Great Western Hospital is a large hospital situated in Swindon, Wiltshire, England, next to junction 15 of the M4 motorway.
- from Wikipedia
What are the sizes of your Cardiology Department and Hospital?
The Great Western Hospitals NHS Foundation Trust provides acute hospital services (at the Great Western Hospital) and community health and maternity services across Wiltshire and parts of Bath and North East Somerset. We have approximately 5,500 staff who pride themselves in delivering an outstanding service to patients and users.
The Cardiology Department incorporates both emergency and elective work, offering a full range of investigations and procedures. Our Cath lab has just undergone a £3 million refurbishment which has seen us increase from 1 to 2 labs. This has helped us to be able to repatriate some of our complex pacing work and increase our activity. We have a 10 bedded recovery area which we also use for day case patients. We have a 14 bedded Acute Cardiac Unit and an 18 bedded Cardiology ward.
What is the geographical intake area and population served by your hospital?
We cover a large area including Swindon, North Wiltshire and parts of Gloucestershire, Oxfordshire and West Berkshire and saw over 460,000 patients last year. We are based closely to the M4 and have a helipad for the air ambulance.
How many staff? Roles?
We have:
6 Consultant Cardiologists
2 SpRs
2 Staff grades
Cardiology Matron
Cath lab Sister
10 Nurses WTE
Radiographers 2.4 WTE ( 1 dedicated full time, the rest from rotational posts)
Cardiac Physiologists
1 Waiting List Officers
Acute Cardiac Unit= 27 WTE
Mercury Ward 39.5 Nurses WTE
Heart Failure Nurses 1 WTE
ACS Nurse 1 WTE
Cardiac Rehab Nurses - 3 WTE
Types of procedures?
We undertake elective
- Angiograms (Inpatients and Outpatients)
- PCI ( In patients and Out patients)
- Permanent Pacemakers
- PPM Box Changes
- Reveals
- Cardioversions
- ICD’s and CRT’s
- Pressure Wire Study
- IVUS
Cardiac Outpatients:
- Echo
- Stress Echo
- TOE
- Holter Monitoring
- Tilt Testing
- 12 Lead ECG’s
- Pacemaker Checks
- Cardiac CT
Types of equipment used?
- St Jude pressure wire
- Boston iLab IVUS machine
- Maquet IAPB
- 2 x Phillips IE33
- 1 x GE E9
- 1 x Vivid 7 Dimension 3D
- 1 x Vivid I
- 2 X GE Vscan
Have you had any new equipment installed recently?
X-Ray Kit: Philips Allura FD10 x2
Physiological kit: Philips XIM (Xper Information Management)
Archive: Xcelera Server for storing and viewing of our cardiac investigations.
We went through a tender and evaluation process and it was felt that the Phillips kit best met our requirements.
How many procedures are performed a year?
Angiograms = 1330
PCI = 410
Pacemakers = 280
What is the approximate percentage of cath lab cases performed radially compared with femorally?
60% Radially
40 % Femorally
Does your department offer a Primary Angioplasty Service?
We do an 8-4.30pm PPCI service, we have been doing this for approximately 2 years, with very good door to balloon times. We have no current plans to go 24/7. One of the issues was how PPCI would interrupt the work when we only had 1 lab, which at times was a challenge, but throughout we maintained good DTB times. This has now been resolved with our expansion to 2 labs.
What new procedures / techniques have you implemented into the department recently?
We have started to do CRT-P and CRT-D in our labs. This has been a significant development for our department and patients, as they prefer to be treated locally.
We are now using Bivalirudin for our PPCI.
We have started doing day case PPM and PCI, this has played a key part in being able to reduce our length of stay and patients would rather go home.
Stress echo service has been commenced.
What are the benefits to patients attending your facility?
We offer a complete range of cardiac services which are delivered in a timely manner to meet all expected targets. Our recovery environment is new, light and airy with windows along one side. The patients will be dealt with by a friendly professional in a respectful way. We do have same sex bays to enhance the patients privacy and dignity while they are with us.
How is your inventory managed?
Currently we use barcodes when logging items during a procedure, and a spread sheet logging system for ordering and cross checking stock.
How does the lab handle haemostasis?
TR Bands for Radials
Digital pressure/ Angioseals for Femorals
We have Femstops also available.
What measures has the department implemented to cut costs?
As a department we are part of the South west regional tender which has helped us save money. Also having stock on a consignment basis has been cost effective.
Changing some procedures to day cases has also help reduce length of stay which saves money, this has also helped improve patient experience as it means patients are back at home more quickly.
What kind of training can new employees expect to receive?
A period of being supernumery, they work towards a competency pack, in order to ensure staff are being trained in all areas and meeting standards required.
What kinds of continuing education programs are available to staff?
- The critical care course
- Teaching and Assessing course
- Governance Study time monthly.
- Industry Study days.
How do you deal with late finishing of cases? For example staggered working hours or just staff overtime?
We allocate staff to stay late just in case we run over, this is then taken as time owing.
What is you policy for company reps within the labs?
We only book 1 rep per day to avoid any competitive companies, this is for education and for new products. All nice food donations are gratefully received!
What is the best part of working at your facility?
Working with a professional team, in a new environment which creates a happy working atmosphere. We receive very positive feedback from patients and have a low turn over of staff.
