November 14, 2011

Mercy Medical Center named a “Top U.S. Hospital for Heart Care” by Thompson Reuters

Thomson Reuters recently released its annual study identifying the top U.S. hospitals for inpatient cardiovascular services. The study, in its thirteenth year, singled out 50 hospitals that achieved superior clinical outcomes, including Mercy Medical Center, which is a ministry of the Sisters of Charity Health System.

Read more in the announcement from Thomson Reuters, as well as a localized story by Modern Healthcare.

Thomson Reuters Announces Top U.S. Hospitals for Heart Care
Top Hospitals Show Across-the-Board Improvement

Ann Arbor, MI November 14, 2011 - Thomson Reuters today released its annual study identifying the top U.S. hospitals for inpatient cardiovascular services.

The study, in its thirteenth year, singled out 50 hospitals that achieved superior clinical outcomes.

"This year's 50 Top Cardiovascular Hospitals have continued to deliver excellent care and have been able to improve their performance in a tough economic climate," said Jean Chenoweth, senior vice president for performance improvement and 100 Top Hospitals® program at Thomson Reuters. "The hospitals in this study have provided measurably better care and are more efficient than their peers, demonstrating incredibly strong focus by hospital leadership at a time when the healthcare system is steeped in volatility."

The study shows that 97 percent of cardiovascular inpatients in U.S. hospitals survive and approximately 96 percent remain complication-free, reflecting improved cardiovascular care across-the-board over the past year. The 50 top hospitals' performance surpasses these high-water marks as indicated by:

    • Better risk-adjusted survival rates (23 percent fewer deaths than non-winning hospitals for bypass surgery patients).

    • Lower complications indices (40 percent lower rate of heart failure complications).

    • Fewer patients readmitted to the hospital after 30 days.

    • Shorter hospital visits and lower costs. Top hospitals discharge bypass patients nearly a full day sooner and spend $4,200 less per bypass case than non-winners.

    • Increased use of internal mammary artery (IMA) for coronary artery bypass surgeries. Top hospitals have increased their use of this recommended procedure from 88 to 96 percent

The study evaluated general and applicable specialty, short-term, acute care, non-federal U.S. hospitals treating a broad spectrum of cardiology patients.

Thomson Reuters researchers analyzed 2009 and 2010 Medicare Provider Analysis and Review (MedPAR) data, Medicare cost reports, and Centers for Medicare and Medicaid Services (CMS) Hospital Compare data. They scored hospitals in key performance areas: risk-adjusted mortality, risk-adjusted complications, core measures (a group of measures that assess process of care), percentage of coronary bypass patients with internal mammary artery use, 30-day mortality rates, 30-day readmission rates, severity-adjusted average length of stay, and wage- and severity-adjusted average cost.

The Thomson Reuters 50 Top Cardiovascular Hospitals were classified into three comparison groups. (The order of hospitals in the list does not reflect performance ranking.)

Teaching Hospitals With Cardiovascular Residency Programs

    • Mayo Clinic Hospital - Phoenix, AZ

    • The University of Kansas Hospital - Kansas City, KS

    • Lahey Clinic - Burlington, MA

    • Saint Vincent Hospital - Worcester, MA

    • Park Nicolett Methodist Hospital - St. Louis Park, MN

    • Hackensack University Medical Center - Hackensack, NJ

    • Deborah Heart and Lung Center - Browns Mills, NJ

    • NYU Langone Medical Center - New York, NY

    • Kettering Medical Center - Kettering, OH

    • Doctors Hospital - Columbus, OH

    • The Washington Hospital - Washington, PA

    • Allegheny General Hospital - Pittsburgh, PA

    • Robert Packer Hospital - Sayre, PA

    • Bryn Mawr Hospital - Bryn Mawr, PA

    • Lankenau Hospital - Wynnewood, PA

Teaching Hospitals Without Cardiovascular Residency Programs

    • Morton Plant Hospital - Clearwater, FL

    • St. Luke's Boise Medical Center - Boise, ID

    • St. John's Hospital - Springfield, IL

    • Decatur Memorial Hospital - Decatur, IL

    • Marquette General Hospital - Marquette, MI

    • St. Joseph Mercy Hospital - Ann Arbor, MI

    • Mercy Medical Center - Canton, OH

    • Aultman Hospital - Canton, OH

    • Bethesda North Hospital - Cincinnati, OH

    • St. Luke's Hospital - Bethlehem, PA

    • UPMC Hamot - Erie, PA

    • St. Joseph Medical Center - Reading, PA

    • Memorial Hermann Hospital System - Houston, TX

    • Baptist St. Anthony's Health System - Amarillo, TX

    • Corpus Christi Medical Center - Corpus Christi, TX

    • St. Mark's Hospital - Salt Lake City, UT

    • St. Mary's Hospital - Richmond, VA

    • Aspirus Wausau Hospital - Wausau, WI

    • Gundersen Lutheran - La Crosse, WI

    • Meriter Hospital - Madison, WI

Community Hospitals

    • St. Francis Medical Center - Lynwood, CA

    • French Hospital Medical Center - San Luis Obispo, CA

    • Martin Memorial Medical Center - Stuart, FL

    • Provena Covenant Medical Center - Urbana, IL

    • St. Vincent Heart Center of Indiana - Indianapolis, IN

    • Heart Hospital of Lafayette - Lafayette, LA

    • Nebraska Heart Institute & Heart Hospital - Lincoln, NE

    • Gaston Memorial Hospital - Gastonia, NC

    • The Chester County Hospital and Health System - West Chester, PA

    • Doylestown Hospital - Doylestown, PA

    • Maury Regional Medical Center - Columbia, TN

    • Heart Hospital of Austin - Austin, TX

    • Dixie Regional Medical Center - St. George, UT

    • Memorial Regional Medical Center - Mechanicsville, VA

    • Bellin Hospital - Green Bay, WI

About Thomson Reuters

Thomson Reuters is the world's leading source of intelligent information for businesses and professionals. We combine industry expertise with innovative technology to deliver critical information to leading decision makers in the financial, legal, tax and accounting, healthcare and science and media markets, powered by the world's most trusted news organization. With headquarters in New York and major operations in London and Eagan, Minnesota, Thomson Reuters employs more than 55,000 people and operates in over 100 countries. For more information, go to www.thomsonreuters.com.

