Implantable Cardiac Devices Standardized Throughout Fraser Health

Effective September 2012, a regional model to standardize the service and delivery of Implantable Cardiac Electrical Devices (ICED) has been implemented throughout the Fraser Health Authority (FHA).

The purpose of the ICED project is to improve inpatient and outpatient access to device implants and replacement.

The types of devices included are:

• Permanent pacemakers (PPM)
• Implantable cardioverter defibrillators (ICD)
• Cardiac resynchronization therapy (CRT) devices

In his role as Hospital Medical Coordinator for the Jim Pattison Outpatient Care and Surgery Centre (JPOCSC), Dr. Holmes (president of Global Medical Services) was involved with the ICED project by assisting and providing input into the project to the extent it impacted on physicians and/or service planning at the JPOCSC.

The team at Global Medical Services also contributed to revisions to the transport and admission protocols for the JPOCSC and other FHA facilities for patients receiving cardiac implants.

Presently, two hospitals have been designated as regional ICED sites:

• Royal Columbian Hospital (RCH) – PPM, ICD and CRT devices
• Jim Pattison Outpatient Care and Surgery Centre (JPOCSC) – PPM only

The development of the ICED project has led to a variety of new clinical practice tools with the standing goal of improving device implants and replacement:

• Regional referral form
• Pre and post-procedure pre-printed physician orders
• Inter-hospital transfer instructions and checklists, outpatient checklist and pamphlets
• Patient and Family Information booklets

Current pacemaker practices were refined to align with the new regional model, such as the exclusion of an anaesthesiologist during PPM implantation for certain patients who meet defined criteria.

In lieu of an anaesthesiologist there will be trained personnel present during the procedure dedicated to monitoring the patient. In the future, this practice change will allow for PPMs to be implanted in procedure rooms other than operating rooms; allowing for more versatile use.

Dr. Holmes and Global Medical Services applaud Fraser Heath for their excellent work developing the ICED project.