I have seen outpatient "physician based labs" contract their ultrasound
services to hospital Mon-Fri daylight. I would recommend that any vascular
study worth doing right be done by an RVT. Steve is right, there are a lot
of criteria and hoops to jump through to make sure your staff would be
allowed to work in the hospital setting; and then negotiating hours and
coverage. The radiology staff may definitely take issue to losing volume
and still having to maintain the challenging overnight and weekend hours.
You should definitely make sure to have all the departments involved at the
table to discuss so that your staff are not met with resistance at the
bedside. Another option would be to contract your services to train the
techs already doing the studies, but that again requires the radiology
team to agree.
Good luck.
Amanda
On Mon, Jan 9, 2017 at 6:09 PM, Steve Knight <[log in to unmask]>
wrote:
> MIndy I've been through that process and fortunately did not have to cover
> the service outside of the day shift.
> There are some things you will need to keep in mind about the in-patient
> side.
> First off, you need to understand that when a patient comes to you for an
> elective outpatient test, they are there to see you and possibly also a
> doctor or a mid-level provider as well. It's fairly easy to anticipate the
> work flow demands and scheduling.
> In-patients are the other side of the coin. Multiple services are all
> vying for time with the same individual. You will get to their room and
> wait for the portable chest x-ray to be taken, then the anesthesia service
> will round and make you wait while they consult with the patient. You will
> have to rearrange furniture and monitoring equipment. You will need to wait
> for help from the floor staff to position patients. And you will have to
> decontaminate your equipment after each patient.
> The bottom line is, in patient tests take much longer and are physically
> harder on the lab staff.
> It is hard to do a good job when trying to stick to a schedule, which may
> be why your surgeons are dissatisfied with the quality of studies done in a
> busy radiology department.
> It may be easier to train the radiology staff than to take over this
> burden.
> Maybe you've worked in an in-patient setting and you're aware of the
> frustrations and restrictions.
> I'm not trying to discourage you but you should go into this anticipating
> many logistical complications.
> Also be aware that the bean counters have a different appreciation for
> in-patient studies (they cost the facility rather than generate revenue).
> Bean counters loath inefficiency, particularly when it costs money. They
> don't understand why you can't do 16 superb in-patients studies every day
> per staff member. Also know that when you finally get Mr. Whoosey back off
> the potty chair, back into bed and finally get that glimpse of the renal
> artery stent you've been hunting for your pager will go off and your
> surgeon will want you in the OR stat to look at something.
>
> Cheers,
> Steve
>
> On Mon, Jan 9, 2017 at 1:08 PM, Jeff Stanley <[log in to unmask]>
> wrote:
>
>> This sounds like something that should be worked out and agreed on with
>> your medical director, the radiology director, and hospital admin for your
>> staff to have privileges to work in the hospital (unless you are already
>> employed by the hospital). Or work something out to where the hospital
>> techs can visit you in your outpatient lab to learn your techniques,
>> protocols, and criteria. We are also an outpatient lab and this has also
>> been briefly mentioned to take over the inpatient labs but with multiple
>> locations and hospitals that our surgeons work in, it would be very
>> political and might cause world war three. One of our techs has privileges
>> to go to one of the hospital’s operating rooms to assist our surgeons with
>> some arterial procedures and in order for him to be able to do that it
>> involved a lot of paperwork and approval before he was able to go work in
>> the hospital. Almost wasn’t worth it.
>>
>>
>>
>>
>>
>> *Jeff Stanley BS, RVT*
>> *Vascular Lab Manager*
>> THE SURGICAL CLINIC, PLLC
>> 356 24th Ave North, Suite 300
>> Nashville, TN 37203
>> Phone: 615.301.5261 <(615)%20301-5261> | Fax: 615.320.3662
>> <(615)%20320-3662>
>> www.TSClinic.com
>>
>>
>>
>> *From:* UVM Flownet [mailto:[log in to unmask]] *On Behalf Of *Audrey
>> Fleming
>> *Sent:* Monday, January 09, 2017 2:27 PM
>> *To:* [log in to unmask]
>> *Subject:* Re: Vascular Lab and Inpatient studies
>>
>>
>>
>> I hope this proposal will be to perform ALL vascular studies 24/7. I
>> think if you are going to start performing inpatient studies, then you need
>> to be prepared to take call and perform all the vascular studies. It is
>> unfair to "cherry pick" the daytime impatient studies and leave the after
>> hours work for someone else. T, and radiology, may be more amenable if they
>> can see a benefit from somoen coming in and taking revenue from their
>> department.
>>
>>
>>
>> Audrey
>>
>>
>> ------------------------------
>>
>> *From:* Mindy Crotwell <[log in to unmask]>
>> *To:* [log in to unmask]
>> *Sent:* Monday, January 9, 2017 7:30 PM
>> *Subject:* Vascular Lab and Inpatient studies
>>
>>
>> Hi everyone,
>> I wanted to ask a question to everyone out there. Right now our lab is
>> an outpatient lab. We are connected to the hospital but only see
>> outpatients. My medical director would like us to start going over to the
>> hospital and seeing inpatient studies. Right now the general ultrasound
>> (under the radiology department) handles everything done in the hospital
>> including vascular studies. A few of them are RVT's however that is not
>> there specialty and our Medical director is not happy with their studies.
>> I agree with him in that we need to start going over to the hospital and
>> seeing these patient. I am trying to put a proposal together on why it is
>> important for vascular lab to be present in the hospital performing these
>> specific studies.
>>
>> Does anyone out there know of any good articles I can reference to help
>> my case?
>>
>> I always appreciate all the great advice I get on here.
>>
>> Thanks in advance,
>>
>> Mindy Crotwell, BS, RVT
>> UAB Kirklin Clinic
>> Birmingham, AL
>> 205-801-8895 <(205)%20801-8895>
>>
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