Kent gets OK for lifesaving procedure

Hospital to build second cardiac catheterization lab

John Howell
Posted 3/21/15

“It will go right here,” Dr. Chester Hedgepeth, MD, PhD., chief of cardiology at Kent, said yesterday as he ran his hand over an interior wall to the control room of the hospital’s cardiac …

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Kent gets OK for lifesaving procedure

Hospital to build second cardiac catheterization lab

Posted

“It will go right here,” Dr. Chester Hedgepeth, MD, PhD., chief of cardiology at Kent, said yesterday as he ran his hand over an interior wall to the control room of the hospital’s cardiac catheterization lab.

What Hedgepeth envisions is a second cardiac catheterization lab as the hospital performs elective – followed, in about eight months, by emergency coronary angioplasty – procedures.

The move to implement a coronary angioplasty program at the hospital goes back years. In 2008 the Department of Health approved a limited program for emergency procedures, but then because of staffing issues it was never implemented. Last year, the hospital reapplied to the Department of Health, and last week, Care New England gained approval to run a program.

“We have the doctors and we are getting the staff trained,” Michael Dacey Jr., MD, Kent Hospital president and COO, said in an interview yesterday.

Dacey said it “makes sense” that the hospital start with elective procedures and then graduate to the emergency ones. That will happen once the second lab, which will cost about $4.5 million, is built and is operational. That is expected to happen by the end of this year.

It can’t come fast enough for Warwick residents and those living south of the city, in Dacey’s opinion.

From the outset of efforts to perform coronary angioplasty, a procedure that opens a blocked coronary artery by inflating a balloon and stent in the diseased artery, the hospital has stressed how important time is to saving the life of a person or averting complications for a patient having a heart attack.

Dacey said every 30 minutes following a heart attack adds 8.5 percent to the rate of mortality. On that basis, he points out, even a 20-minute ride from Kent to Rhode Island or Miriam Hospital under good traffic conditions reduces a patient’s chances of a good recovery. Patients coming from communities to the south of Kent face an even longer run to reach the hospitals in Providence.

“There’s no doubt we’re going to save lives in the first year we’re open,” Dacey said.

He estimated Kent is currently referring about 65 emergency coronary cases annually to the hospitals in Providence. He pointed out that women and diabetics who frequently don’t experience the gripping heart pain of a heart attack would be able to quickly gain treatment when diagnosed rather than being sent elsewhere.

Further, he noted that Kent’s emergency department, which averages 70,000 cases annually, places the hospital in the top 10 percent of busiest emergency departments in the country.

“It’s an essential technology,” he said, “to have at a busy hospital.”

Hedgepeth said patients generally spend a day at the hospital after a procedure, whether it is done electively or on an emergency basis. In some cases, he said, they don’t even spend the night and are discharged.

In a statement released by the hospital, Dacey said, “We look forward, through our clinical affiliation with Brigham and Women’s Hospital, to developing this critical program for our community.”

Dacey said Drs. Edward Thomas and David Williams would play key roles in the establishment and operation of the program at Kent. Williams, who preformed the fourth-ever coronary angioplasty and is a pioneer in the field, will oversee the program.

Hedgepeth thought it would be six to eight weeks before the first elective procedure is preformed. He said yesterday that apart from some equipment and the stents, the existing lab is ready. Currently, the lab is performing between four and 10 cardiac diagnostics and imaging, cardiac ablations and implantation of pacemakers and other devices daily.

In an email response to questions, Andrea Bagnal Degos, spokeswoman for the Department of Health, wrote, “The Director of Health accepted the recommendation of the Health Services Council to approve the proposal for an angioplasty program at Kent Hospital. HEALTH is appropriately concerned about the cost of this type of procedure, and therefore added a condition to the approval, requiring shared decision-making including a discussion of the efficacy of angioplasty verses medical management in each case.”

In a March 27 letter to Dacey, Dr. Michael Fine, Director of Health, voices his concern over the “high cost of tertiary care services such as angioplasty.”

He writes, “The efficacy of the certificate on need process to guard the public from overburdening costs is critically important, and requires a robust capacity to determine those costs. Health care which is unaffordable is by definition inaccessible.”

Conditions of approval include that capital costs associated with the plan not exceed $4,478,000, and that operating costs for the first full year of operation not exceed $3,234,000.

According to data provided by Kent, 2,339 coronary angioplasties were performed in the state last year.

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