South County Hospital to open cath lab

South County Hospital plans to open a $2 million diagnostic cardiac catheterization lab early next month, staffed by local physicians and backed up by Rhode Island Hospital’s cardiology program, which will provide oversight, consultations and follow-up care as needed.
The lab, for which the hospital first sought state approval almost three years ago, is expected to serve about 300 patients per year, all of whom would have otherwise traveled to Rhode Island Hospital for the service, and possibly more in the future.
It will only perform diagnostic catheterizations, however, not therapeutic procedures such as angioplasties and stent insertions, and it will only serve patients who are deemed to be stable, not emergency cases or patients likely to need immediate treatment.
That’s because South County doesn’t have a cardiac surgery program, so it can’t perform an emergency open-heart surgery.
For many years, hospitals weren’t allowed to have cath labs if they didn’t have heart surgery programs, but as technology and medications have improved over time, complications have become less common, and regulations have been eased, especially for diagnostic procedures.
The majority of hospitals, in Rhode Island and nationwide, now have cath labs, so when local cardiologists suggested that South County Hospital build one, the idea was well received.
“A lot of technologies, particularly things that can be done as an outpatient, have moved into the community setting, and we have tried to keep up,” President and CEO Louis R. Giancola said in an interview. South County is fundamentally a community hospital, with limited services and no desire to “stretch itself too much,” he said, but this was a good fit.
Cardiology is one of South County’s strengths, Giancola noted – the hospital offers a wide array of prevention and wellness programs, as well as cardiac rehabilitation – and two cardiologists on the staff, Drs. Steven Fera and John Murphy, are cath-lab veterans.
The two doctors, both of whom are faculty members of The Warren Alpert School of Medicine at Brown University, have been performing catheterizations for many years at Rhode Island Hospital, Giancola noted, and they were “very comfortable” with setting up a new lab.
To serve their patients at South County Cardiology Associates, Murphy said, he and Fera have to travel to Providence frequently, performing about 250 catheterizations a year. “The convenience alone” of being able to stay close to home, he said, will “mean a lot” to everyone.
In its certificate-of-need application for approval of the lab, the hospital also noted that having a cath lab in the community hospital would make it easier to coordinate care and follow up with patients, and it would help avoid delays due to scheduling conflicts.
Cardiac catheterization involves inserting a thin, flexible tube – a catheter – into an artery or vein in the arm or leg and advancing it to the heart, often injecting dye into the coronary arteries, to gauge blood flow, the heart’s pumping ability and blood oxygen levels.
When patients have a catheterization at South County, the results will be integrated with their electronic medical records, Murphy noted, and they’ll also be available instantly for review at Rhode Island Hospital, if needed.
Partnering with a larger institution is common in these situations, Giancola said, and the Rhode Island Hospital cath lab team’s expertise has been valuable even before opening the lab – in the design, choice of equipment, development of a quality oversight system and more.
But it’s still taken a long time from the idea to the execution. The CON application was filed in February 2006, anticipating a November 2006 opening, but the project didn’t get the green light until December of that year, and then there were more delays actually getting it done.
South County had already “waited very carefully” before even seeking state approval, Giancola said, making sure that the quality of the program would be on par with Rhode Island Hospital, the staff would be skilled enough and it would “make sense financially.
Giancola said he expects the lab to “make a modest contribution to overhead” once it is operating at the anticipated levels, and that’s fine: “We did not get into it in order to enhance our revenue. We just wanted to make sure that we could do it responsibly, that it was not going to end up being a financial drain on the hospital.” •