Maximizing Patient Management in the Cath Suite

by Richard C. Haines Jr.

Issue: May/June 2012

Patient flow in the cath suite generally has followed predictable patterns that are evidenced in many procedure suites and surgery centers. There is a waiting room easily available upon patient arrival. The patient is checked-in and brought back to a holding bay/room. They then are taken into the cath room for the actual procedure. After the procedure, they may go to a recovery room or back to the bay/holding room for recovery before discharge. Although this is a very defined sequence of events, there are different ways that they can be “packaged” and some of those alternatives may be appropriate for your cath environment. This article will discuss two of these alternatives.

Figure 2. Outpatient cath lab with pre-/post-procedure spaces.

Figure 1. Outpatient cath lab with decentralized, “wavy” family waiting.

Decentralized Waiting

In the scenario of decentralized waiting, the large waiting room at the front of the cath lab is eliminated. Instead, family waiting areas are clustered outside of each patient prep/holding room (Figure 1).

Figure 1. Outpatient cath lab with decentralized, "wavy" family waiting.

Figure 2. Outpatient cath lab with pre-/post-procedure spaces.

Images: Richard C. Haines Jr.; reprinted with permission.

The decision was made early in the design process that each patient would have his or her own prep/recovery room. The patient would go from this room to the cath lab and would return to the room following the procedure. This room had a solid wall between it and the decentralized family waiting area. The other end of the room had a glass wall that opened into the cath suite. This allowed the nurses easy supervision of patients in those rooms.The idea behind the decentralized family waiting area originated with the doctors and nurses. It was felt that this accomplished four things:

It provided smaller subsets of seats so that each family could cluster in its own area and be close to their loved one.
The nurses could easily get family in and out of the prep/recovery room without going very far or to too much effort.
By being able to get the family to the patient more quickly, the nursing staff could involve the family in caring for their post-procedure family member; this would lighten some of the workload of the nurses.
It was also felt that the close proximity of both the patient and the family to each other would give both a greater sense of comfort and reduce apprehension regarding the procedure.

The curved exterior wall along the family waiting area was glass block, producing a lot of natural light without sacrificing patient/family privacy. These characteristics combined to give this cath lab a non-institutional “feel” yet still allowed the facility to be high-tech. Both the patients’ and staff’s physical and psychological burdens were reduced.

Pre-, Post-Procedure Rooms

There is no doubt that in the cath lab the actual procedure room is the expensive space. This single room requires hundreds of thousands of dollars in expensive equipment to perform complex procedures. The issue of concern for many cath labs is just how often is this expensive equipment actually being used compared with how often it is sitting idle just waiting to be used.


	Richard C. Haines Jr.

The idea of the cath room shown in Figure 2 came about from the need to optimize the productivity of the procedure room when the suite itself could only accommodate one cath room. So the question was how much of the work that is often done on the cath table could be offloaded to other spaces? The cath suite actually accommodates three patients “in-process” simultaneously. One patient is in the prep room being readied for the cath procedure; a second patient is on the cath table in the cath room; and a third patient is in the sheath removal/groin press room. This allowed a small facility to support higher patient volumes. The efficiency result was that the expensive cath room was actually being used more intensely for cath procedures and thus yielded a better return on the investment in that equipment.

It will also be noted that there is a hold room just outside of the cathing suite. There are actually 10 such rooms in the suite; it was felt that the 10 rooms were needed to support the potential volume of the streamlined flow through this cath lab.

Conclusion

These particular cath suites reflect just two different ways of getting patients processed through their procedure. Neither one is right or wrong. A variation on one of them may be appropriate to your particular situation.

For more information:

Richard C. Haines Jr. is the president of Medical Design International based in Atlanta, which provides consulting for medical space planning and architecture to health care professionals.

Disclosure: Mr. Haines reports no relevant financial disclosures.