Environmental Scan - Government of Nova Scotia

Physician Resource PlanningAn Environmental Scana coronary artery. Special x-ray dye or contrast is passed into the catheter, allowing thecardiologist to see the chambers, valves or coronary arteries on an x-ray screen.• Echocardiography Service• Sentinel Service indicators: Echocardiogram, Doppler Ultrasound, Contrast Echo, Stress Echo• Maintenance of competency:• Transthoracic 200 studies / year, Transoesophageal 25/ year, Stress echo 100 / year 63• Angioplasty Service• Sentinel Service indicators: Percutaneous Coronary Intervention (PCI), Percutaneous TransluminalCoronary Angioplasty (PTCA), Insertion of Intracoronary Stents• Maintenance of competency:• Individual – 75 PCIs per year is the recommended minimum including 11 cases per year involvingprimary PCI (PPCI) for ST elevation myocardial infarction if the operator participates in a routinePPCI service.• Centre – at least 200 interventions per year with an ideal minimum of 400 interventions per year,including 35 PPCI cases per year if the centre offers a PPCI service.• Nuclear Cardiology Service• Sentinel Service indicators: Cardiac perfusion scan, stress radionuclide cardiac imaging studies,gated cardiac scan• Maintenance of Competency: 100 cardiac imaging studies per year (source: American CollegeCardiology)• General cardiology Service• Sentinel Service indicators: Consultations, follow-up, half-day clinics, Exercise ECG Tests• Maintenance of Competency: 25 exercise ECG tests per year (source: American CollegeCardiology)• Cardiac critical care Service• average daily patient count, hours on service (in-hospital and 1 st call)23.2.2 Critical Care MedicineCurrently, and in comparison to, Nova Scotia:• QEII Level 1 ICU is 1,340 clinical and 450 academic scheduled hours, plus 104 hours on 1 st call over andabove scheduled hours for a total of 1,894 hours on service per year.• Benchmark(s)• Average Level I (only) ICU intensivist annual hours on service (scheduled hours in-house plus hourson 1 st call) is 1,898 across the seven surveyed Level I adult CCUs. The 40 th and 60 th percentileswere 1,659 and 1,826 respectively.• Outreach hours (formal, separately scheduled, separately staffed and paid) are integral to service.Most centres provide night outreach service via a cross-coverage model where the attending onnight call covers in-house and outreach services.63 The Cardiac Society of Australia and New Zealand, Training Guidelines in Adult Echocardiography, Nov 2009199 | Page Social Sector Metrics Inc. & Health Intelligence Inc. | 12/31/2011