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CARDIOLOGY: Higher volume linked to better outcomes

We demonstrate through a large regional database a positive relationship between volume and outcomes in interventional cardiovascular care.”

The volume-outcome relationship in health care has been studied quite a bit over the years – particularly related to various surgical specialties.  It is intuitively pleasing to think that if a surgeon, if a surgical team, if a hospital has a higher volume of … whatever… there will be better outcomes than providers who only see patients of this type now and then.  This study confirms this relationship for heart attack patients who were treated in the interventional cath lab.

The study analyzed outcomes data for 9,360 patients in the Dallas metro area who received care from 2010 to 2015.  Interestingly, for these patients who were diagnosed as having the most severe type of heart attack, 59 percent of patients arrived at the hospital either by themselves or transported by a family member; 39 percent arrived by ambulance.

Mortality in the facilities classified as low volume (less than 200 percutaneous coronary intervention procedures per year) was 9.55 percent.  Mortality in the intermediate and high volume facilities was almost identical – at 6.25 and 6.22 percent, respectively.

Source: Langabeer, J.R., Kim, J., and Helton, J. (2017, July-September). Exploring the relationship between volume and outcomes in hospital cardiovascular care. Quality Management in Health Care, 26(3), 160-164.  Click here for publisher’s website http://journals.lww.com/qmhcjournal/pages/articleviewer.aspx?year=2017&issue=07000&article=00006&type=Abstract    Posted by AHA Resource Center (312) 422-2050, rc@aha.org

Best practices to reduce readmissions for heart patients

Memorial Hermann Memorial City Medical Center (Houston, TX, 427 beds) ranks among the best hospitals in the country for low readmission rates for patients with acute myocardial infarction.  This case study examines changes made in the hospital’s heart and vascular institute that resulted in substantial performance improvement.  Of key importance were changes that resulted in a decrease in door-to-balloon time down to an average of 65 minutes.  Tips on how to achieve this are included in this white paper.

Source: Memorial Hermann Memorial City Medical Center: excellence in heart attack care reduces readmissions.  Case Study: High Performing Health Care Organization [The Commonwealth Fund], Feb. 2011.  http://www.commonwealthfund.org/~/media/Files/Publications/Case%20Study/2011/Feb/1470_Lashbrook_Memorial_Hermann_readmission_case_study_web_version.pdf