Cardiovascular Quality MeasurementsIn cardiac care, as in all fields of medicine, each patient’s case is different; yet, patterns emerge. Recognizing and responding to patterns, while retaining personalized treatment is a cornerstone of continuous quality improvement in cardiac care at Froedtert & the Medical College of Wisconsin.
Help Shape Care
To monitor quality, staff uses cardiovascular care measurements developed by the Centers of Medicare and Medicaid Services (CMS) and the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO). Among the measurements:
- Percentage of patients who receive beta blocking medication, if appropriate, and aspirin upon arrival
- Percentage of smokers who are given smoking cessation advice during a hospital stay
- Door-to-balloon time, a marker of how fast a team is able to get blood flowing in the heart again, measured from the time patients enter the “door” to the time they receive balloon angioplasty or other treatment to open blocked arteries
- Percentage of patients who undergo a key ventricular function test (LVF) soon after discharge (An LVF tests function of the left ventricle for people with suspected heart failure.)
“The focus is on these measures because research has shown they impact patient outcomes in terms of shorter hospital stays and improved quality of life,” said Karen Hanson, administrative director of Quality Management, Staff Development and Safety for Froedtert Hospital.
Froedtert & the Medical College of Wisconsin, like most other large healthcare providers in the state, report results on these and other measurements to organizations such as the Wisconsin Collaborative for Healthcare Quality and the Wisconsin Hospital Association. These organizations make results and ratings available on their Web sites. The results show Froedtert & the Medical College of Wisconsin go well beyond state averages in nearly every JCAHO/CMS cardiovascular quality measurement listed.
In addition to those measurements, a Froedtert committee generates other quality goals with the aim of optimizing systems and increasing overall patient satisfaction.
At the hospital, data on quality measures don’t collect dust; they are put to work. A team of cardiologists, emergency medicine physicians, case management nurses, pharmacists and quality managers meets monthly to review cardiac care and share knowledge. The meetings help clarify adjustments the team should make and enhance ongoing learning that characterizes Froedtert & the Medical College of Wisconsin.
“It’s our ethos to study what we do and improve upon it; we get everyone engaged,” David Marks, MD said. Dr. Marks is a Medical College of Wisconsin cardiologist and director of the Froedtert & the Medical College of Wisconsin Cardiac Catheterization Laboratory. “We bring a high level of inquiry, exposure and transparency to our processes, because as an academic medical center, we set the example of quality care.”
The team approach to quality leads to upgrades in cardiac care. Most recently, a more detailed and exacting discharge form was created, and an elaborate Six Sigma smoking cessation effort was launched.
“We’ve also found ways to reduce costs by being more efficient in buying equipment, which translates to lower costs and insurance premiums for patients and increased capabilities on our part,” said James Kleczka, MD, Medical College of Wisconsin cardioloigst, director of Cardiology Inpatient Services at Froedtert and chairman of the Cardiovascular Medicine Quality Committee.
Patient input has a direct effect on quality, as teams also review patient satisfaction surveys to target methods to boost communication between patient and provider. “Getting patients more empowered in their care is one of our goals,” said Annette Bertelson, supervisor of Quality Management at Froedtert.
Source: Froedtert Today
Date: June 2006