Cardiac & Vascular Update June 2009New Cardiac Catheterization Suite Coming to Bronson By the end of summer, Bronson patients. Occupying the old NICU space Archiving Communications System (PACS),Methodist Hospital (BMH) will launch a and immediately adjacent to the which allows physicians to readily accessnew cardiac catheterization suite housing catheterization laboratory will be the patient medical records and diagnosticfour labs and including space for a fifth Pre Procedure Unit (PPU) and Post Recovery images via the computer. The cardio-lab. The new suite will provide greater Unit (PRU), which is a suite of all-private vascular PACS will allow faster accessefficiency and support outstanding rooms. From pre-op to post-procedure, to cardiovascular reports for attendingcustomer service. In addition, the suite family members and physicians will and referring physicians. In addition,will consolidate operational processes, know the patient will be on 3 West. the system allows physicians to directmaximize technology, and provide These improvements are the direct patient care from off-site locations byoptimal patient experience. result of feedback Bronson received from catheterization lab patients in accessing patient information throughContinuity of Care on 3 West a secure Internet connection. Kaizen events. Patients shared their The current cardiac catheterization thoughts about what worked well Learn Morelabs are on the second floor of the East during their experience and where Look for the next edition of Cardiacand West Pavilions on BMH’s downtown process improvements could be made. & Vascular Update for more detailedKalamazoo campus. The new suite will information about the opening of thebe housed on the third floor of the West Cardiovascular PACS cardiac catheterization suite at Bronson.Pavilion, creating a single destination The new cardiac catheterization suitefor cardiology and peripheral vascular will feature a cardiovascular PictureBronson Assures the Appropriateness of Cardiac Catheterizations According to the Dartmouth Atlasof Health Care, the inpatient cardiac *catheterization rate for the Kalamazooarea is 44 percent higher than thenational average. Bronson takes care toassure that we are not contributing tothis problem by carefully selectingpatients for whom cardiac catheterizationis an appropriate diagnostic test andthen tracking our results. Bronson routinely audits the morethan 1,800 cardiac catheterizationsperformed at the hospital annually toensure adherence to nationally acceptedInterQual® criteria (continued on page 4) * Defined as Incidence of Obstructive Coronary Artery Disease (CAD): Patients having a left heart catheterization (including only patients Thomson Reuters 100 Top Hospital® for Heart Care with the indications of rule out CAD and/or The 2008 Thomson Reuters 100 Top Hospitals®: Cardiovascular Benchmarks arrhythmia) where all coronary branches have < 50% stenosis. (Note: if a vessel is not for Success study examined the performance of 970 hospitals by analyzing assessed, its stenosis is assumed as 0). clinical outcomes for patients diagnosed with heart failure and heart attacks and for those who received CABG surgery and angioplasties. Bronson achieved high scores across eight performance criteria that reflect the use of evidence-based medicine, good clinical outcomes, high procedure volume, great efficiency and reasonable cost.
Atrial Fibrillation Patients: How to Restore a Higher Quality of Life Atrial fibrillation (AF) is found in about of risks, and likelihood of success are there are three options:2.2 million Americans. Treating AF is an major considerations in deciding 1. prescribing medication to help theimportant way to help prevent stroke. whether ablation is the right treatment. patient feel better while suffering AF,About 15 percent of strokes occur in Trials and studies have shown improved 2. prescribing medication to correct AFpeople with AF. That’s why the American outcomes from this procedure. However, and restore the heart’s own rhythm,Heart Association recommends aggressive it is not yet known if this can improve 3. and a surgical procedure to restoretreatment of this heart arrhythmia. mortality. If found true, this procedure the heart’s own rhythm.” For patients with AF, there are two could revolutionize treatment of AF. To learn more, consult with anapproaches to treatment. One approach According to both Joel Reinoehl, MD, electrophysiologist. This specialist canis to treat the patient with medication Advanced Cardiac Healthcare, and Xiaoke help you determine the best treatmentthat may slow down the rapid heart Liu, MD, Heart Center for Excellence, plan for your patient.rate associated with AF. Drugs can “regardless of approach, it’s essentialsometimes restore the heart’s