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Collaboration among peers is critical to improving cardiac surgery outcomes

Alan Hartman, MD, performs surgery at the Sandra Atlas Bass Heart Hospital.
Alan Hartman, MD, performs surgery at the Sandra Atlas Bass Heart Hospital.

Society of Thoracic Surgeons’ shared data provides valuable insight to cardiothoracic programs in US and Canada. Find out why.

With so many clinical ranking systems and hospital report cards, it’s easy for consumers as well as providers to get confused and feel misguided. Improving quality is the goal, and perhaps there is no better sign than receiving top honors from an organization that bases its ranking on information furnished directly from clinical colleagues.

The Society for Thoracic Surgeons (STS), for example, establishes these peer-reviewed ratings of nearly 980 cardiothoracic programs across the US and Canada. The society represents more than 7,600 surgeons, researchers and other health care professionals worldwide, so it has strong credibility when it comes to measuring quality.

As chair of cardiothoracic surgery at Northwell Health, I was thrilled to learn recently that the Sandra Atlas Bass Heart Hospital at North Shore University Hospital was one of only two cardiac programs in North America to receive STS’ three-star quality rankings — the highest possible — in five surgical categories.

Ranking clinical quality has become a cottage industry in health care, where providers often must pay for the marketing rights to promote their success, so STS provides cardiothoracic surgeons with a refreshing and welcoming approach that also provides a great opportunity to learn and share best practices. I thought I’d share a few basic insights that have worked incredibly well for us.

A comprehensive team effort…daily

Generally in the US, heart surgery is very safe and very effective, as demonstrated by the STS findings. So, what makes North Shore University Hospital’s Heart Hospital so unique? The answer is simple — laser-focused attention to detail, constant communication between the entire health care team and dedicated follow through.

It starts with our daily team meetings. Each morning at 7 a.m., our entire team — from cardiologists to physical therapists to surgeons to the hospital’s Magnet-designated nursing staff — convenes to discuss each patient to determine care plans. We typically review 50-60 patients each day, including weekends and holidays, so every member of the care team is prepared to deliver the right care at the right time.

Everyone is on the same page, resulting in enhanced patient experiences and positive outcomes. This nuance, along with our incredible commitment from the entire department, has become a real differentiator for us.

Alan Hartman, MD, (center) looks on during a daily meeting between all members of the care team at the Sandra Atlas Bass Heart Hospital.

Why this matters

The timeliness of the STS data is much more current than other ranking institutions, which typically lag two or three years. It analyzes data from a one-year period for participants for isolated coronary artery bypass grafting (CABG), as well as a three-year period for four other cardiac surgical categories.

Established in 1989, the STS developed its national database to help improve quality and patient safety among cardiothoracic surgeons. It primarily collects data for four areas of cardiothoracic surgery — adult cardiac surgery, general thoracic surgery, congenital heart surgery and other mechanical circulatory interventions.

Other than the New York State Department of Health, which issues annual reports on risk-adjusted mortality outcomes for adult cardiac surgery and percutaneous coronary interventions, STS offers access to data that is peer-reviewed, totally objective and comes with no financial attachments. Participation is voluntary. And even third-party insurance companies and the US Centers for Medicare and Medicaid Services have used their rankings to determine reimbursements.

Alan Hartman, MD, is senior vice president and executive director of Cardiothoracic Services at Northwell Health. He is also chair of Cardiovascular and Thoracic Surgery at Northwell as well as the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell.

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