February 20, 2009

VHVI meet outlines performance goals

VHVI meet outlines performance goals

The Vanderbilt Heart & Vascular Institute (VHVI) held its quarterly town hall meeting Feb. 12, and the economy was front and center on the agenda.

Keith Churchwell, M.D., executive medical director of VHVI, outlined ways in which the Heart Institute can help implement the Medical Center's plan to reduce spending.

“We need to look at our own ability to enhance patient access to VHVI, to provide excellent services and to reduce overall expenses,” he said.

“We have been going through a process over the last eight weeks or so on what we need to do better — to be more efficient. This includes maximizing patient care and outperforming budget so we have enough resources to be able to do what we need to do over the next several months.”

VHVI clinic administrators have been keeping a close eye on overtime, while the inpatient units on 5 North, 6 South and 7 North have been monitoring staffing to ensure that they have the proper number of staff to provide quality patient care.

“Our main expense is salary,” said Todd Griner, department manager for inpatient cardiology. “The charge nurse e-mails me throughout the day to make sure we're staffing at an appropriate level. We've been under budget for the last three pay periods.”

Doug Sawyer, M.D., Ph.D., director of the Division of Cardiovascular Medicine, addressed the topic of creative growth — projects that don't cost money but enhance the bottom line.

These include:

• A surgical approach to atrial fibrillation that involves a multidisciplinary team of electrophysiologists and cardiac surgeons collaborating in the operating room to treat this most common form of arrhythmia

• A combined cardiology/oncology clinic to offer cardiac services to patients who are getting complicated cancer treatment, which can have detrimental cardiac effects

• A formalized prevention program that will be primarily located at One Hundred Oaks beginning in April

• A recommitment to the heart transplant program that has resulted in doubling the number of transplants VHVI has performed over the last year.

On the research front, MacRae Linton, M.D., and Sergio Fazio, M.D., are studying early atherosclerosis and found if they remove a receptor for a prostaglandin, which is an inflammatory mediator, they can remove the tendency for atherosclerosis.

This opens up potential preventive therapy, Sawyer said. Clinical research includes looking at new strategies to image atherosclerosis to detect inflammation early in its development.
Cardiac surgery volume was up in September and January. “We had banner months,” said

John Byrne, M.D., chair of the department, adding that he expects the department to continue to perform about 100 cases a month.

He reminded the standing-room-only crowd that VHVI is part of a large institution capable of weathering the economic storm.

“We need to reprioritize our expenditures, but it will be good for us and will make us better and stronger and more efficient,” he said.