San Antonio—Methodist Hospital has received the Texas Hospital Association’s 2012 Bill Aston Award for Quality in the Non-Research/Non-Teaching Hospital/Health Care System category in recognition of its implementation of an innovative cardio-hospitalist program. The award was presented Feb. 13 at the THA 2013 Annual Conference and Expo in Austin.
“Our system is reforming itself with quality and patient safety as chief priorities, and leaders like those we are recognizing with this achievement are examples of what is required to be at the leading edge of a changing health care system,” said Dan Stultz, M.D., FACP, FACHE, THA president/ chief executive officer.
The ability to treat cardiac patients more quickly is one of many advantages Methodist Hospital of San Antonio discovered after implementing its cardio-hospitalist program. Methodist Hospital worked with a large cardiology group to create this leading-edge program featuring round-the-clock in-hospital coverage and seamless outpatient cardiac care. The advantages are many: Costs have decreased, length of stay is shorter, readmission rates are lower, and most importantly, in-hospital mortality rates have dropped.
“This award is a tremendous distinction,” said Ken Davis, M.D., FACP, chief medical officer of Methodist Healthcare of San Antonio. “Many of us here at Methodist Healthcare knew Bill Aston, and to be recognized for an innovation in quality with an award in his name is an honor for us.”
In late 2010, the Cardiology Clinic of San Antonio, a specialty group of 27 cardiologists, aligned itself with the Methodist Healthcare System of San Antonio. This newly formed affiliation provided the opportunity to explore something novel: the design of a specialty hospitalist program that would allow the greatest level of success with tangible benefits to patients, physicians and the health care system. The joint program opened its doors on September 1, 2010.
Two cardio-hospitalists, or cardiologists, are onsite at the hospital 24 hours a day and 365 days a year. One cardio-hospitalist is assigned to the cardiology critical care unit/telemetry area and the other to the emergency department (ED). The physicians work in eight-hour blocks; one shift is from 7 a.m. to 3 p.m., the next from 3 p.m. to 11 p.m., and the third from 11 p.m. to 7 a.m. On weekends, the shifts are expanded to 12 hours.
This system is significantly different from the standard practice at most hospitals, where cardiologists do their rounds, but have to be phoned to come in if there is an emergency situation at night or on the weekend. The cardiologist then has to wake up, drive to the hospital and do the procedure, or alternatively, direct the ER physician over the phone. At Methodist Hospital, a cardiologist is always at the hospital, alert and ready to treat. He or she is directly connected to cardiology colleagues conducting rounds in the hospital or at the outpatient clinic.
As a result, when patients arriving at the Emergency Department at Methodist Hospital require cardiac care, they don’t have to wait for a member of the ED staff to call a cardiologist at home, even if it’s in the middle of the night. Having a cardiologist already on-site can mean the difference between life or death. Nationally, the time between when a patient arrives at the hospital and when the blocked artery is opened is 90 minutes. At Methodist Hospital, the average is well below 60 minutes; in some cases, it’s only a half hour.
“When it comes to urgent intervention, time equals heart muscle,” said Davis. “The quicker we can open up the blocked artery causing a heart attack, the more heart muscle we can save. It can make a huge difference in a patient’s survival and quality of life.”
In addition to improved patient outcomes, Methodist Hospital has realized other tangible benefits of its cardio-hospitalist program. With physician burnout in the United States at an all-time high, this unique situation provides an alternative for physicians seeking more control over their work schedules. The physicians rotate shifts and days off, and they can concentrate their efforts on each of the settings – outpatient, inpatient, nights, weekends – depending on individual preferences.
Methodist Hospital’s patients and their families are impressed when they meet a cardiologist in the emergency department, and are comforted by being able to get direct, immediate answers to their questions. Nurses, technicians and other hospital staff benefit from improved accessibility and communication with cardiologists, as well.
Methodist Hospital has also dramatically changed how its patients are treated upon leaving the hospital. Its Transitional Heart Failure Clinic has helped heart patients get better and stay better, and has lowered the incidence of hospital readmissions. At most hospitals, these patients are discharged with instructions to see their cardiologist in three weeks. However, at the Transitional Heart Failure Clinic, either a nurse practitioner or a doctor sees them immediately and then weekly for the first month after their hospital stay. This practice helps identify negative health developments before a patient’s health is compromised.
About Methodist Healthcare System of San Antonio
Methodist Healthcare System – San Antonio is the largest provider of health care in South and Central Texas with 26 facilities including nine hospitals serving 90,000 inpatients and 390,000 outpatients annually. The Methodist Healthcare team is comprised of 8,000 employees, making Methodist Healthcare the second largest private employer in San Antonio. In 2012, Methodist Healthcare was one of only two hospitals in Texas recognized by the Texas Medical Foundation with a Gold Award for Quality. Methodist Healthcare has won the National Research Foundation’s Consumer Choice Award for 13 consecutive years, more times than any other health care provider in Texas. For the past four years, Methodist Healthcare has received “Best Hospital” Gold Award by the San Antonio Express-News’ Readers’ Choice Awards. With more than 2,700 credentialed physicians, Methodist Healthcare provides the largest array of medical services in the region including neurosurgery, cardiovascular services, oncology and women’s services. Visit www.SAHealth.com to learn more.
About Texas Hospital Association
Founded in 1930, the Texas Hospital Association is the leadership organization and principal advocate for the state’s hospitals and health care systems. Based in Austin, THA enhances its members’ abilities to improve accessibility, quality and cost-effectiveness of health care for all Texans. One of the largest hospital associations in the country, THA represents more than 85 percent of the state’s acute-care hospitals and health care systems, which employ more than 369,000 health care professionals statewide.
The Bill Aston Award for Quality
In 2010, the Texas Hospital Association established the Bill Aston Award for Quality through an endowment of the Baylor Health Care System. The award is named for the late Baylor Health Care System Board Member and Texas Healthcare Trustees Chairman Bill Aston, a longtime leader in and champion for quality and patient safety. All THA active institutional members are eligible for the award. Nominated projects must demonstrate improved outcomes in patient care and be related to a national or state standard for improved patient care. In 2011, the program was expanded to include two categories – one for Academic or, Large Teaching Hospitals or Systems, and one for Non-Research, Non-Teaching Hospitals or Systems.