Cardiac cath labs operate in an increasingly challenging environment, contending with a variety of clinical, demographic, regulatory and competitive factors.

Recent trial results, multidetector CT and new and more uses for the services and equipment of the traditional cardiac catheterization lab are impacting the bottom line of facilities across the country. These and more factors may have temporarily decreased cath lab procedures, but experts in the field predict recovery—albeit a changing face for the cath lab.

Door-to-balloon time (D2B) is a critical cardiac quality indicator. As a whole, U.S. hospitals are doing fairly well with other quality indicators, says Betsy Bradley, PhD, professor of public health at Yale University in New Haven, Conn., but D2B time is a challenge for many sites. Here are some prescriptions to break the 90-minute barrier.

Cardiac catheterization labs across the country are evolving. Changes in types and volumes of procedures combined with an increasingly competitive environment and reimbursement cuts are forcing cath labs to adapt and fine-tune their management strategies. What brings success? Diversifying into EP and peripheral vascular procedures, tightly managing and even consigning pricey inventory such as drug-eluting stents, cross-training staff, and ensuring high flexibility.