Journey to top performance: a multipronged quality improvement approach to reducing cardiac surgery mortality
| Autor: | Donna Moravick, Yosef D. Dlugacz, Karen Nelson, Lori Stier, Kerri Anne Scanlon, S. Jacob Scheinerman, Alan R. Hartman |
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| Rok vydání: | 2015 |
| Předmět: |
medicine.medical_specialty
Quality management Leadership and Management media_common.quotation_subject Psychological intervention New York Tertiary care Preoperative care Risk Assessment Perioperative Care Excellence Medicine Humans Hospital Mortality Cardiac Surgical Procedures Coronary Artery Bypass Intensive care medicine Hospitals Teaching media_common Quality Indicators Health Care business.industry Mortality rate Quality Improvement humanities Cardiac surgery Outcome and Process Assessment Health Care Heart Valve Prosthesis Emergency medicine business Risk assessment |
| Zdroj: | Joint Commission journal on quality and patient safety. 41(2) |
| ISSN: | 1553-7250 |
| Popis: | Article-at-a-Glance Background In 2006, leadership at Long Island Jewish Medical Center (New Hyde Park, New York) noted significantly higher cardiac surgery mortality rates for isolated valve and valve/coronary artery bypass graft procedures compared to the New York State Department of Health's Cardiac Surgery Reporting System statewide average. Methods Long Island Jewish Medical Center, a 583-bed nonprofit, tertiary care teaching hospital, is one of the clinical and academic hubs of North Shore-LIJ Health System. Senior leadership launched an evaluation of the cardiac surgery program to determine why cardiac surgery mortality rates were higher than expected. As a result, the cardiac surgery program was redesigned, and interventions were implemented related to preoperative care, intraoperative monitoring, postoperative care, and the cardiac surgery quality management program. Results According to the most recent New York State Department of Health reporting period (2009–2011), Long Island Jewish Medical Center had the lowest risk-adjusted mortality rate in New York State for adult patients undergoing surgeries to repair or replace heart valves and for adult patients in need of valve/coronary artery bypass graft surgery. The medical center has sustained significantly lower mortality rates compared to the statewide average for the past three cardiac surgery reporting periods. Conclusions Cardiac surgery mortality rates can be significantly reduced and sustained below comparative norms when the organization is committed to clinical excellence and quality and is involved in continuously assessing organizational performance. The evaluation launched at Long Island Jewish Medical Center led to the redesign of the cardiac surgery program and prompted widespread improvement efforts and cultural change across the entire organization. |
| Databáze: | OpenAIRE |
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