outcomes - baylor scott & white heart and …...those medical centers, baylor jack and jane...
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621 North Hall StreetDallas, Texas 75226
BaylorHeartHospital.com 1.800.4BAYLOR
Notice Regarding Physician Ownership: Baylor Jack and Jane Hamilton Heart and Vascular Hospital is a hospital in which physicians have an
ownership or investment interest. The list of the physician owners or investors is available to you upon request. Physicians are members of the
medical staff at one of Baylor Health Care System's subsidiary, community or affiliated medical centers and are neither employees nor agents of
those medical centers, Baylor Jack and Jane Hamilton Heart and Vascular Hospital or Baylor Health Care System. ©2013 Baylor Health Care
System. BHVH 505 2012 Outcomes Brochure. MOD 12107 3/13. 2,000
OUTCOMES:
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This year the Baylor Jack and Jane Hamilton Heart and Vascular Hospital celebrated its 10th anniversary.
The hospital opened in 2002 as the first in North Texas dedicated
solely to the care and treatment of heart and vascular patients.
Today, BHVH is still the only hospital in Dallas County with that focus.
In the past 10 years, our employees and the physicians on our
medical staff have worked together to provide patients with
outstanding service, quality care, and advanced heart and vascular
treatments. The collaborative focus and commitment to excellence
has again led to impressive results in FY 2012.
all employee retention rate:
95.2%
2012 Magnet award for“Excellence in Nursing”
12,2
70no
n-in
vasi
vepr
oced
ures96.5%
satisfactionoverall rate - inpatients & outpatientsad
mis
sion
s&
regi
stra
tions
22,6
25
admissions ®istrations
22,625
frien
dlin
ess
of s
taff:
97.2
%
12,2
70no
n-in
vasi
vepr
oced
ures
post-procedure
mortality rate:0%ICD
96.5%
admissions & registrations22,625
all employee retention rate:
95.2%
2012 Magnet award for“Excellence in Nursing”
12,2
70no
n-in
vasi
vepr
oced
ures96.5%
of inpatients say they’re likely to recommend BHVH
overall satisfaction rateamong inpatients & outpatients
Press Ganey Summit Award, second year in a row
OUTCOMES:
front cover9.5” x 9.5”
spine.25” x 9.5”
interior fold-over (die-cut)9.375” x 9.5”
back cover9.5” x 9.5”
back pocket9.375” x 8”
10.25” total trim height
38.65” total trim width
Nancy Vish, PhD, RN, NEA-BC, FACHE
President and Chief Nursing Officer
BHVH was recognized again as a Magnet™-designated facility, an honor representative of our hospital’s
excellence in nursing. The Joint Commission again recognized BHVH for its core measure outcomes and
we are now fully accredited for percutaneous coronary intervention by Accreditation for Cardiovascular
Excellence (ACE).
Modern Healthcare named Baylor Hamilton Heart and Vascular Hospital as one of the 100 “Best Places to
Work” in health care nationwide. This award is a testament to the people who come to work every day with
an attitude of caring, not only for our patients, but for each other as well.
In FY12, we were honored for the second straight year with the Press Ganey Summit Award. A second consecutive Summit Award means BHVH has had a patient satisfaction rate greater than 95 percent for 16 consecutive quarters, or 4 years in a row.
These awards help validate that the dedication to our goals of clinical excellence, patient and family satis-
faction, health care team satisfaction, and fiscal responsibility, do help provide a quality patient experience.
As part of our continuing dedication to education, BHVH continues to offer fellowships in cardiology,
electrophysiology, and vascular surgery residency program that are fully accredited by the Accreditation
Council for Graduate Medical Education.
In the spirit of innovation, research at BHVH continues utilizing adult stem cells to improve heart function
in patients with congestive heart failure and in treating acute myocardial infarction. Also, we are one of a
limited number of sites in the country researching the use of the transcatheter aortic valve implantation
through our participation in the CoreValve® clinical trial.
We are proud of our accomplishments, accolades, accreditations and awards in FY 2012 and over the
past decade. We look to the future with great anticipation, striving to make the next 10 years better than
our first.
Sincerely,
3BAYLOR JACK AND JANE HAMILTON HEART AND VASCULAR HOSPITAL
Awards and Honors
This year the Baylor Jack and Jane Hamilton Heart and Vascular Hospital celebrated its 10th anniversary.
The hospital opened in 2002 as the first in North Texas dedicated
solely to the care and treatment of heart and vascular patients.
Today, BHVH is still the only hospital in Dallas County with that focus.
