Today, the need for continuous improvement is a given. How can we do more with less, but not sacrifice quality? Ultimately, how can we deliver greater value? That is the core idea of value-based payment models now being tested across the country and lies at the heart of the mandatory cardiac bundles recently proposed by the Centers for Medicare and Medicaid Services (CMS). Getting the highest quality from all components of a bundled service is paramount. One such component, cardiovascular perfusion, can have a significant impact on outcomes, recovery, and readmissions. But, how do you know that the perfusionists in your OR are capable of driving value and helping you achieve your quality goals?
Surgeons will tell you that trust is a key driver of satisfaction with IONM services—trust that the IONM professionals will be present and ready as an integrated part of the team whenever they’re needed, trust to establish meaningful baselines before surgery, and trust to provide knowledgeable and confident support in the most crucial moments during surgery. When vetting a potential IONM provider, future trustworthiness might seem difficult to assess, but there are many indicators that will help you be confident that you’re making the right decision.
At the 37th Annual Meeting of the American Academy of Cardiovascular Perfusion (AACP), we presented research that used goal-directed perfusion methodology to determine oxygenator performance during clinical cardiopulmonary bypass. The study evaluates three oxygenators currently in clinical use and reflects how information collected by perfusionists could be utilized to provide new information to bridge gaps in knowledge when an absence of quality data is encountered.
Historically, there has not been a great understanding about the “obesity paradox,” which suggests that overweight and obese patients may have better outcomes than normal weight patients. Our newly published research confirms that while overweight and mildly obese patients do experience less blood transfusion and post-surgical bleeding than patients of normal weight, much of the observed reduction in transfusion rates in obese patients can be accounted for by other known confounds.
When I learned of a concern regarding Nontuberculous Mycobacteria (NTM) infections from use of LivaNova’s (previously Sorin) 3T heater-coolers and a change in their Instructions for Use (IFUs), I brought it to the attention of my OR Director at Memorial Medical Center. The situation has led to the development of best practices in team collaboration and infection control.
There’s good reason why I don’t roof my own house or fly my own plane. I rely on others for their specialized skills, experience, and economies of scale—knowledgeable people focused on specific activities that ensure quality and safety, keep costs in check, and know the codes and regulations that must be followed. Today, more than ever, we rely on specialization to get things done. Healthcare is no different. In fact, healthcare may be one of our best examples of an industry that can benefit significantly from specialized teams.
One of the most significant trends facing our industry today is the severe shortage of perfusionists. A current sample of 10% of active perfusionists found that nearly 50% are over 50 years old, and in 2015 there were almost 30% fewer new graduates entering the field than professionals leaving the field. This rate of decline cannot be sustained for long before the deficit poses serious risks to the 350,000 patients who need heart surgeries and perfusion services each year.