Duke University Health System is expanding patient care with the addition of new Saturday hours to meet the growing demand for cardiac catheterization procedures and gastroenterology endoscopic procedures.
The volume of patients referred for catheterization care at Duke has steadily grown by about 15% annually over the last three years to 30 procedures a day. Not only is volume increasing, so are the complexity of the procedures that Duke’s 20 cardiovascular technicians, 20 cardiovascular nurses and 20 interventional cardiologists routinely perform.
“We were near capacity for heart caths at Duke Hospital with over 90% room utilization during weekdays,” said Dr. Manesh Patel, chief of the Division of Cardiology. “We do acute MI and acute cases 24/7, 365 days but we needed another way to help with in-patients with urgent and not-emergent needs, and also to move care along.”
Duke University Health System owns large cardiovascular labs in all three hospitals with the labs at Duke University Hospital and Duke Regional Hospital operating 24/7 to accommodate emergencies such as heart attacks. Hours are currently Monday through Friday from 7 a.m. to 7 p.m. with the same start time on Saturdays running through mid-afternoon.
“A faculty member with two nurses and two techs would do somewhere between four and six procedures to offset any demand to prioritize those patients who could be discharged or we could facilitate care so that they got something sooner if they didn't have to wait until Monday,” said Dr. Schuyler Jones, medical director of the cardiac catheterization lab. “This is great for patients. On Saturday we were able to prioritize a cath where the patient got a more rapid diagnosis and is getting a heart surgery on Tuesday rather than much later in the week, which is what he needs.”
Improved Access
A pilot program between the Division of Gastroenterology (GI), anesthesiology and nursing programs to offer outpatient endoscopic procedures on weekends began in April. Many of the procedures are colonoscopies for colon cancer screening, which requires sedation.
“We have been trying to improve access for patients for endoscopic procedures,” said GI Chief Dr. Andrew Muir. “We recently improved access significantly in Wake County by opening a new ambulatory endoscopy unit on the Duke Raleigh campus. The wait time in Durham remains too long so we have been looking for alternative ideas on how best to use our current endoscopy units.”
The new hours will be attractive to patients who work during week days and have to take time off, Dr. Muir pointed out.