Allied Professionals Community of Practice

For those of you who have device clinics in different locations, especially those some distance from the central practice, how do you train/staff those clinics. Do you try to hire people that live in those localities? Does the training occur in the outlying clinics, or does the trainee travel to the central location during the orientation period, which can be lengthy? Are you ok with a new trainee staffing an outlying clinic, as opposed to more senior staff? Do you staff out of the main device clinic, requiring occasional travel for everyone?

Thanks

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Janet Powell MSN, FNP
Nurse Practitioner
EP Program Manager
Ballad Health CVA Heart Institute
Kingsport TN
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Hi Janet,

I had an outlying clinic 90 miles from my main office.  We made sure to use remote monitoring on everyone we could and had patients come in once per year.  We scheduled a "device clinic day" once or twice a month.  Staff would take turns traveling to the clinic on those days and doing in-office checks.  The staff doing the checks needed to be comfortable and independent in decision making so we utilized  senior staff. If a patient had an urgent need for a device evaluation, we used remote transmission first.  If this was not possible, or if we then decided in-person was needed, we sometimes were able to get assistance from a rep.  Otherwise, the patient made the trip to our main office.  Hope this helps.

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Maryellen King MSN, ANP, RN, CCDS
VP of Clinical Operations
Cardiac RMS
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Hello Janet,
We have 9 total device clinics within our system.  3 of them are in medical plazas connected to hospitals with multiple EP MDs, EP APPs and are implant centers.  The other 6 range in size and a few are in rural areas.  If we don't have staff that live close to an outlying clinic, we will rotate seasoned clinicians to travel for clinic coverage.  We will not place a device clinician (RN or Tech) in an outlying clinic until they have at least one year of experience.  We will train staff in the outlying clinics to give them hands-on-experience and to help them develop the skills they need to function independently - which means more than checking devices.  They learn how to navigate the review of messages in EPIC, handle add-on patients, assist with remote alerts if those patients need to be seen in person, etc. Over the years it has just worked out organically that we have staff that live nearer to some of the smaller clinics and they end up taking them over as the lead clinicians.  This has proven to be a great retention strategy for staff and it is a definite patient engagement win.
thanks - ​

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Elizabeth (Beth) Davenport, MSN, RN, BA, CNML
Clinical Director of Virtual Care & Cardiac Device Clinic
Sanger Heart & Vascular Institute
Atrium Health
Charlotte, NC
704-446-2214
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Hi Janet,

University Hospitals of Cleveland maintains 12 outpatient clinic locations.  Most of the clinics are staffed by RN members of our central device staff.  Due to the physician presence requirement, one of the EP physicians is accompanied  to the satellites by one or two device nurses.  The EP sees a separate list of patients while the device clinic RNs see a schedule of device patients.  One of our newer locations is a hospital about 100 miles from Cleveland.  The RN that staffs that location completed several weeks of orientation with our main campus staff. 
Some of the satellite clinics are staffed by me.  As an NP I see device patients at various locations. 
Please let me know if I can help you in any way.
-paul            ​

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Paul Kohanski CNP, FHRS, CCDS
Nurse Practitioner Device Clinic
Univ Hospitals of Cleveland, Cardiology
Cleveland OH
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