U-M CVC: Taking risks and realizing rewards

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The opening of the Cardiovascular Center building in 2007 signified a broader commitment by Health System leadership to prioritize and invest in cardiovascular patient care, education and research.  CVC leadership – including Directors Kim Eagle, David Pinsky, Richard Prager and James Stanley, along with Chief Administrative Officer Linda Larin – took this opportunity to renew the entire U-M cardiovascular community’s vision of being the best academic heart and vascular center in the world.  From the main medical campus to sites in Ann Arbor, Brighton, Canton, Chelsea and Livonia, the CVC community has rallied behind this vision and behind the center’s four core values: respect and compassion; collaboration; innovation; and commitment to excellence.

By aligning services under a leadership model of four directors working together to share resources and make decisions to benefit the cardiovascular community and Health System, CVC leadership began breaking down walls between specialties, creating collaborative care models that discourage internal competition and cultivating a culture of respect, accountability and teamwork.

Their work is paying off, most notably in a steady climb in U.S. News & World Report rankings in heart and heart surgery, which rose from 22nd in 2007 to 11th in 2010. Below I’ve highlighted some of the many other CVC successes:

Patient- & Family-Centered Care (PFCC)

Guided by the principles and practices of the national Institute for Patient- and Family-Centered Care, the CVC  has consistently demonstrated how to creatively embed PFCC values in everything they do with initiatives like:

  • Creating  the CVC Patient Family Advisory Committee, made up of patients, family members, faculty and staff, and chaired by a patient;
  • Ensuring that waiting areas and patient rooms support a healing environment. In fact, in 2009, the Cardiac Procedures Unit was profiled in an EpLab Digest article about creating the “ideal waiting room experience;”
  • Exploring the idea of having a physician and patient co-present at resident orientation to share a “real life” experience that exemplifies the importance of PFCC;
  • Planning to add a “Wish I Would’ve Known” blogspot to its Facebook page so that patients and families can share information that helps other patients and families better plan and prepare for cardiovascular care visits.

Collaboration & Innovation

In the CVC community, collaboration means honoring the synergy of team built on trust and innovation means honoring the individual and collective creativity. When put into action, there is no limit to what can be accomplished. Consider these stellar examples:

  • The CVC is one of 40 hospitals nationwide to participate in the Medtronic CoreValve U.S. Pivotal Trial, which focuses on percutaneous aortic valve replacement procedures that have the potential to transform care for patients who can’t tolerate open heart surgery. To date, our team led by Dr. Michael Deeb of Cardiac Surgery and Dr. Stanley Chetcuti of Cardiovascular Medicine has completed seven successful procedures.
  • After a highly competitive process, U-M was named the Data and Clinical Coordinating Center for REVIVE-IT, a $13M National Institutes of Health and industry-sponsored trial for implanting left ventricular support devices in heart failure patients. U-M Drs. Francis Pagani and Keith Aaronson are two of the trial’s three principal investigators.

Quality & Excellence

CVC faculty and staff have embraced lean thinking and quality improvement with great results, including:

  • A multidisciplinary group of catheterization lab and ER staff has reduced the time it takes for an acute myocardial infarction patients to get from “door to balloon” to 50-60 minutes, which is well below the Centers for Medicare and Medicaid Services benchmark of 90 minutes.
  • Multidisciplinary lean projects undertaken by cardiac and vascular surgery units – and involving patients – have helped standardize post-operative care and decrease length of stay by an average of one day.
  • When there is a significant time gap between discharge and a patient’s next appointment with a cardiologist, patients are offered an interim visit with a Nurse Practitioner or Physician’s Assistant through the Bridge Clinic. These visits take place within 14 days of discharge and ensure the patient has appropriate resources and support at home and understands her/his medications, diet and  self-care instructions. Early data indicate a positive impact on decreasing hospital readmission rates and Emergency Department visits for coronary artery disease and heart failure patients.

Amidst all of the CVC community’s great achievements, however, is one that impresses me the most: nobody thinks that their work is done. For every success, CVC faculty and staff have identified other opportunities for improvement.

I know the CVC is poised to continue its upward trajectory as a leader among peer institutions worldwide because they understand that it’s not just about where you are, it’s about where you are going.

What do you think?

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