Title

Journey to top performance: a multipronged quality improvement approach to reducing cardiac surgery mortality

Publication Date

2015

Journal Title

Jt Comm J Qual Patient Saf

Abstract

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.

Volume Number

41

Issue Number

2

Pages

52-61

Document Type

Article

EPub Date

2015/05/16

Status

Faculty; Northwell Researcher

Facility

School of Medicine; Northwell Health

Primary Department

Cardiovascular and Thoracic Surgery

Additional Departments

Science Education

PMID

25976891

DOI

http://www.ingentaconnect.com/content/jcaho/jcjqs/2015/00000041/00000002/art00002

Comments

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