In the past 10 years, our employees and the physicians on our
medical staff have worked together to provide patients with
outstanding service, quality care, and advanced heart and vascular
treatments. The collaborative focus and commitment to excellence
has again led to impressive results in FY 2012.
all employee retention rate:ll lt ti t
95.2%
2012 Magnet award for“Excellence in Nursing”
012
,2700
non-
invas
ive
pro
ced
uress9966.5%
of inpatients say they’re likely to recommend BHVH
Ba
ylo
rH
ea
rtH
os
pita
l.co
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Hospital Leadership
Trey WickeVice President of Finance
Kevin Wheelan, MDChief-of-StaffCo-medical Director of Cardiology
Robert Stoler, MD, FACC, FSCAICo-medical Director of Cardiology,Medical Director of Cath Lab
Gregory Pearl, MD, FACSMedical Director of Vascular Surgery
Paul Grayburn, MD, FACCMedical Director of Non-invasive Cardiology
Bertram Smith, MD, FACSMedical Director of Non-invasive Vascular
Rafic Berbarie, MD Medical Director of Cardiac Rehab
Stephen Hohmann, MD, FACS Medical Director of Patient Safety
Jeffrey Schussler, MD, FACC, FSCAI, FSCCT Medical Director of Critical Care
Michael Ramsay, MD, FRCA Medical Director of Anesthesia Services
William Dockery, MD Medical Director of Radiology
Edward Mays, MD Medical Director of Laboratory
Board of Directors
Timothy OwensChairman
Michael Graham
John McWhorter, III
John Schumacher, MD
Kevin Wheelan, MD
C.T. Beckham
J. Kent Newsom
Don Wills
Richard Lockwood
Robert C. Kowal, MD, PhD
Brad R. Grimsley, MD, FACS
Ba
ylo
rH
ea
rtH
os
pita
l.co
m
Con
tent
s
54 MEASURING INNOVATION IN HEART AND VASCULAR CARE BAYLOR JACK AND JANE HAMILTON HEART AND VASCULAR HOSPITAL
Awards, Accolades and Accreditations ........................................................ 5
BHCS Circle of Care ..................................................................................... 8
Admissions and Registrations .................................................................... 10
Hospital Website ........................................................................................ 11
QUALITY
Centers for Medicare and Medicaid Services ....................................... 14
Performance Report .............................................................................. 15
Readmissions ........................................................................................ 18
Interdisciplinary Quality and Safety Committee .................................... 19
Patient Falls ........................................................................................... 20
Hospital Acquired Pressure Ulcers ........................................................ 21
Graduate Medical Education ................................................................. 22
SERVICE
Patient Satisfaction Surveys .................................................................. 24
Preventative Health Education .............................................................. 26
Community Outreach ............................................................................ 28
PEOPLE
Employee Incentives.............................................................................. 30
Employee Retention .............................................................................. 32
Employee Awards and Accolades ......................................................... 33
Nurse Certification ................................................................................. 34
Shared Governance ............................................................................... 36
INNOVATIONS
Center for Complex Arrhythmias ........................................................... 44
Innovations ............................................................................................ 46
Cardiac Rehab and Return to Work Lab ............................................... 50
Clinical Trials and Studies ...................................................................... 51
Physician and Employee Research and Publications ........................... 55
Accelerating Best Care at Baylor (ABC Baylor) ..................................... 61
ACCREDITATIONS
ACE Accredited for PCI BHVH
has been fully accredited
for percutaneous coronary
intervention by Accreditation for
Cardiovascular Excellence, an
organization dedicated to ensuring
adherence to the highest quality
standards for cardiovascular and endovascular care.
ACE accreditation is a professional review of an
organization’s structure, internal processes, patient
safety practices, and clinical outcomes to determine if
it meets the standards established by experts in cardiac
and endovascular care.
American College of Radiology
– Accreditation for Computed
Tomography (CT) The American
College of Radiology awards
accreditation to facilities for the
achievement of high practice standards
after a peer-review evaluation of the practice.
Intersocietal Commission
for the Accreditation of Echo
Laboratories (ICAEL) The ICAEL
accreditation review process is a
means by which echocardiography
laboratories can evaluate and demonstrate the level of
patient care they provide. After a laboratory submits the
Aw
ards, A
ccolades and
A
ccreditations
76 MEASURING INNOVATION IN HEART AND VASCULAR CARE BAYLOR JACK AND JANE HAMILTON HEART AND VASCULAR HOSPITAL
application to the ICAEL, the application undergoes a confidential
peer-review by ICAEL’s trained reviewers, including both physicians
and sonographers.
Intersocietal Commission for the
Accreditation of Vascular Laboratories
(ICAVL) The purpose of ICAVL is to provide a
mechanism for accreditation of facilities which
perform comprehensive testing for vascular
disease with non-invasive testing modalities.
