The annual MedAxiom Cardiovascular Service Line Symposium, which this year took place June 10-12 in Atlanta, allowed presenters and attendees to examine the nuts and bolts of high-quality patient care and share insights on what works and what doesn’t. Here is a sampling.
Joining network puts heart program in perspective
Michael Mack, MD, chair of the cardiovascular governance council and director of cardiovascular surgery at Baylor Scott & White Health in Dallas, explained how partnering with the Cleveland Clinic elevated its program. In December 2014, Baylor joined the Cleveland Clinic’s Cardiovascular Specialty Network, making Baylor the Cleveland Clinic’s exclusive provider for Texas and Oklahoma referrals.
The network is designed to allow patients whose employers use Cleveland Clinic’s services to receive high-quality regional care rather than have to travel, he says. It emphasizes shared protocols to reduce variation in practice and improve outcomes, and it requires full transparency in peer review of outcomes.
The greatest benefit to Baylor Scott & White has not been in its ability to draw patients beyond its established footprint, Mack says. “If we never saw a patient from the employer-direct contracting network, the affiliation would still be worth it. As good as we thought we were, the Cleveland Clinic is just a little bit better.”
Supply metrics reward cardiologists who meet utilization goals
Christopher White, MD, isn’t just chief of medical services and medical director at the John Ochsner Heart & Vascular Institute in New Orleans. He’s also a veteran who applies lessons learned in the Army to running an efficient service line.
The challenge for systems such as Ochsner is aligning its disparate physician groups to meet goals. While all of Ochsner’s physicians at the medical center are employed, only about 20 percent in community hospitals are; about 60 percent are aligned or independent.
That’s where his training in the Army proves useful. “If you are going to be a good leader in the Army you have to be a good follower,” he says. That credo creates cooperation and collaboration, and those who work together to achieve goals earn autonomy.
Ochsner uses employed and community cardiologists in its seven catheterization labs. As part of a supply chain management initiative, Ochsner polled cardiologists about their drug-eluting stent preferences, which proved “all over the map.” Leadership proposed that if the cardiologists used one vendor for half of their cases—a cost-saving move that wouldn’t impact quality—they could have their preferred stents for the other half.
Systemwide, they achieved a 53 percent utilization rate and met their target with $300,000 in savings.
“The doctors are not unhappy about this,” he says. “They thought they had the power and accountability that earned them autonomy.”
They since have extended the strategy to defibrillators and pacemakers.