Lodovico ‘Vico’ Marziale

Lodovico ‘Vico’ Marziale is director of the cardiology service line, including the cath/electrophysiology labs, at Ochsner Medical Center in New Orleans, LA.

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How long have you been in your current position and what are your primary responsibilities?

I'm approaching my tenth year here at Ochsner, and my primary responsibilities are overseeing the day-to-day management of our interventional cardiology and electrophysiology program at the main hospital. I also have oversight over the service line of all the cath labs in the other eight community hospitals in our health system. There are 23 labs in total that handle a range of procedures. We have a very large structural heart program that includes TAVR, left atrial appendage (LAA) closure, and MitraClip procedures. We also have a big cardiology program, as well as vascular surgery and pediatric interventional cardiology. We're in the process of building a hybrid room that is expected to be finished in the first quarter of 2021. That room will be used primarily for structural heart procedures and will eliminate the need to use the OR in many instances.

Are your staff currently involved in any clinical trials?

Yes, we have a little over 100 cardiology-related clinical trials going on at the moment. One of the trials is evaluating a renal denervation system in hypertensive patients. Another, in patients with resistant hypertension, is testing an investigational device that is implanted in the carotid artery to reshape the carotid sinus and stimulating baroreceptors to reduce blood pressure. Other technology trials involve the MitraClip device and LAA closure.

How do staff train for new technology in the lab?

In our electrophysiology lab, for example, we set aside an education hour on Wednesday morning. Whenever there's a new trial that we will be participating in we have staff meetings and in-services to educate the staff on their part in the trial, as well as all relevant background clinical information that they need to know. Also, if they need to train with new equipment or a new technique, they can do it at that time.

Have you had any recent challenges that your labs have faced? How have you dealt with that?

Staffing is a continuous challenge, whether it’s techs or nurses. Just when you think you are fully staffed, you’re not. We've really tried to work to create a better environment for retention as well as recruitment purposes. I moved everybody to a 4-day work week, which people seem to like. We also have incentives for getting certified. You move up to a different job description with some of those certifications. Another thing we’ve done is create competency levels that are based on involvement and investment in the department whereby people are rewarded for achieving higher levels of competency. One thing that I am always stressing to staff is that we place great importance on bringing all our ideas to them to get their input prior to implementing anything, and that we want any and all ideas they have for improving the work environment.

We're a big hospital, which means 24/7 we have a large group of well-trained nurses who are working. One improvement I’ve been considering lately is trying to see if we get an in-house nurse to cover call for the cath lab. Nurse recruitment is an area of particular difficulty right now, so new and creative ways of making things easier for them is always on our minds.

What do you like best about your job and why do you think it's a good fit for you?

The people I work with are great and they are always receptive and open to working with me on whatever problems might be going on in the labs. That support is the number one thing that has kept me here this long. The other thing is the ability to be creative. There are always a large volume of issues and problems you need to deal with daily, and sometimes you need to attack those from different perspectives. Ochsner actually encourages thinking out of the box and trying new things, and I enjoy being able to do that. I have a very good group of peers who have managing director positions over the caths labs at the community hospitals, and we get together once a month to discuss everything from supply contracts to quality to staffing. We all have the same goal of ensuring that patients are being treated the same at our hospitals and that the quality is consistent.

What do you like to do in your free time?

One of the things I love most about living in New Orleans is the great food and music. I have a tiki bar in my backyard and enjoy having folks over and entertaining. It’s always fun to come up with special cocktails and plan good times for my family and friends. I have four grown children, my baby just turned 21, and my family is very close. Fortunately for me, they all live nearby, so it’s easy for us to get together frequently.

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