June 9, 2011

Heart Institute key initiatives updated at town hall meeting

Heart Institute key initiatives updated at town hall meeting

Vanderbilt Heart & Vascular Institute held its quarterly town hall on Monday, at which time leadership updated faculty and staff on key initiatives centered on the themes of quality, safety and patient-centered care.

John McPherson, M.D., associate professor of Medicine, provided an overview of the Acute Coronary Syndrome (ACS) Demonstration Pilot, an opportunity to explore new ways to serve patients and their families. VHVI has been chosen by Vanderbilt to pilot this new program and develop a bundled "package" of care for ACS patients, those with conditions such as unstable angina or heart attack.

“Instead of billing for each test and procedure (i.e., fee for service) we are changing the way we think about health care delivery in this country,” McPherson said. “This is in alignment with the health care reform bill…instead of being compensated for every procedure we do, we’re going to take ownership of every patient for six months, from inpatient care to outpatient care to ancillary care.”

Over the course of the past year, the pilot program has identified three “high value” opportunities for change: the transition of care from inpatient to outpatient (it will no longer be called discharge); medication reconciliation, the most difficult and most important step; and engaging the patients and their families so they take ownership of their health.

“Through this process we learned we deliver care based on what we think is best for the patient, but we’re not always putting ourselves in the patient’s position. We need to think about patient-centered care when they leave the hospital and make sure that our patients understand everything going on in that transition,” McPherson said.

The expectation is that this new payment structure will roll out broadly in 2014.

In other announcements, John Byrne, M.D., chair of the Department of Cardiac Surgery, announced the hiring of Simon Maltais, M.D., Ph.D., who will join VHVI in July as the head of the heart transplantation program and ventricular support program. Maltais comes to Vanderbilt from the Mayo Clinic. Additionally, Joseph Fredi, M.D., is the new medical director of the Cardiovascular Intensive Care Unit, a position held by McPherson, who was recently named the associate program director for the Department of Medicine residency program.

Leading safety expert Allan Frankel, M.D., visited VHVI in May to make recommendations on how VHVI can fulfill its mission to be among the safest institutions in the country. He stressed the importance to plan forward (caregivers need to brief each other before beginning work with patients); debrief (at the end of the day, procedures, patient interventions); communicate clearly; resolve conflict (to promote identification of safety and reliability issues); standardize care; fix what you can, get someone to fix what you can’t and tell everyone what you have fixed.

Keith Churchwell, M.D., executive medical director for VHVI, offered congratulations to medical receptionist Edna Wilson and her colleagues on 6 south (cardiovascular step down unit), who achieved 100 percent compliance in hand hygiene.

The next Town Hall is scheduled for Wednesday, Aug. 31, at 7 a.m.