normal to recognize AF early.”rhythm. In this case, the patient still has Liu stresses the importance ofAF, but the medications help control it, protecting patients from symptoms.making the patient feel better. “Patients with many AF symptoms can The second approach involves surgical restore their quality of life by treatingprocedures that restore the heart’s own AF. I would encourage physicians torhythm. A common surgery over the last consider other options, including surgicaldecade is catheter ablation, a minimally procedures, if their patients haveinvasive procedure that can improve the symptoms despite medical therapy.” Joel Reinoehl, MD Xiaoke Liu, MDpatient’s quality of life. For each person, Reinoehl recommends developing contributed to this contributed to thisthe severity of symptoms, assessment a treatment plan for AF, “know that article. article.Tailored Calcium Scores by Age, Gender and Race Patients with a positive calcium score “We began using MESA scoring at MESA results will help the physicianfrom the Bronson Heart Scan now have the end of last year,” said John A. Freeby, determine if further tests, such as athe “age of their arteries” calculated MD, Bronson Advanced Radiology stress test, should be scheduled.with MESA (Multi-Ethnic Study of Services radiologist. “With MESA The free calculator, found atAtherosclerosis) scoring, providing a scoring, we now know what is typical mesa-nhlbi.org, can be accessed andbetter representation of the patient’s or normal for a person based on age duplicated by primary care physiciansarterial health. and race. This should allow patients to by inputting the patient’s Agatston Coronary artery calcium (CAC) better understand the prognostic Calcium Score,accumulation, a stage of atherosclerosis, significance of their results and may age and gender.differs significantly among patients of ensure better compliance with For moredifferent ethnicities. CAC scores can be preventive treatment.” information, visitused to predict the risk of cardiovascular With this method, a 50-year-old mesa-nhlbi.org orevents. With data from MESA released white male with a CAC score of 40 has contact Dr. Freebyin 2006, one can calculate the coronary a coronary age of a 61-year-old white at freebyj@age of a person based on the extent of man — for a black man with a score of bronsonhg.org.CAC in that person compared to that 40, the coronary age is 70. John A. Freeby, MDof other people of the same age, The primary care provider is sent the contributed to thisgender and race. MESA scoring results as part of the article. report from the Bronson Heart Scan.
New Cardiac Surgeon Joins Bronson Bronson Methodist Hospital surgical critical care of Chest Physicians, American College ofwelcomed Zahir Rashid, MD, as medical at New York Medical Surgeons, Society of Thoracic Surgeonsdirector of cardiac surgery in January College. He com- and The American College of Cardiology.2009. Rashid joined the cardiac surgery pleted residencies Cardiovascular services performed byteam of Alphonse DeLucia, III, MD; in general surgery the Cardio Thoracic Surgery team atMichael P. Halpin, MD; M. Michael (chief resident) at Bronson include prevention and education,Khaghany, MD; and Zulfikar A. Sharif, Cornell Medical early detection, minimally invasiveMD at Cardio Thoracic Surgery in College and New procedures, surgical interventions,Kalamazoo. Zahir Rashid, MD York Medical personalized rehabilitation programs, Rashid is board certified in General College and critical care at New York and home telemonitoring. Learn moreSurgery, Thoracic Surgery and Surgical Medical College. Rashid completed his about the future of thoracic and cardio-Critical Care. His special interests include internship and received his medical vascular surgery at Bronson below.minimally invasive cardiothoracic degree from R. G. Kar Medical College Cardio Thoracic Surgery is located insurgery, beating heart surgery, valve Hospital in Calcutta, India. Most the Medical Office Pavilion at Bronsonrepair, thoracic oncology, aortic surgery recently he has been in medical Methodist Hospital, 601 John St. inand surgery for arrhythmia. practice at Marshfield Clinic in Kalamazoo. The surgeons may be Rashid completed fellowships in Marshfield, Wisconsin. reached at (269) 344-7000.thoracic and cardiovascular surgery at He is a member of the AmericanMedical College of Wisconsin, and Medical Association, American CollegeThe Future of Cardiovascular and Thoracic Surgery Cardiac surgery continues to advance of complications related to traditional Robotic-assisted Heart Surgeryat a rapid pace with new technology, heart surgery, as well as shorten the Robotic-assisted surgery is changingprocedures and progressive surgeons. length of the hospital stay. In addition, the way certain