04 Oct RADPAD Daily Dose Newsletter Fall 2024
SO, WHERE IS EVERYBODY?
If there is one thing almost all labs in the country have in common, it is staff shortages at every level and position. In these times it’s truly rare to see a lab fully staffed in all its procedure rooms and completely up and running. What was beginning to be a problem prior to Covid, has blossomed into a full-blown crisis which has led to some labs being forced to shut down for lack of trained staff. Traveling personnel have become the norm instead of the exception and they make up a much higher percentage of staff than in years past. (85% of labs are employing travelers). Additionally, new cardiac ambulatory centers are siphoning off talent and exacerbating the situation by offering attractive Monday-Friday hours and no call to qualified personnel. This all this leads to smaller hospital staffs which means a greater call burden and increased personal stress to those remaining.
The staff shortage burden extends to the hospital’s profitability margin as well. Less staff means fewer procedures and that means reduced hospital revenue. In addition, travelers and temporary workers can cost up to 50-100% more than employed staff. Hospital margins are currently down 40% from pre-Covid levels. Hospitals are feeling the squeeze.
HOW ARE LABS COPING WITH THIS CHALLENGE?
Many labs have tried to mitigate their reduced revenues by examining their internal issues. This may include actions like “sending people home early in the first part of the week to avoid overtime charges, and then holding them over later in the week (cutting into personal time) to accommodate late add-on cases”. Others have tried raising wages and offering bonuses to those who stay. For the most part, labs have begun valuing employees and working to create the best possible work atmosphere for everyone. Recently an article in Cath Lab Digest (Staff Retention in a Time of Never-Ending National Shortages-Jenna Linton) highlighted how Carle Heart & Vascular of Urbana, Illinois adopted new employee friendly programs to help them build back and retain staff. Carle has created programs to reduce the call burden on everyone by hiring dedicated RTs and RNs for After Hours On-Call (AHOC) positions. Carle has also initiated job sharing opportunities for employees in the ED, CVICU and HVI to reduce burnout and job fatigue and expose them to opportunities for professional growth.
AND THEN, THERE’S THE MD SHORTAGE…
The staff shortages are not limited to RNs and RTs. Despite almost 1,000 more interventional fellowships a year, 24% of cath programs and 19% of EP programs expressed challenges in finding and retaining interventional physicians. A record numbers of older physicians are retiring or trimming back their hours at a time when a rapidly aging and increasingly obese population is driving up demand for cardiac services.
SO, WHAT DOES ALL THIS MEAN?
In the short term (through 2026) we are going to continue experiencing the pain and challenges of understaffing. The bad news is, it will get worse before it improves. However there is good news. Many facilities are investigating and moving toward hybrid cardiovascular/vascular services models to help alleviate some of the problems. There is a light at the end of the tunnel.
Thank you, Joel Sauer, MBA
May/June 2022 Cardiac Interventions Today
OPN NC, the super high-pressure balloon (35 atm) that safely cracks and dilates the most stubborn calcified lesions has come to America!
OPN NC’s proprietary twin wall structure ensures that it won’t “dog bone,” even at the highest of atmospheres reducing the risk from dissections and perforations. Tested and proven over 7 years in hundreds of thousands of cases in Europe, OPN NC has delivered an excellent record for safety and efficacy.
OPN NC’s multiple indications often allow it to be the first and only device needed to treat PTCA, saving time and money on complicated procedures.
- Vessel Prep
- Calcified Lesions
- ISR
- Stent Dilatation
- Under-Expanded Stents
- Overlapping Stents
- Post Atherectomy
- IVL Prep and Post IVL
OPN NC Super High Pressure Balloons are exclusively distributed in the US by Worldwide Innovations & Technologies, Inc. manufacturers of RADPAD® Radiation Protection Products.
Contact info@radpad.com for your free demonstration.
TABLE TALK
Where you stand makes a huge difference in how much scatter radiation you receive in a procedure.
As you study this graphic, you’ll see that the operator (#1 position) receives 58% more radiation than the person in the #2 position and 97% more radiation than the person in the #3 position. No surprises here; we may not have known the exact percentages, but we knew there was a significant drop off in exposure levels the further away we get from the image intensifier.
There are, however, two surprising points in this graphic. First, note the difference in the radiation dose at the thyroid level compared to the top of the head. There is a significant bump in radiation dose at our thyroid because it is 9” closer to the beam than the top of our head. Turning knowledge into power, this means we can reduce the dose to our brains by 30-40% if we move our heads 9” further back from the imaging area (the same distance from the thyroid to the top of your head). So, if you are tied to the table holding meds or catheters and can’t step back, at least you can lean back to protect your brain.
Second, the circulating nurse (#4 position) receives almost 4X the dose of the operator when he/she is at the table. No pull-down glass and no table skirt equals double jeopardy for this unfortunate one. It is critically important that the circulator stay as far as possible from the table for as long as possible, and only approach the table when a rolling shield or a sterile disposable shield is in place. Talk to your RADPAD® Rep to learn how to best protect yourself in these circumstances.
WHEN IN DOUBT, BRING IN AN EXPERT.
Have you or your team ever wondered about scatter radiation levels in your lab? Which room is the hottest? What’s the dose over here? Over there? Where’s the best place to stand, etc.? You can’t Google it, but you can quit guessing. Bring in a scatter radiation specialist from RADPAD® to measure every room, every procedure, with every operator. Contact us at info@radpad.com and we’ll schedule a clinical expert to visit your lab for a day or more, to take scatter measurements in every room and answer all your radiation related questions. (If allowed, they have been known to bring snacks).
TATTOO CONTEST
The great RADPAD® International Tattoo Contest is over! The winners in nine categories as well as the Overall Grand Champion, First Runner Up and Honorable Mention have been decided.
During the process (taking more than 2 years, thanks to Covid), hundreds of lab personnel from all over the country shared pictures of their tattoos in hopes of gaining 15 minutes of fame and cashing in on extravagant gift card prizes. Tattoos ran the gamut from homemade (pretty much a prison tattoo) with a Sharpie saying, “I Love RADPAD” to complex, 3-D like open mouthed lizards jumping off the skin. The tattoos shown in this newsletter are the ones the censors let through for your enjoyment. A big thank you to all of you and our apologies in advance for any name misspellings. A big shout out to Christ Advocate Hospital in Oak Lawn, IL where almost 100% of the cath lab team entered their tattoos! Congratulations to our winners!
GOOD GRIEF. ANOTHER TIME OUT?
Radiation safety timeout.
Is this the right patient, the right procedure, etc.? Time outs are the last safety check we perform on ourselves to ensure that we have everything right before starting a medical procedure. Everybody knows it’s necessary, but few really want to take the time to do it, but we do. Realizing this, why would anyone want to add another timeout layer to each of our procedures? Because a clinical study in New York demonstrated a 20% overall scatter radiation dose reduction to patients and staff in those labs that stopped to take a “Radiation Timeout” before starting their procedures. Staff soon realized and embraced that the timeout prompted team members to think about their individual radiation safety practices.
Just taking the timeout helped them to remember to do things like:
- Raise the patient as close as possible to the image intensifier.
- Collimate the image as tightly as possible.
- Reduce the frame rate to safer, lower levels.
- Use all available shields all the time on every procedure.
The study proved that safety is a mindset we all need to adopt if we truly want to protect ourselves.
Eventually, everybody needs a little CME.
RADPAD® provides a free 1-hour CME course to any lab requesting it. Our trained CME presenters will come to your lab, give you free radiation safety training and prep your team for the take home CME course. Contact us at info@radpad.com to schedule a CME for your lab.
No Comments