Peripheral Vascular Care: Should You Have a "Vascular Center"?

Written by Barbara Sallo, RN, MBA


Continued from page 1
In addition torepparttar patient entrance and medical staff/exam location there are a number of additional components located in areas throughoutrepparttar 115151 hospital that provide services forrepparttar 115152 PVD patient: 1.The Noninvasive Lab: ideally located in or close torepparttar 115153 Vascular Center, performs a comprehensive range of testing to diagnosis PVD, and should provide same day testing with rapid report turnaround, utilizing a dedicated staff. It is advisable forrepparttar 115154 Noninvasive Lab to be accredited by Intersocietal Commission for Accreditation of Vascular Lab and/or American College of Radiology Accreditation. 2.Magnetic Resonance Angiography: a diagnostic tool for PVD that hasrepparttar 115155 patient benefit of not requiring contrast use and few procedural side effects. The equipment requires specialized software and personnel education. A new type of contrast (MS-325) to be released next year will offer additional imaging potential. 3.Radiology Suite: provides diagnostic and intervention procedures and advanced imaging quality. It is still consideredrepparttar 115156 “Gold Standard” for diagnostic testing, invasive procedures using both radiation and iodine based contrast. Procedures are performed typically by interventional radiologists. 4.Cardiac Catheterization Lab: typically used for cardiac procedures, however, underutilized labs may provide accommodation of advanced imaging for PV catheter based procedures. Labs with high cardiac volumes may prohibit PVD procedures and non cardiology practitioners are not always made welcome. 5.Operating Room: can be equipped to provide advanced imaging for catheter based minimally invasive procedures, should involve vascular surgeon in imaging choices, fixed equipment may limitrepparttar 115157 room flexibility, sterile environment offers advantages for PVD procedures, supplies of stents and catheters should be controlled/coordinated with radiology and cath lab 6.Wound Healing Center: PVD is a common diagnosis for patients with non healing wounds. These patients may utilizerepparttar 115158 services ofrepparttar 115159 wound center resulting inrepparttar 115160 need for good coordination betweenrepparttar 115161 Vascular Center and Wound Center if they not located withinrepparttar 115162 same department. What arerepparttar 115163 Staffing Considerations of a Vascular Center? A number of physician disciplines have experience and involvement with vascular care. Today, we are seeingrepparttar 115164 emergence ofrepparttar 115165 Vascular Medicine Specialist. This physician often has a background in family practice and/or internal medicine. They can serve asrepparttar 115166 Medical Director ofrepparttar 115167 Vascular Center. This individual determinesrepparttar 115168 appropriate referral of patients torepparttar 115169 most appropriate sub specialist and maintainsrepparttar 115170 continuum of care process with daily rounding on all inpatients. The Vascular Medicine Specialist which is most common at academic medical centers can serve as attending physician for Interventional Radiologists. They also can be responsible for reading and reporting on vascular tests. While this physician staff model is growing in popularity, historically many different types of physicians have been in charge of patients’ PV care as shown in Exhibit 4. The nursing and technical staff has had a “home grown” tendency as it has only been of late thatrepparttar 115171 rationale for dedicated, trained and focused staff has taken off. The role and function ofrepparttar 115172 personnel vary from hospital to hospital but some distinct models are developing as shown in Exhibit 5. What isrepparttar 115173 Revenue Associated with PVD Care? If PVD services are provided in existing surgery and interventional radiology suites, no additional capital costs can be expected. The expansion of catheter-based care inrepparttar 115174 cath lab to include peripheral vascular interventions will give rise to additional expenses. Imaging requirements forrepparttar 115175 PVD patient may require new equipment purchases but many hospitals have been able to use existing coronary cameras. Specialized supplies are also required. Staff education and training must be expanded to include peripheral procedure techniques and potential PV complications. Revenue from PVD care providesrepparttar 115176 opportunity for healthy margins for hospitals. Medicare contribution margins for vascular DRGs compare favorably with cardiac DRG margins. Across all vascular DRGsrepparttar 115177 average contribution margin (revenue less direct costs) is more than 30 percent (Source: Market Insights, Inc., San Francisco; Cardiovascular Roundtable analysis 1999). While there are no statistics onrepparttar 115178 revenue generating figures for interventional radiologists and cardiologists treating PVD, a recent survey provides that information on vascular surgeons. Results from a survey of 1,200 hospital CFOs reveals that vascular surgeons generate an average of $2.2 million in revenue—derived from referrals and associated treatments—for their affiliate hospitals each year as show in Exhibit 6. Where to Go to from Here? Cardiovascular care is big business. This year alone,repparttar 115179 American Heart Association anticipates that $329 billion will be spent on this patient population. Whilerepparttar 115180 PVD portion ofrepparttar 115181 total is significantly smaller thanrepparttar 115182 cardiac portion,repparttar 115183 patients arerepparttar 115184 same. Peripheral vascular care is an essential component of full service cardiovascular care. There is no question thatrepparttar 115185 number of PVD patients is growing and these patients are underserved today. Hospitals must decide how to best care for this population. One ofrepparttar 115186 first steps is compiling a PVD dedicated business plan that covers: Market size/opportunity Competitive environment/issues Scope of service Physician specialties/medical coverage Clinical operations model Marketing and outreach initiatives Financial requirements/assumptions Structure/governance/ownership Conditions for success Implementation recommendations and timeline Withrepparttar 115187 growing trend toward healthcare self-education supported throughrepparttar 115188 press andrepparttar 115189 Internet,repparttar 115190 public is becoming increasingly aware ofrepparttar 115191 potential dangers of untreated vascular disease. Quality of life has taken on new meaning andrepparttar 115192 older population will continue to seek healthcare resources that will enable them to maintain active lifestyles. Be prepared forrepparttar 115193 baby boomers to seek out and demand assessment and treatment of peripheral vascular problems.