heart operations areAmong the trends emerging in cardiac it has been found to reduce the performed. It allows surgeons to performsurgery are off-pump surgery, minimally incidence of renal failure, stroke, certain types of complex heart surgeriesinvasive heart surgery, robotic-assisted respiratory failure, and bleeding, with smaller incisions and precisesurgery, and bloodless medicine. resulting in fewer patients requiring motion control, offering patients a blood transfusion. improved outcomes.Off-pump surgery Patients benefit from robotic-assisted Zahir Rashid, MD, (see article above) Minimally invasive heart surgery cardiac surgery through smaller incisions,is an expert in off-pump beating heart Benefits of minimally a shorter hospital stay, less pain, lesssurgery. Approximately 98 percent of invasive heart surgery risk of infection, less blood loss, lesshis cases are off-pump. This area of need for transfusions, less scarring,expertise gives patients one more • Smaller incisions faster recovery, and faster return tooption for heart surgery, including • Smaller scars • Reduced infection risk daily activities.patients with multi-vessel coronary • Less blood loss Rashid envisions establishing aartery disease. Patients who were not • Less pain minimally invasive and robotic-assistedconsidered for bypass surgery in the • Shorter hospital stays thoracic and cardiac surgery programpast due to poor lung condition, kidney • Fewer physical restrictions at Bronson.function or poor heart contraction, can • Shorter recovery timenow be considered for bypass with a Bloodless Medicineminimally invasive approach. Blood conservation provides medical The next phase of minimally invasive Off-pump surgery has been shown and surgical care while reducing or heart surgery lies in valve surgery andto improve patients’ outcomes and eliminating blood transfusions. It provides arrhythmia surgery.decrease the cost of healthcare. This a better way to manage the communityprocedure also can reduce the rate (continued on page 4)
Non-Profit Org U.S. Postage PAID Kalamazoo, MI Bronson Methodist Hospital Permit No. 431 601 John Street, Box 19 Kalamazoo, MI 49007 bronsonhealth.com Inside: New Cardiac Catheterization Suite Coming to Bronson Appropriate Catheterizations Restoring Quality of Life for those with Atrial Fibrillation Tailored Calcium Scores by Age, Sex and Race New Cardiac Surgeon Joins Bronson The Future of Cardiovascular and Thoracic SurgeryThe Future of Surgery Appropriateness(continued) blood supply. In addition, These innovations are changing (continued) for procedure appro-it offers choices for people who choose the face of cardiac surgery, producing priateness. In 2008, 96 percent of thenot to have a blood transfusion. improved clinical outcomes, with cases audited demonstrated clearly greater efficiency, at more reasonable documented evidence of meeting the Benefits of blood conservation cost. Setting the new standard for appropriateness criteria. during cardiac surgery cardiac surgery, these procedures will Another way to evaluate appro- • hospital stay decreased by lead to patient outcomes that continue priateness is to look at the percent nearly three days on average to be among the best in the nation. of cardiac catheterizations without • significantly fewer complications At Bronson, the cardiac surgery significant blockage. Bronson is post-op team is embracing the future of cardiac performing better than the ACC • mortality rates lower surgery through our focus on clinical Database rate of 34.5 percent.* excellence to support our vision of being This means Bronson is very effective Other benefits a national leader in healthcare quality. at case selection and minimizing unnecessary risk, disruption and cost • less exposure to new viruses Zahir Rashid, MD contributed to our patients and community. and infections to this article. • less risk of using old donor blood that may not be as good for the patient HealthGrades® Best Rated for Overall Cardiac Care • fewer infections after having Bronson is best rated in southwest Michigan for overall cardiac care surgery or treatment by HealthGrades®, the nation’s leading healthcare ratings company. • faster recovery Bronson also earned a five-star rating, the highest possible, for the • better outcomes after surgery treatment of heart failure. In addition, the hospital was one of only or treatment 270 hospitals and the only hospital in southwest Michigan to achieve H the 2009 Distinguished Hospital for Clinical Excellence honor; placing it among the top five percent of hospitals in the nation in terms of mortality and complication rates across a comprehensive range of procedures and diagnoses. H E A L T H G R A D E S® G U I D I N G A M E R I C A T O B E T T E R H E A LT H C A R E ® J12624-1 6/09