ICAVL assesses every aspect of a lab’s daily operation and its
impact on the quality of health care provided to patients.
AWARDS
American College of Cardiology Foundation’s
NCDR® ACTION Registry® – GWTG Platinum
Performance Achievement Award
BHVH is one of only 164 hospitals nationwide to
receive this award, which recognizes BHVH’s commitment and
success in implementing a higher standard of care for heart attack
patients, and signifies that BHVH has reached an aggressive goal of
treating these patients to standard levels of care as outlined by the
American College of Cardiology/American Heart Association clinical
guidelines and recommendations.
American Heart Association’s Get With The Guidelines – Gold
Award BHVH was recognized with the Gold Award for heart failure.
BHVH achieved at least 90 consecutive days of 85 percent or
higher adherence to the Heart Failure Performance Achievement
indicators to improve quality of patient care outcomes. Get With
The GuidelinesSM (GWTG) is the premier hospital-based quality
improvement program for the American Heart Association and the
American Stroke Association. It empowers health care provider
teams to consistently treat heart and stroke patients according to
the most up-to-date guidelines.
American Heart Association’s Get With the Guidelines –
Gold Level Get With The GuidelinesSM (GWTG) is the premier
hospital-based quality improvement program for the American Heart
Association and the American Stroke Association. It empowers
health care provider teams to consistently treat heart and stroke
patients according to the most up-to-date guidelines.
American Heart Association – Mission
Lifeline – Gold AHA recognizes BHVH
for achieving 85% or higher composite
adherence to all Mission: Lifeline
STEMI Receiving Center Performance
Achievement indicators for consecutive 12-month intervals and
75% or higher compliance on all Mission: Lifeline STEMI Receiving
Center quality measures to improve the quality of care for STEMI
patients.
Innovation Award from the American
Association of Cardiovascular and
Pulmonary Rehabilitation (AACVPR)
This award acknowledges programs that have enhanced their
delivery of care for a patient population in a unique and creative way,
beyond the traditional model of cardiac and pulmonary rehabilitation.
AACVPR is dedicated to reducing morbidity, mortality and disability
from cardiovascular and pulmonary disease through education,
prevention, rehabilitation, research and disease management.
START! Fit-Friendly Gold Award The American Heart Association
awarded Baylor Hamilton Heart and Vascular Hospital the “Start!
Fit-Friendly Award.” Companies reach Gold-level status by
implementing various activities and programs for their employees
to encourage physical activity, nutrition and culture enhancements
such as on-site walking routes, healthy food choices in cafeterias
and vending machines, annual employee health risk assessments
and online tracking tools.
Awards, Accolades and Accreditations
Magnet Award for Excellence in Nursing
Services The Magnet Recognition Program®
was developed by the American Nurses
Credentialing Center (ANCC) to recognize health
care organizations that provide nursing excellence.
The program also provides a vehicle for disseminating successful
nursing practices and strategies.
Press Ganey Summit Award –
Second Year in a Row
The 2010, 2011 Press Ganey Summit Award, one of Press Ganey’s
most prestigious honors, was bestowed upon Baylor Hamilton Heart
and Vascular Hospital. BHVH achieved this distinction by sustaining
an overall rank above the 95th percentile for inpatient satisfaction
in the “All Press Ganey” database for at least three years. There are
approximately 1,800 hospitals in the inpatient survey database and
about 1,500 emergency departments in the All Press Ganey database.
Texas Health Care Quality Improvement Awards
– Award of Excellence Winners of this non-
competitive award are measured by the frequency of
best care practices utilized on patients with specific
conditions, including acute myocardial infarction,
heart failure, and pneumonia as well as surgical
infection prevention.
VHA Leadership Award in Clinical
Excellence The award honors health
care organizations that have differentiated
themselves around national performance
standards by achieving performance at the 90 percent level or
above on clinical core measures. Baylor Hamilton Heart and
Vascular Hospital won the award for acute myocardial infarction
treatment, heart failure and surgical infection prevention.
ACCOLADES
Becker’s Hospital Review – BHVH
Named One of the Physician-
Owned Hospitals to Know
Becker’s Hospital Review is proud to announce the publication of
its list, “50 Physician-Owned Hospitals to Know,” which recognizes
high-performing leaders in patient care and clinical quality. To
compile this list, the Becker’s Hospital Review editorial team
analyzed and reviewed research and data from sources including
U.S. News & World Report, HealthGrades, Press Ganey, CareChex
and Thomson Reuters to identify leading hospitals.
The Joint Commission – Top Performers on
Key Quality Measures BHVH is on a list of
405 hospitals and critical-access facilities
nationwide ranked as top performers based
on 22 measures related to cardiac, pneumonia,
surgical and pediatric asthma care. A hospital had
to earn a compliance score of at least 95 percent on two
measurements to be named a top performer.
