CV Directions Vol. 1, No. 2 - Page 7

CATH 7 Code Cath Process and Decision Tree (Carolinas Medical Center) PCL receives call for cardiac cath N 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. Practice Implications 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. Process 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?" No Yes Yes No 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 management. 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 completed. Patient a