How Our Unique Multidisciplinary Care Model Leads to Superior Outcomes for Cardiac Surgery Patients

Abstracts from the Kaiser Permanente2018 National Quality Conference


Yong Shin, MD; Brian Timm, PA-C; William Shely, MD; Thomas Lampros, MD;
David Tse, MD; Josh Andrew, PA-C; Julie Faulk, PA-C; Piotr Starosta, PA-C;
Victoria Brownlow, PA-C

From Northwest

Background: The mission of Kaiser Permanente is to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. A multidisciplinary approach to caring for complex patients has proven successful in serving this mission, which benefits our members and the health care team that serves them.
Methods: All cardiac surgery patients are cared for via a multidisciplinary team. Our team—physicians (surgeons, anesthesiologists, intensivists, internists), physician assistants, nurses, pharmacists, physical therapists, dieticians, care coordinators, and social workers—rounds twice daily on each patient. The commitment to rounding has established a culture of clear communication, daily goal setting, team accountability, and group decision making which has resulted in proven excellent outcomes including: markedly lower overall and coronary artery bypass graft mortality, decreased blood usage, increased early extubation, and decreased length of stay.
Results: Our multidisciplinary approach has led to the following excellent results: An overall mortality rate of 0.5%, coronary artery bypass graft outcomes of 0.0% mortality for 2 years in a row, transfusion rate of 13.3 % compared with 42.6% nationally, early extubation rate of 78.9% with patients being extubated in the operating room regularly, and an average postprocedure length of stay of 4 days.
Discussion: Modeling the Kaiser Permanente Northwest multidisciplinary approach to caring for complex cardiac surgery patients will result in improved program quality and patient outcomes that further serve Kaiser Permanente’s mission of providing high-quality, affordable health care services and improving the health of our members and the communities we serve. Quality is becoming an increasing driver of reimbursement; therefore sustainability is directly linked to quality outcomes.

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