Best Places to Work in Healthcare
BHVH has been named to the Modern
Healthcare list of the Best Places to
Work in Healthcare. The list recognizes
outstanding employers in the health care industry on a national
level.
Quality Texas Foundation – Achievement Level Recognition
Recognized for organizational excellence with well-deployed,
effective, systematic approaches to organizational management
with good performance levels and trends evaluated against industry
standards.
BH
CS
Circ
le o
f Car
e
98 MEASURING INNOVATION IN HEART AND VASCULAR CARE BAYLOR JACK AND JANE HAMILTON HEART AND VASCULAR HOSPITAL
Our Vision
To redefine the relationship between physicians and the hospital
with an integrated heart and vascular delivery system focused on
high quality, cost effective care.
Our Mission
To operate an integrated heart and vascular health care delivery
system, founded as a Christian Ministry of healing, that exists to
serve people by offering a continuum of quality service committed
to quality care and patient safety, medical education, research and
community service.
Our Values
Baylor Heart and Vascular Hospital values guide our actions as we
remain faithful to our mission and work toward our vision.
Integrity: Conducting ourselves in an ethical and respectful manner.
Servanthood: Serving with an attitude of unselfish concern.
Quality: Meeting the needs and striving to exceed the expectations
of those we serve through continuous improvement.
Innovation: Consistently exploring, studying and researching new
concepts and opportunities.
Stewardship: Managing resources entrusted to us in a responsible
manner.
Our Care Model
With the opening of Baylor Hamilton Heart and Vascular Hospital,
we designed a care model that is a foundation for our daily
operations.
Our founding principles define the qualities we look for in our
team members. We believe that if we work to exceed people’s
expectations, the results will be satisfaction, care excellence,
and a trusting relationship. Our goals are Clinical excellence
(Quality), Patient and family satisfaction (Service), Health care team
satisfaction (People), and Fiscal responsibility (Finance). We review
our model of care at our hospital team meetings and the metrics
associated with the goals we have set.
• Clinical Excellence (Quality)• Patient & Family Satisfaction (Service)• Health Care Team Satisfaction (People)• Fiscal Responsibility (Finance)
FOUNDING PRINCIPLES:Honesty + Respectfulness + Integrity + Compassion
+ Communication + Positive Attitude
results inresults inSatisfaction,Excellence
& Trust
People’sExpectations
Exceeded
QualityCare
BHCS CIrcle of Care
Our “Circle of Care” encompasses our mission, vision,
and priorities, and places our patients front and center.
Our mission supports this patient-centered approach.
We recognize that there are four key areas of excellence
that must be in place to ensure that patients are our
number one priority: people, quality, service and fiscal
stewardship.
What does this mean? It means that Baylor Health Care
System supports and cares for patients as individuals.
We promote a healing environment in which the
members of the health care team work together as one,
for the benefit of the patient.
To do that, Baylor adopts best practices and industry
standards that support and sustain a patient-centered
culture. When these are put into place, we not only
enhance patient safety and quality of care, we also
increase our level of performance as a health care
system.
During the strategic planning process, Baylor Hamilton
Heart and Vascular Hospital leadership uses the Circle
of Care as a framework to identify the principal factors
that determine success relative to competitors and
sustainability for its key stakeholders.
Ad
mis
sion
s an
d
Reg
istr
atio
nsB
aylorHeartH
ospital.com
1110 MEASURING INNOVATION IN HEART AND VASCULAR CARE BAYLOR JACK AND JANE HAMILTON HEART AND VASCULAR HOSPITAL
0
5000
10000
15000
20000
25000
TotalOutpatientInpatient
FY2012FY2011FY2010FY2009FY2008FY2007
2,680
18,929
21,609
2,124
19,831
21,955
1,952
20,956
22,908
2,015
20,891
22,906
2,0732,131
20,552
22,625
20,679
22,810
FISCAL YEARLENGTH OF STAY
(IN DAYS)
FY 2007 1.9
FY2008 2.3
FY2009 2.4
FY2010 2.7
FY2011 3.1
FY2012 3.2
PROCEDURE COUNT
Transthoracic Echocardiogram 8062
Stress Echocardiogram 251
Dobutamiine Stress Echocardiogram 95
Signal Average ECG 9
Metabolic Stress Test 8
Holter Monitors 19
Exercise Arterial Test 0
Transesophageal Echocardiogram 1277
Cerebrovascular Studies 438
Arterial Studies 955
Venous Studies 1039
Visceral Studies 20
Dialysis Access Scan 97
TOTAL 12,270
*Intensive Care Unit (ICU) opened January 2010
HOSPITAL ADMISSIONS AND REGISTRATIONS
INPATIENT AVERAGE LENGTH OF STAY
NON-INVASIVE PROCEDURES (FY2012)
22,625admissions & registrations
BaylorHeartHospital.com
BaylorHeartHospital.com got a new look in 2012. Baylor
Heart and Vascular Hospital continues to move forward
in the utilization of BaylorHeartHospital.com for patient
engagement, marketing and administrative efficiency.