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MODERN HEALTHCARE

Heartening Trends
Thomson Reuters' annual roster of the 50 top cardiovascular hospitals details how some facilities are outpacing their peers

By Elizabeth Gardner
Posted: November 14, 2011 - 12:01 am ET

If you must have heart trouble, have it in Canton, Ohio. The two major hospitals serving this city of 70,000—337-bed Mercy Medical Center and 547-bed Aultman Hospital—offer cardiovascular services that rival any in the nation. Both appear on the Thomson Reuters 50 Top Cardiovascular Hospitals for 2012.
Both are teaching hospitals, though neither has a cardiovascular residency program. Aultman has its own health plan, AultCare, which covers more than 500,000 lives in Canton's five-county area. That factor, plus competition from top-level medical centers in Cleveland, Columbus, Ohio, and Pittsburgh—each a 90-minute drive, keeps the hospital motivated to excel, says Chris Schoelles, vice president for the Aultman Heart Center.
“I don't want any patient saying, ‘I had to go to Cleveland because Aultman doesn't have this service,” he says. Aultman shoots for 100% of patients to receive optimal care, breaking down each process into pieces to locate areas for possible improvement, he adds. Aultman has been on the list twice before.Top of Form

Being an insurer as well as a provider gives the organization a strong incentive to keep its patients as healthy as possible, and Schoelles believes Aultman is well positioned to benefit from the trend toward value-based purchasing.
Mercy Medical, on the list for the fifth time, has something that Dr. Ahmed Sabe, an interventional cardiologist who is the hospital's medical director, believes is unique: a cardiac catheterization lab within the emergency room. Patients with suspected heart troubles can be evaluated and treated in one place, rather than going to the cath lab after the ER has confirmed a heart attack. Sabe says he's been able to re-establish blood flow to a patient's heart in as little as six minutes after arrival at the ER.
Sabe concedes that having a cath lab in a location where it's not in steady use is a hard sell, and he gives credit to Mercy's owners, the Sisters of Charity Health System, for putting patient welfare before strict return on investment.
“This few minutes extra has been worth it for hundreds of patients,” he says.
Such stellar performance on one important metric has inspired Mercy's cardiovascular team to excel on others as well, Sabe says. For example, the hospital has cross-trained all of its cardiovascular nurses to handle both critical patients and stable ones; as a result, the patient can have the same team of nurses throughout the stay and get more consistent care.

Steady improvement

Cardiovascular care nationwide has gotten steadily better over the 13 years that Thomson Reuters has been analyzing Medicare data to come up with its annual rosters of the nation's top cardiovascular hospitals. Read more about the methodology used (PDF). Nonetheless, there's still room for improvement. If all hospitals achieved the same performance as the 50 top cardiovascular hospitals, Thomson Reuters projects that almost 7,700 lives and $1 billion could be saved, and 6,500 additional patients could avoid complications.
For example, for coronary artery bypass grafts, the top hospitals' median mortality rate was almost 22.8% lower than the median for all the hospitals in the study, and the complication rate was 10.1% lower. Their length of stay was 9.7% lower, and their cost per case was 12% lower.
Since Medicare will penalize hospitals for high readmission rates for heart attacks and congestive heart failure starting next year, providers are preoccupied with making sure their efforts to shorten length of stay don't backfire and result in patients having to come back within 30 days. Fortunately for hospitals, patients and the nation's healthcare tab, the Thomson Reuters study shows that the best practices are better all around.
“There were some concerns early on that shorter length of stay might lead to higher readmissions, and our research has shown that's not true,” says Jean Chenoweth, senior vice president at Thomson Reuters. The top performing hospitals had both shorter length of stay and lower readmission rates.
New York University's Langone Medical Center appears on the list for the first time. The 786-bed teaching hospital, which has a cardiovascular residency program, committed several years ago to having the best performance possible on a variety of cardiovascular care metrics, says Dr. Aubrey Galloway, chairman of cardiothoracic surgery.
The hospital's Cardiac and Vascular Institute redesigned its systems so that all its patients get optimal treatment in line with benchmarks from the University HealthSystem Consortium and the Society of Thoracic Surgeons, among others. The systems also encompass all patients with congestive heart failure, even when they are in the hospital for some other reason. Galloway estimates that 97% to 98% of Langone's patients receive inpatient heart treatment that adheres to state-of-the-art guidelines.
Now the team is working on improving follow-up care. Each discharged patient is called within 24 hours. “If anything sounds funny, we get them back to see their doctor more quickly so they don't bounce back into the hospital,” Galloway says. Patients at particular risk get home nurse visits as needed.
French Hospital Medical Center in San Luis Obispo, Calif., has been on the list three years out of the last four. Alan Iftiniuk, the hospital's president, says that's because cardiac care has been the core of the hospital's mission since Catholic Healthcare West took over the almost bankrupt 112-bed community hospital in 2004.
Surveys of the community showed high demand for a first-class cardiac program, which the county lacked at the time. Local donors ca

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