Barbara Sallo, RN, MBA is the President of Health Care Visions, Ltd. a cardiovascular consulting firm based in Pittsburgh, Pennsylvania. The firm brings extensive knowledge and expertise in this area of clinical care. Health Care Visions, Ltd. has assisted a multitude of hospitals in all phases of cardiovascular programs from market assessments, program assessments and feasibility studies to business planning and implementation.


Mr David J. Adams

Written by Michele Carelse


Continued from page 1

The Michele Carelse WeightLoss and Detox Programs providerepparttar following key features at unbelievably affordable prices:

Daily emails over a period of four weeks (or five days forrepparttar 115150 Detox WeightLoss Deluxe) offer you support, encouragement and insight intorepparttar 115151 emotional factors underlying overeating A specially devised WeightLoss Eating and Exercise Plan is provided to help you to lose those excess pounds in allrepparttar 115152 right places and to keep them off Designed by Michele Carelse,repparttar 115153 program takes into accountrepparttar 115154 emotional factors that cause binging and depression while dieting. Daily email support helps to carry you step by step towardsrepparttar 115155 weight loss that you desire. Inrepparttar 115156 process you get to learn about how emotional factors are affecting your ability to eat a healthy diet. This helps you to lose weight and keep it off!

How haverepparttar 115157 WeightLoss Programs helped others?

"Afterrepparttar 115158 5 days I felt so energetic and healthy that I could almost not believe I wasrepparttar 115159 same person" - Deirdre, USA

"It is really true what they say aboutrepparttar 115160 food that you eat. Apart from losing 10 pounds, I ended up feeling on top ofrepparttar 115161 world! Before starting I suffered from fatigue, backache and headaches - all gone! Also there is a big difference in my sex drive - what a bonus!" - John, 37 years old, USA

"I was a bit unsure about trying this program, because I have been on so many weird diets before. They all promise so much, but ......... ! But I thought I would try just one more and this one seemed reasonable. They say you are not allowed to weigh yourself duringrepparttar 115162 5 days - boy was that difficult because I could feelrepparttar 115163 pounds slipping off me! Whenrepparttar 115164 5 days were over, I literally jumped onrepparttar 115165 scale - I had lost SEVEN pounds in FIVE days! I thought I would write and say "This really WORKS!!!" - Nicole, 28 years old.

"My problem was always that I couldn't stick to any diet. First two or three days all went well - then somehow I always dropped out. The Detox and WeightLoss program is short enough to stick with and long enough to really work! This isrepparttar 115166 first diet I have ever completed in my life and byrepparttar 115167 way, I lost 6 pounds and I feel great" - Greta, USA

"This diet has changed my eating habits forever! Not only does it give yourepparttar 115168 support you need, it also gives you tools to keep on using after you have finished. Thanks Michele!" - Sara, USA

"Thank you very much Michele To anyone who is thinking of trying this diet - I can really recommend it very highly. It is not too difficult andrepparttar 115169 support is wonderful." - David, 46 years old

This time you don't have to do it alone! For more information www.remedymaster.com clickrepparttar 115170 flashing button. Native remedies.

Well known author of dietry advise and conducting of research into obesity problems in mainly the over 16 age groups male and female.


    <Back to Page 1
 
ImproveHomeLife.com © 2005
Terms of Use