Website traffic spiked 66 percent, in the last quarter of
FY12, after the site redesign.
BaylorHeartHospital.com JULY 2011 JUNE 2012
Visits: 3,345 6,365
Unique Visitors: 2,870 5,550
eNewsletter
Monthly issues of the automated electronic newsletter
were distributed to more than 7,000 people per month.
The newsletter contains tips for healthier living, plus
the latest information about Baylor Heart and Vascular
Hospital.
1312 MEASURING INNOVATION IN HEART AND VASCULAR CARE BAYLOR JACK AND JANE HAMILTON HEART AND VASCULAR HOSPITAL
Real Patients. Real Stories.
JERÉ CYPERT
Jeré Cypert was pushing her granddaughter in a stroller up a hill when she
became very short of breath. Her back, head and neck hurt. She ignored
the symptoms, thinking she was just out of shape. When the symptoms
returned a month later, she went to her doctor, where they told her she
would never have a heart attack. Not satisfied with the diagnosis, Jeré
went to Baylor Jack and Jane Hamilton Heart and Vascular Hospital where
she learned she had two blocked arteries.
At Baylor, Jeré had an angioplasty, a minimally invasive procedure that
cleared the blockages, and two stents were inserted to keep her arteries
open. She then participated in six months of cardiac rehab. “Baylor was
awesome. I can’t say enough good things about them. They got my blood
flowing and my energy back.”
An angioplasty at Baylor got my blood flowing again.”
– JERÉ CYPERT
“
Cen
ters
for
Med
icar
e an
d M
edic
aid
Ser
vice
s Perform
ance Rep
ort
1514 QUALITY | MEASURING INNOVATION IN HEART AND VASCULAR CARE BAYLOR JACK AND JANE HAMILTON HEART AND VASCULAR HOSPITAL
Centers for Medicare & Medicaid
Services (CMS) FY2012
The core measures that the
hospital tracks include Acute
Myocardial Infarction (AMI), Heart
Failure (HF), and Surgical Care
Infection Prevention (SCIP). In each
of these measures, the hospital
has exceeded national averages.
Concurrent data acquisition is in
place with data elements reviewed
daily. Variances are also managed
daily with education and/or process
design review and modification.
HEART ATTACK QUALITY INDICATOR
HEART FAILURE QUALITY INDICATOR
SURGICAL INFECTION QUALITY INDICATOR
HEART ATTACK (ACUTE MYOCARDIAL INFARCTION) NATIONAL TEXAS BHVH
AMI Bundle 100%
Aspirin at arrival 99% 99% 100%
Aspirin at discharge 99% 99% 100%
ACEI or ARB for LVSD 99% 97% 100%
Adult smoking cessation advice/counseling 100% 100% 100%
Beta blocker at discharge 99% 99% 100%
HEART FAILURE NATIONAL TEXAS BHVH
CHF Bundle 99.1%
All discharge instructions 93% 92% 100%
Evaluation of LVS function 98% 99% 100%
ACEI or ARB for LVSD 97% 96% 100%
Adult smoking cessation advice/counseling 99% 99% 100%
SURGICAL INFECTION IMPROVEMENT PROJECT NATIONAL TEXAS BHVH
SCIP All or None Bundle 99.4%
Antibiotic received within one hour of incision 98% 98% 100%
Antibiotic selection 98% 98% 100%
Antibiotic discontinued within 24 hours 97% 97% 100%
Appropriate hair removal 100% 100% 100%
Beta blocker use preoperatively 97% 96% 100%
Performance Report FY2012
Baylor Hamilton Heart and Vascular Hospital
also monitors several other quality indicators
in atrial fibrillation and percutaneous
interventional cardiology. These diagnoses
require several evidence-based measures
to be in place to assure quality of care. The
hospital’s data is collected concurrently and
reviewed daily. The hospital has exceeded
national standards in these areas as well.
Baylor Heart and Vascular Hospital participates
in preventive health measures with the American
Heart Association. This program requires several
indicators of preventive health to be monitored as
part of secondary prevention. The hospital puts these
measures into place in an effort to assure that we are
addressing prevention of heart disease. The hospital
has exceeded national averages in these areas.
