Posted on: 29 July 2016
Whether you're a cardiologist starting a new practice or an internal medicine specialist looking to enhance your services, if you're setting up a cardiac stress test lab, there's a lot to think about. Here are four considerations you don't want to ignore.
Cardiac stress testing equipment takes up more square footage than you might imagine. You will need room for at least one treadmill (preferably with an extra-long deck, see below), as well as for an EKG (ECG) monitor/control station and multiple people administering the test (e.g., physician/exercise physiologist, nurse/EKG technician, radiation technologist, etc.).
You can easily mark out prospective equipment locations with masking tape on the floor to see if you have allowed enough space for both the equipment and people maneuvering around it. If your patient will be changing and prepped in the same space as the test, you will also need additional square footage for that.
Because cardiac stress testing can occasionally precipitate medical emergencies, you need to make sure you have adequate room in or nearby your testing space for a crash cart and, in the worst case, a code team or ambulance service. You should have a bed on hand for such emergencies and for patients who may need to rest lying down or elevate their legs after a test.
Treadmill and EKG Equipment
The treadmill and EKG monitoring equipment should be from a reputable supplier, whether you purchase new or used equipment, and should have a warranty period during which any parts will be fixed or replaced. While it may be cheaper to piece together a system using a health club-grade treadmill, it's better to purchase a system that is designed expressly for cardiac testing, since it will be easier to integrate the various components.
The newest EKG systems transmit 12 lead data wirelessly to the technician's stand for both live viewing on a monitor and printing to EKG paper for analysis later and for medical records. Some systems can also send digital data to electronic medical records. Other factors to look for include:
- extra-long, heavy duty walking deck to accommodate taller patients
- weight capacity that can handle your larger patients
- front and side rails for safety
- zero-start feature that allows you to gradually build up speed
- ability to handle a full standard Bruce protocol
- gradual stop feature
- emergency stop button
- minimal motor and belt noise to facilitate conversation with patients and hear blood pressure readings
Distance from Radiation Services
If you are offering myocardial perfusion studies in addition to simple exercise tolerance tests (ETTs), you will need to carefully consider the distance of your treadmill room from radiation services. You want to make sure it's not too far for patients to walk between resting images, testing, and exercise images, or you will have to arrange for wheelchair services for some. Also, you need to know that your radiation technologist can make it on time with your tracer injection, so it can be given at the optimum time during testing.
Opportunity for Alternative Stress Tests
Finally, if you will be providing myocardial perfusion studies, you will likely want to offer chemical testing alternatives (adenosine, dobutamine, etc.) for patients who cannot walk on a treadmill or for whom a left bundle branch block prohibits an ETT. In this case, you will need a large bed, as well as IV equipment and space for a physician and/or nurse to sit by the patient's side.
It can be challenging to accommodate all the necessary components, but once you have done so, not only will you be able to better serve your patients, you'll be able to increase your bottom line as well.
For more information, contact Chesapeake Healthcare Planning or a similar company.Share