Recently I attended the 2017 Annual Meeting of The American Academy of Cardiovascular Perfusion. The AACP, as always, offered strong educational content and a great opportunity to meet up with friends and colleagues. While there, I had the pleasure of presenting co-authored research on “The Effectiveness of Acute Normovolemic Hemodilution and Autologous Prime on Intraoperative Blood Management during Cardiac Surgery.” The AACP honored our team, which includes our perfusion associates and their tireless dedication to clinical excellence and data collection, by selecting this work as the meeting’s Best Paper. I encourage you to read the abstract for additional detail, but here’s a summary of our findings, which highlight the value of thoughtful perfusion strategies that can reduce the need for costly transfusions and increase the likelihood of better clinical outcomes.
Changes in reimbursement models are driving changes in operations, including data collection and reporting. Providers are being encouraged and incentivized to implement value-based care (VBC) that emphasizes cost savings and quality outcomes instead of the traditional fee-for-service (FFS) reimbursement model that pays according to the number of procedures performed. The idea is that when hospitals have financial incentives to be accountable for patient outcomes, then the comprehensive focus on quality will result in overall lower costs. Transitioning from FFS to VBC may be especially difficult for ORs with their high costs of procedures, but several strategies can help clear the path to progress.
SpecialtyCare has completed an asset purchase of Trident Health Resources, Inc., a highly regarded, clinically focused perfusion company. With the people of Trident joining SpecialtyCare and moving forward as one team, under one name, we have the opportunity to support each other and learn from each other as we participate in some of the most complex and interesting procedures performed today. We are uniquely positioned to define what superior clinical and financial outcomes look like and to provide those outcomes for our patients and our customers. We are thrilled to join together to serve as a resource for perfusion care and best practices that in-house and competitive programs simply cannot match. It’s an exciting time, and we look forward to all that we will accomplish together.
Ultrafiltration is thought to reduce morbidity and the risk of red blood cell transfusion, however very few studies have examined the relationship between ultrafiltration and the overall risk of intraoperative RBC transfusion. Using data from the SpecialtyCare Operative Procedural Registry (SCOPE™), our study looks at a population of nearly 98,000 adults undergoing cardiac surgery at 197 hospitals to evaluate the effects of ultrafiltration volume removed during CPB on the relative risk of receiving an intraoperative RBC transfusion. Recognizing the findings of our own previous work, we were especially interested in testing potential differences between male and female patients in the effects of ultrafiltration.
Those of us who work in healthcare understand the importance of structured processes and clear communication during a patient handoff. Discontinuity puts the patient at risk and increases the likelihood of medical errors. As an outsourced OR services provider, a handoff takes on another meaning for us at SpecialtyCare—the transfer of an entire service without interrupting hospital operations or compromising patient care.
The mission of The Joint Commission (TJC) is “to continuously improve health care for the public, in collaboration with other stakeholders, by evaluating health care organizations and inspiring them to excel in providing safe and effective care of the highest quality and value.” It’s a lofty goal, and one that has helped thousands of healthcare organizations improve. Unfortunately, the prospect of a TJC review is stressful and overwhelming for many healthcare providers. It doesn’t have to be. Check out these three things we’ve learned by designing and implementing a tested program that ensures that the people of our organization are always prepared to pass a stringent TJC evaluation while also meeting the requirements of our own internal quality programs.
From a healthcare perspective, the only thing we can be certain of in 2017 is that there will be uncertainty. For healthcare administrators, there is uncertainty around how to manage changes in provisions of the Affordable Care Act, Bundled Payments for Care Improvement (BPCI), and the Medicare Access and CHIP Reauthorization Act (MACRA). Restructuring Medicare and Medicaid could have a significant impact on planning, implementation, and payments for providers. But, regardless of the new format, healthcare providers like SpecialtyCare will always have an obligation—both to their patients and their customers—to improve value by providing high-quality care while containing costs.
It is a fairly well-known fact in the cardiac community that women have higher morbidity and mortality associated with coronary artery bypass (CABG) procedures. The reasons traditionally given for this disparity include women’s relatively smaller vasculature, higher incidence of anemia, and smaller circulating blood volume. Early in 2016, we in the Medical Department were discussing this phenomenon and decided to design a study using the robust data from our SpecialtyCare Operative Procedural Registry to find something in the intraoperative space that might be leading to these very different post-operative outcomes for men and women. Our findings were somewhat surprising.
SpecialtyCare is determined to drive awareness of perfusion as both a vital medical service and a smart career choice. As part of this effort, we are proud to officially launch the Brown-Brukardt Perfusion Scholarship Program. Every year, SpecialtyCare will award perfusion education tuition to two students enrolled in CAAHEP-accredited programs. Jim Brown and Gary Brukardt—men with close ties to SpecialtyCare who helped evolve the practice of perfusion over the last three decades—exemplified integrity, leadership, and dedication to patient care. Our goal is to support students who share these qualities and demonstrate outstanding potential as cardiovascular perfusionists.
It’s been said that “Everyone has a special talent, some are just flashier than others.” And so it is in healthcare. Behind every high-visibility physician and hands-on surgical team, there is a large group of people in back offices providing invaluable support. Everyone plays an important role—from human resources and training to accounting and scheduling. But today, as part of National Medical Staff Services Awareness Week, we proudly recognize our credentialing team at SpecialtyCare, and indeed in healthcare settings everywhere, for their contributions to quality patient care and safety.