Core Curriculum Clinical Expert Consensus Statement on Best Practices in the Cardiac Catheterization Laboratory: Society for Cardiovascular Angiography and Interventions Srihari S. Naidu, 1 * MD, FSCAI, Sunil V. Rao, 2 MD, FSCAI, James Blankenship, 3 MD, FSCAI, Jeffrey J. Cavendish, 4 MD, FSCAI, Tony Farah, 5 MD, FSCAI, Issam Moussa, 6 MD, FSCAI, Charanjit S. Rihal, 7 MD, FSCAI, Vankeepuram S. Srinivas, 8 MD, FSCAI, and Steven J. Yakubov, 9 MD, FSCAI Key words: angiography coronary; diagnostic cardiac catheterization; complications adult cath/intervention; percutaneous coronary intervention INTRODUCTION The cardiac catheterization laboratory (CCL) is a set- ting in which elective, urgent, and emergent percutaneous procedures are performed. This poses challenges to main- taining and prioritizing high quality care and patient safety. Nonetheless, process expectations of a high-qual- ity CCL include appropriate periprocedural communica- tion, clinical management, documentation, and universal protocol. Regulations primarily targeted at open surgical operating rooms have the potential to negatively impact care because they may mandate focus on performance measures that are not necessarily relevant to the cardiac catheterization laboratory. For example, routine site mark- ing for percutaneous access is irrelevant for most patients since failure to obtain access on one side (e.g., right femo- ral artery) simply leads to attempting access on the other side (e.g., left femoral artery). Instead, directives should be tailored to the percutaneous procedure setting to assure quality and optimal patient safety. This document will therefore provide expert consensus opinion on a number of issues pertaining to ‘‘best practices’’ within the CCL, focusing on quality and safety during each step of the pro- cess. The writing committee acknowledges a dearth in high-quality published studies in this area, making many of the enclosed recommendations based primarily on expert consensus. Although references are provided when available, further research specifically in catheterization laboratory processes and quality improvement is needed. The document is divided into ‘‘best practices’’ that should be performed during the preprocedure, intrapro- cedure, and postprocedure settings for diagnostic car- diac catheterization and coronary intervention, to be consistent with the typical patient flow into and out of the CCL. Despite the long history of cardiac catheteri- zation that dates back several decades, a document describing these ‘‘best practices’’ has not yet been writ- ten. The purpose of this document is not to represent all acceptable practices, but to provide consensus opin- ion on what would currently be considered ‘‘best prac- tices’’ as future goals for catheterization laboratories. 1 Division of Cardiology, Winthrop University Hospital, Mineola, New York 2 Division of Cardiology, Duke University Medical Center, Durham, North Carolina 3 Geisinger Medical Center, Danville, Pennsylvania 4 Division of Cardiology, Naval Medical Center, San Diego, California 5 West Penn Allegheny Health System, Pittsburgh, Pennsylvania 6 Division of Cardiology, Mayo Clinic, Jacksonville, Florida 7 Division of Cardiology, Mayo Clinic, Rochester, Minnesota 8 Division of Cardiology, Montefiore Medical Center, New York, New York 9 Riverside Methodist Hospital, Columbus, Ohio Conflict of interest: Nothing to report. *Correspondence to: Received 28 November 2011; Revision accepted 24 December 2011 DOI 10.1002/ccd.24311 Published online 00 Month 2012 in Wiley Online Library (wiley onlinelibrary.com) J_ID: Z7V Customer A_ID: 11-1714.R1 Cadmus Art: CCD24311 Date: 9-March-12 Stage: Page: 1 ID: srinivasanv I Black Lining: [ON] I Time: 04:00 I Path: //xinchnasjn/01Journals/Wiley/3b2/CCD#/Vol00000/120041/APPFile/JW-CCD#120041 V C 2012 Wiley Periodicals, Inc. Catheterization and Cardiovascular Interventions 00:000–000 (2012)