Outpatient care migration + other challenges this California hospital's cardiovascular department is facing

Shifts to outpatient care are one of the greatest challenges cardiology departments at hospitals are navigating today, says Connie Boyd, cardiovascular service line director at Santa Barbara (Calif.) Cottage Hospital.

Ms. Boyd recently joined the Becker's cardiology podcast to discuss outpatient care migration and other challenges she's leading through today. 

Here is an excerpt from the podcast. Click here to download the full episode. 

Editor's note: This response was lightly edited for length and clarity.  

Q: What are the biggest challenges you're facing today?

Connie Boyd: In cardiovascular in particular, we're addressing shifts of care from the inpatient setting to the outpatient setting as these technologies and procedures that are minimally invasive evolve. There are hospital stays now that are less than 24 hours often, or maybe just 24 hours.

For us, in the case of TAVR and MitraClip, [patients] go home the next day, and so CMS is looking at that. They're looking at cost cutting as well, Medicare. So we're going to see whether they're going to offer payment and reimbursement for these procedures in an outpatient setting. That's not in the too distant future. 

For hospitals, we've invested heavily in equipment and resources. ...Technology is evolving very quickly, particularly in digital healthcare, as well as some of the artificial intelligence, and oftentimes these things come with a pretty hefty investment and with it evolving so quickly, it can be a challenge for hospitals to want to stay at the forefront of these emerging advancements. 

Knowing you may have made a huge investment in infrastructure and resources, and in one or two years down the line it's changed — that's a huge challenge. 

And then again, the workforce and the changes happening with that. For example, with nursing, a lot of nurses are coming up on retirement age and getting ready to do that and so, I know a lot of nursing school programs have worked very hard to get nurses in and trained. But it's not just the supply of these clinical resources, and we're seeing some of these same occurrences with physicians. But it's also their expectations — I think the workforce today has very different expectations as to the workforce 20 or 30 years ago. 

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