Episode # 3 • 17 Jan 2025
Quality Improvement in the Cardiac Cath Lab: Strategies & Impact
A creatinine of 0.9 can hide a GFR of 45, and at Columbia that gap is now called out in every cath lab time-out. On this episode of BackTable Cardiology, Dr. Sameh Sayfo talks with Dr. Megha Prasad, interventional cardiologist and co-director of the interventional cardiology fellowship at Columbia University, about the side of the cath lab most fellows are never taught: quality improvement, operations, and making the case for new technology. Dr. Prasad traces her interest back to root cause analyses during residency, explains who really defines quality, and walks through two initiatives, a contrast checkpoint to prevent acute kidney injury and a standardized weaning protocol for mechanical circulatory support. She also explains why awareness and an operator's own data move colleagues more than penalties, and how fellows can become a lab's standard keepers.
This podcast is supported by an educational grant from Cheisi.
Timestamps
00:00 - Introduction
03:10 - From Root Cause Analysis to Quality Improvement
05:20 - Who Defines Quality in the Cath Lab?
07:50 - A Time-Out Checkpoint to Prevent Contrast-Associated AKI
11:55 - Winning Buy-In Without Penalties
16:04 - Engaging Fellows in Quality Improvement
21:04 - When Quality Metrics Go Too Far
27:30 - Cath Lab Turnover and Team Morale
33:02 - Building a Culture of Respect in the Cath Lab
41:45 - Learning to Talk With Hospital Administration
45:54 - Making the Case for New Therapies
51:28 - Closing Remarks
Resources
You may also like
More about this episode
The doctors then discuss what happens when quality metrics go too far: public reporting that can push operators away from the most complex patients, and why Dr. Prasad thinks interventionalists, like artists, must choose which outside feedback to take. She describes how team morale drives cath lab turnover, why a hierarchical cath lab is a dangerous one, and how physicians can learn the art of negotiation with hospital administration. They close on leaving ego at the door, backing every request for a new therapy with data, and how patients informed by AI are changing the conversation.
The Materials available on BackTable are provided for informational and educational purposes only and are not a substitute for the independent professional judgment of a qualified healthcare professional in diagnosing or treating patients. Any opinions, statements, or views expressed are those of the individual contributors and do not necessarily reflect those of the publisher, platform, or any affiliated organization.