The Kaiser Permanente Northwest Ventricular Assist Device Program



 

Barbara Amos, RN, MSN, CNS; Timothy Jacobson, MD; Yong Shin, MD; Ryan Morrissey, MD; Siobhan Gray, MD; Pamela Montes, RN, MSN;
Allison Lipnick, LCSW

https://doi.org/10.7812/TPP/19-039-36

Abstracts from the Kaiser Permanente 2019 National Quality Conference

From Northern California and Northwest

Background: Approximately 670,000 people in the US are diagnosed with heart failure each year, with half dying within 5 years of diagnosis. The ventricular assist device (VAD), an implanted mechanical pump, is a promising treatment. Although VAD therapy is complex, high risk, and expensive, it has been shown to improve survival and quality of life.
Methods: Kaiser Permanente (KP) Northwest (KPNW) launched its VAD program to improve outcomes and patient satisfaction, with an eye toward creating a national model. Candidates are rigorously evaluated for degree of illness, ability to undergo implant, and availability of postdischarge support. Evidence-based protocols guide the interdisciplinary team, and detailed scripts ensure smooth transitions at each point of the care journey. This approach has yielded impressive results. The VAD program exceeds national standards for hospital length of stay, 30-day readmission, and 1-year survival. Patients also score higher on quality-of-life measures.
Results: Average length of stay is 12 days, compared with 23 days nationally. Thirty-day readmissions are 0%, compared with 28% nationally. Survival at 38 months is 100%, compared with 60% nationally. In addition, the KPNW VAD program has implanted in 17 patients without using blood transfusions during the operative phase; although this is not reported data, this is an outlier among all implanting centers.
Discussion: The KPNW multidisciplinary approach to VAD patient care with proven successful outcomes can stimulate a national discussion among KP Regions who are involved in VAD therapy to improve outcomes, decrease variability, enhance patient selection, standardize protocols, decrease the financial impact to KP, and improve the lives of our members nationally.

Abstracts from the Kaiser Permanente 2019 National Quality Conference

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