Excellence in Cardiology
Outstanding Heart Care
The pursuit of Excellence in Cardiology began with a multi-disciplinary
team approach, consisting of representatives from Cardiology, Administration,
Case Management, Medical Records, and Performance Improvement, along with
a Physician Advisor. One of the first decisions made was to define
“excellent performance”. Benchmarks researched included top performance according to
Centers for Medicare and Medicaid Services (CMS),
Louisiana Hospital Association (LHA), and
Thomson Reuters Top 100 Hospitals for Cardiology. This encouraged Thibodaux Regional Health System to set
the bar high for this initiative.
Defining Best Practices
HealthGrades, a nationally recognized health care consulting firm, was
engaged to assist in clinical improvements focusing on cardiology outcomes.
A detailed analysis of our cardiology outcomes was performed by a HealthGrades
physician and engineer, and our performance was compared to best practices.
This information was presented to the Cardiologists. Consensus was gained
to focus on Heart Failure, Acute Myocardial Infarction, Percutaneous Angioplasties
and Morbidity and Mortality Reviews. Teams were formed and developed guidelines
and protocols based on best practices.
Examples of best practices implemented include the use of research based
scoring tools such as the Mayo Score and Euro Score to assist the cardiologists
in predicting a patients risk of mortality for coronary artery bypass
graft (CABG) surgery versus an angioplasty. The results of the scoring
tools lead to proactive treatment for moderate risk patients. The Heart
Failure team has implemented a comprehensive educational program for patients
with this chronic condition. The education covers diet instructions, weight
management, pathophysiology and medication compliance. The team has also
implemented post discharge phone calls to reinforce the teaching the patient
received in the hospital, discuss follow up appointments and track the
patient’s daily weight gain. These two interventions have made a
tremendous impact on congestive heart failure (CHF) readmissions. The
acute myocardial infarction (AMI) team developed a comprehensive physician
order set under the direction of the cardiologist. Implementation and
use of the order set has demonstrated a reduction of length of stay by
one day. The successes we have seen thus far would not have been possible
without physician support and leadership to improve cardiology outcomes.