Time motion study for the first case in the Cath Lab in the hospital. The first procedure was done in the cardiac catheterization lab in the hospital. The case was studied to find any gap in the functioning of the process of a cath lab.

Recommendations : • The training was given to the staff regarding process flows and the manual • Drills were given to the staff regarding the emergency cases to achieve Door to Balloon time. • Storage and inventory management was done in the Cath lab. • The tariff was set for the procedure by the billing department and by the insurance department. • Risk assessment was done to avoid any unnecessary delays and risk.

Limitation: • As it was the first case in Cath lab which was not planned therefore equipped material was not present. It needs to be arranged from the Thumbay Hospital, Ajman which causes a delay. • Current procedural terminology not agreed for the procedures of the Cath lab as it is not yet initiated therefore delays from insurance department occur. • Software and documentation are still in process and not yet updated.