Safety & Quality: Heart & Vascular Institute 

Heart & Vascular: Safety & QualityThe Heart & Vascular Institute at Stamford Health is committed to delivering genuine patient-centered care with exceptional quality outcomes. Our achievements include more effective procedures and better outcomes.

Cardiology

As a key component of the Heart and Vascular Institute at Stamford Health, the Cardiology program is committed to the provision of high quality care and the achievement of outstanding results.

Heart and Vascular Team

Approach

The Cardiology team is involved in several leading approaches to quality improvement. These include completion of intensive team safety training with techniques similar to those used in the airline industry, development of care guidelines for best practice, and participation in a number of quality monitoring programs to measure and improve care.

National quality measurement programs the team participates in include the American College of Cardiology National Cardiovascular Disease Registries and the American Heart Association Get With the Guidelines programs. These programs measure care for patients receiving care for heart attacks, cardiac catheterizations, percutaneous coronary interventions (“balloon angioplasty”), implantable cardioverter defibrillators, and heart failure.

 Silver Performance Achievement Award from the American College of Cardiology National Cardiovascular Disease RegistryThe organization recently received the prestigious Silver Performance Achievement Award from the American College of Cardiology National Cardiovascular Disease Registry, for excellence in the care of heart attack patients.

A specific example of the team’s commitment to excellence in cardiac care is its performance on angioplasty (“balloon”) procedures for heart attack patients. For the best chance of survival, these procedures should be done within 90 minutes of arrival to the hospital (“door to balloon time”).

Results

Click Image to Enlarge (Fig. 1)

Using the approaches described above, the team has been able to complete 100% of these procedures within 90 minutes. Figure 1 shows the Cardiology team’s performance on these measures over time and compared to national benchmarks.

The overall commitment to quality and results such as those achieved in the door to balloon initiative, has allowed the team to achieve a better heart attack survival rate than those of other US hospitals, where the benchmark is 15.5%, as you can see in Figure 2.

Click Image to Enlarge (Fig. 1)

For more information on the Program’s quality improvement program and approach to care, contact us.

For more information on the American College of Cardiology National Cardiovascular Disease Registry, visit their website.

For more information on the American Heart Association Get with the Guidelines Program, visit their website.

Cardiothoracic Surgery

As a key component of the Heart and Vascular Institute at Stamford Health, the Cardiac Surgery program has demonstrated a superior commitment to quality of care and achieved outstanding results. The program’s commitment to quality begins with an interdisciplinary team approach to patient-centered care, led by Chief of Cardiac Surgery, Michael Coady, MD, MPH.

Approach

As part of the process, the team monitors a number of measures for quality of care delivered before, during, and after surgical procedures. Examples of measures that are tracked include medications used before and after surgery, types of blood vessel grafts used, rates of complications (for example, kidney failure), and death rates. Stamford Health’s program participates in a national database developed by the Society of Thoracic Surgeons (STS), which allows the cardiac surgery program to monitor all aspects of its performance and compare its results to those achieved nationwide.

Results

To date, the team has completed well over 200 cardiac surgery procedures. It meets on a regular basis to carefully review its performance results and implements processes to continue our efforts to deliver the highest quality of care possible. An example of an area that is closely followed is the use of various medications and interventions on discharge. By following best practice guidelines at discharge, the team strives to maximize patient recovery and reduce the likelihood of a patient being readmitted to the hospital.

SH vs. STS National Isolated Coronary Artery Bypass Graft Discharge Medications

Click Image to Enlarge (Fig. 1)

Results for isolated coronary artery bypass graft surgery procedures from the most recent STS national report are shown in the figures below, for calendar year 2013. Figure 1 shows the cardiac surgery team’s performance on various discharge quality measures for the six months ending June 30, 2013.

Figure 2 shows mortality rates compared to the national average.

Coronary Artery Bypass Graft In-Patient Mortality Rate Stamford Hospital vs. Society of Thoracic Surgeons

Click Image to Enlarge (Fig. 2)

For more information on the Program’s quality improvement program and approach to care, contact us.

For more information on the Society of Thoracic Surgeons, visit their website.

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