Metrics are incorporated into the pre-printed order sets
that are utilized for patient care to assure that these
elements of care are hardwired into our daily activities.
EP/PACEMAKER/ICDin-lab mortality rate:
0% out of1,760cases
Performance Report
1716 QUALITY | MEASURING INNOVATION IN HEART AND VASCULAR CARE BAYLOR JACK AND JANE HAMILTON HEART AND VASCULAR HOSPITAL
IN-HOSPITAL MORTALITY FY2012
EP/PACEMAKER/ICDCASE
COUNTIN-LAB PERCENT
POST PROCEDURE
PERCENT
Pacemaker Only 335 0 0.00% 1 0.30%
Event Recorder 53 0 0.00% 0 0.00%
ICD Only 446 0 0.00% 0 0.00%
EP Cases 926 0 0.00% 2 0.22%
TOTAL 1760 0 0.00% 3 0.17%
CATH LABCASE
COUNTIN-LAB PERCENT
POST PROCEDURE
PERCENT
Diagnostic Cath Only 2061 2 0.10% 15 0.73%
Diagnostic Peripheral Only 436 0 0.00% 1 0.23%
Cardiac Intervention 1285 1 0.08% 6 0.47%
Peripheral Intervention 858 0 0.00% 12 1.40%
Peripheral Diagnostic w/ Cardiac Procedures 723 0 0.00% 8 1.11%
TOTAL 5363 3 0.06% 42 0.78%
100%afib patient follow-up
post-procedure
mortality rate:0%ICD
PERFORMANCE REPORT FY2012
ATRIAL FIBRILLATION PERCENTAGE
Coumadin at discharge 100%
Patient follow-up 100%
Teaching smoking cessation 100%
PERCUTANEOUS CORONARY INTERVENTION PERCENTAGE
Lipid lowering medication at discharge 100%
Plavix at discharge 100%
ASA at discharge 99.8%
Teaching smoking cessation at discharge 100%
BETA BLOCKERS IN VASCULAR SURGERY PERCENTAGE
Prior to surgery 100%
Recovery room 100%
Speciality care room 100%
At discharge 100%
AHA GET WITH THE GUIDELINES PERCENTAGE
HbA1c>7 outpatient diabetic referral 100%
HbA1c>7 letter to PCP 100%
ADA diet orders for diabetic patients 96%
VACCINATIONS PERCENTAGE
Pneumococcal vaccinations 97.8%
Influenza vaccinations 97.5%
Interdiscip
linary Quality
and S
afety Com
mittee
Rea
dm
issi
ons
1918 QUALITY | MEASURING INNOVATION IN HEART AND VASCULAR CARE BAYLOR JACK AND JANE HAMILTON HEART AND VASCULAR HOSPITAL
0.24%lead dislodgement rate
totalreadmission
rate:
abdominal aorta aneurysm
infection rate:2.16% 0%
READMISSIONS TO BAYLOR HAMILTON HEART AND VASCULAR HOSPITAL FY2012
CAUSE/PROCEDURE %
Pacemaker
Lead Dislodgement 0.28%
Infection 0.56%
Another related procedure 2.81%
Other 1.12%
EP Ablation
Re-ablation 4.12%
Same site 2.89%
Different site 1.24%
ICD Only
Lead Dislodgement 0.24%
Infection 2.38%
Another ICD relate procedure 4.51%
Other 0.71%
Coronary Interventions Same Vessel 2.14%
Coronary Angiogram Return for Intervention 5.09%
INFECTION REPORT FY2012
NATIONAL HEALTHCARE SAFETY NETWORK (NHSN)
NO. PROCEDURESBHVH
(RATE PER 100 PROCEDURES)BENCHMARK*
(RATE PER 100 PROCEDURES)
Abdominal aorta aneurysm 10 0 3.19
Carotid endarterectomy 140 0.71 0.33
Peripheral bypass 146 9.59 6.71
Pacemaker/ICD 965 0.52 0.44
Interdisciplinary Quality and Safety Committee
Baylor Heart and Vascular Hospital has selected multiple quality indicators, including nurse sensitive indicators
that are monitored and reported monthly on a performance report card. This report card is reviewed in multiple
forums, including our shared governance councils, Medical Leadership, and Board of Manager meetings. This
report is also reviewed in all employee meetings on a quarterly basis. Actions are taken for areas with improvement
opportunities.
