Code Cath Process and Decision Tree (Carolinas Medical Center)
PCL receives call for cardiac cath
otably, the results through March
2014 are above baseline results,
with only a few data points still below
our target. Significant effort has been
focused on improving the number of
transfers facilitated by in-house
transport, which will improve transfer
coordination and ultimately PCL-toarrival times. It should be noted that
some of the Code Cath transfer
requests came in the afternoon and
were catheterized the next day. This is
an acceptable practice and explains
why the percent cathed before 5 p.m.
may be below the initial target.
Sustainability has been achieved by
creating hardwired practices and
protocols surrounding the acceptance
and transfer process. The data is
readily available and discussed at
quarterly meetings. Discussion keeps
this program in the forefront of efforts
to improve operational efficiency.
Code Cath, the clinical efficiency model
for patients needing immediate cardiac
catheterizations, has been truly
innovative in this primary PCI facility.
Although still in the early stages of
implementation, the potential for
improved patient outcomes and patient
satisfaction are significant. A key
element of success has been the ability
to share across the system without silos
or communication barriers. Therefore,
any institution looking to implement such
a program would be best served to
keep communication as a top priority.
Since the inception of Code Cath,
knowledge of the innovation spread
from within the primary PCI facility to
transferring facilities and members the
Chest Pain Network.
innovations to promote and enhance the
care of the cardiovascular patient are
vital to improve patient outcomes.
PCL asks, "Is the patient unstable
or having active chest pain?"
PCL asks, "Is cath needed TODAY?"
PCL implements Code Cath Process
and immediately accepts patient into
bed 6131. Coordinates
transportation through Med Center.
PCL contacts bed management to
have patient account created. Bed
management calls 6A to solidify a
bed assignment. If no bed
immediately available, patient is
assigned to 6131.
Bed management contacts PCL when
an official bed has been assigned.
PCL notifies EMS / Sending Facility
and CCL "traffic controller."
Priority One- 6A, Priority Two- 7A,
Priority Three- 3B, Priority Four- CCL
Schedule electively with Sanger
Triage and bed management.
PCL asks if the patient needs to be
admitted to DHICU or be directed to
Cath Lab Holding.
PCL notifies Sanger Triage and bed
General Rule: provider can indicate
specific admitting location other than
that listed in this algorithm. The
patient must be place where the
provider indicates, whether or not it's
a Code Cath.
Report received and patient sent to
CMC designated bed. Arrival unit
notifies Sanger Triage to arrange for
patient workup by ACP/MD.
AU T H O R S
Patient is worked up by ACP/MD
and pre-procedure requirements are