*2010 CDC/NHSN pooled mean
Pat
ient
Fal
lsH
ospital A
cquired
P
ressure Ulcers
2120 QUALITY | MEASURING INNOVATION IN HEART AND VASCULAR CARE BAYLOR JACK AND JANE HAMILTON HEART AND VASCULAR HOSPITAL
Patient Falls
Statistical process control charts are utilized to analyze the variance in fall incidence. The data subset has
consistently trended below the NDNQI National Comparative Information mean for bed size <100. The fall rate is
consistently below the NDNQI benchmark. In addition, the injury rate for the Med-Surg group has remained below
the NDNQI benchmark.
COMBINED- ACUITY ADJUSTED 3Q10 4Q10 1Q11 2Q11 3Q11 4Q11 1Q12 2Q12 AVG
Hospital Adult Med-Surg Combined Median 1.41 1.41 2.32 0.80 2.37 1.07 1.79 2.28 1.68
Specialty Care Unit 0.93 1.89 2.71 2.61 1.67 1.45 2.25 1.60 1.89
National Comparative Information–Bed Size<100 Mean 3.52 3.62 3.80 3.62 3.58 3.34 4.21 3.66 3.67
25th percentile 2.26 2.18 2.41 2.14 2.05 2.05 2.52 2.36 2.24
50th percentile 3.43 3.31 3.55 3.50 3.21 3.20 3.93 3.42 3.44
COMBINED- ACUITY ADJUSTED 3Q10 4Q10 1Q11 2Q11 3Q11 4Q11 1Q12 2Q12 AVG
Specialty Care Unit 0.64 0.98 1.04 1.05 0.00 0.19 0.37 0.47 0.59
National Comparative Information–Bed Size<100 Mean 0.91 0.87 0.90 0.89 0.90 0.80 0.84 0.87 0.87
25th percentile 0.27 0.18 0.27 0.00 0.16 0.00 0.07 0.00 0.12
50th percentile 0.78 0.76 0.78 0.64 0.69 0.64 0.64 0.73 0.71
PERCENT OF SURVEYED PATIENTS WITH HOSPITAL ACQUIRED PRESSURE ULCERS
PERCENT OF SURVEYED PATIENTS WITH HOSPITAL ACQUIRED PRESSURE ULCERS STAGE II & ABOVE
COMBINED- ACUITY ADJUSTED 3Q10 4Q10 1Q11 2Q11 3Q11 4Q11 1Q12 2Q12 AVG
Specialty Care Unit 0.00 0.00 0.00 0.00 0.00 0.00 4.59 0.00 0.57
National Comparative Information–Bed Size<100 Mean 2.61 2.73 3.31 2.79 2.93 2.48 3.02 2.55 2.80
25th percentile 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
50th percentile 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
COMBINED- ACUITY ADJUSTED 3Q10 4Q10 1Q11 2Q11 3Q11 4Q11 1Q12 2Q12 AVG
Specialty Care Unit 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
National Comparative Information–Bed Size<100 Mean 1.57 1.78 2.11 2.01 1.90 1.62 1.76 1.41 1.77
25th percentile 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
50th percentile 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
TOTAL FALLS PER 1,000 PATIENT DAYS
INJURY FALLS PER 1,000 PATIENT DAYS
Gra
dua
te M
edic
al
Ed
ucat
ion Graduate Medical Education
2322 QUALITY | MEASURING INNOVATION IN HEART AND VASCULAR CARE BAYLOR JACK AND JANE HAMILTON HEART AND VASCULAR HOSPITAL
Graduate Medical Education
Baylor’s graduate medical education program promotes diversity,
quality and a combination of real-world applications and academic
excellence. The dedicated physician leaders on the medical
staff work to prepare fellows and interns for the challenging
and rewarding field of medicine. Medical education has been a
successful collaborative effort between Baylor University Medical
Center at Dallas and Baylor Hamilton Heart and Vascular Hospital,
both located on the downtown Baylor campus. All programs are
accredited by the ACGME (Accreditation Council for Graduate
Medical Education).
Cardiac Electrophysiology Fellowship
Fellows complete a 12-month comprehensive training program.
The curriculum includes diagnostic and procedure skills, outpatient
management and clinical research. One fellow is accredited per
year.
Cardiovascular Disease Fellowship
Fellows complete a three-year comprehensive training program
which includes all aspects of cardiology. Clinical rotations at
Baylor Hamilton Heart and Vascular Hospital include interventional
cardiology, cardiac electrophysiology, cardiac rehabilitation, lipids,
non-invasive cardiology, nuclear cardiology and vascular medicine.
Two fellows are accepted into the program annually.
Vascular Surgery Residency
The program annually offers two residency positions through the
NRMP (National Residency Matching Program). The two-year
residency is devoted exclusively to general vascular surgery with
research participation.
Cardiovascular Interventional Fellowship
Fellows complete an 18-month comprehensive training program.
The curriculum provides for an interventional clinical and procedural
focus during the first year, followed by a focus on clinical research
during the subsequent six months. One fellow is accepted into the
program annually.
BHVH FELLOWS (FY2012)
Cardiology Fellows:
Brian Schwartz, MD (graduated)
Poorya Fazel, MD
Anumeha Tandon, MD
Betsy George, MD
Adam Falcone, MD
Aneley Hundae, MD
EP Fellow: Senthil Nachimuthu (graduated)
Vascular Fellows:
Todd Cumbie, MD (graduated)
Joshua Gierman, MD (graduated)
Christopher Busken, MD
Allen Lee, MD
Pat
ient
Sat
isfa
ctio
n S
urve
ys
2524 SERVICE | MEASURING INNOVATION IN HEART AND VASCULAR CARE BAYLOR JACK AND JANE HAMILTON HEART AND VASCULAR HOSPITAL
Patient Satisfaction Surveys
BHVH has received the Press
Ganey Summit Award, one of
their most prestigious honors,
for the second year in a row.
BHVH achieved this distinction
by sustaining an overall rank
above the 95th percentile for
inpatient satisfaction in the “All
Press Ganey” database for at
least three years.
BHVH uses Press Ganey Associates to survey their patient population. Press Ganey uses patient discharge information to select a sample of
recipients who receive a sample of mailed satisfaction surveys.
likelihood ofoutpatients to recommend BHVH
96.5%
OUTPATIENT SATISFACTION SURVEY RESULTS FY2009 FY2010 FY2011 FY2012
Std overall 93.7 94.2 94 93.9
Helpfulness of registration person 93.9 94.4 93.3 92.6
Ease of the registration process 93.6 93.7 92.4 91.4
Std facility 91.8 91.8 91.6 91.7
Comfort of waiting area 91.4 91.8 91.3 91.2
Cleanliness of facility 94.8 95.1 95.0 95.1
Std test or treatment 94.9 96.0 96.7 96.4
Friendliness of staff 96.1 96.9 97.5 97.2
Explanations given by staff 93.9 95.1 96.1 96.4
Skill of techs/therapists/nurses 95.6 96.3 97.1 96.6
Staff concern for comfort 95.0 95.9 96.9 96.1
Staff's concern/questions worries 94.3 95.6 96.1 95.8
Std personal issues 93.2 94.2 94.3 94.5
Our concern for privacy 93.6 94.2 94.4 94.2
Our sensitivity to your needs 93.4 94.5 94.3 94.7
Response to concerns/complaints 92.8 94.1 94.2 94.8
Std overall assessment 95.7 96.4 96.4 96.0
Staff worked together provide care 95.0 96.0 95.8 95.7
Overall rating of care 95.6 96.6 96.5 96.3
Likelihood of recommending 96.4 96.8 96.8 96.5
OUTPATIENT SATISFACTION SURVEY RESULTS
INPATIENT SATISFACTION SURVEY RESULTS
FY2009 FY2010 FY2011 FY2012
Std Overall 95.0 95.8 92.1 92.1Overall 95.0 95.8 92.2 92.3Std Admission 91.8 93.2 93.5 93.4Admission 91.8 93.2 93.5 93.4Courtesy of person admitting 93.9 95.0 95.2 95.1Courtesy of person served food 92.0 93.1 93.3 92.7Std Nurses 92.8 93.8 94.0 94.3Friendliness/courtesy of the nurses 94.9 96.0 95.8 96.1Promptness response to call 92.1 93.1 93.2 93.6Nurses' attitude toward requests 93.5 94.7 94.4 94.6Attention to special/personal needs 91.9 93.4 93.2 93.8Skill of the nurses 93.7 94.6 94.8 95.1Extent to which nurses checked ID 94.6 95.5 95.9 96.7Courtesy of person took blood 91.7 92.8 93.4 93.6Staff attitude toward visitors 93.5 94.1 94.0 95.1Friendliness/courtesy of physician 92.4 93.8 93.6 93.3Skill of physician 95.4 96.5 96.1 95.9Staff worked together care for you 94.1 94.7 95.0 95.5Likelihood recommending hospital 95.7 96.7 96.7 96.2Overall rating of care given 95.3 96.2 96.4 96.1Intensive/Critical Care 96.0 96.7
Friendliness/courtesy ICU nurses 96.0 97.0ICU nurse help understand T&T/cond 95.1 96.3
Attention special/personal need ICU 96.6 96.9
Skill of ICU/CCU nurses 96.2 97.6
Operating/Recovery Room 94.0 93.5
Friendliness/courtesy of anesthesia 94.5 94.2
Explanation by anesthesia staff 93.6 92.9
AMBILATORY SATISFACTION SURVEY RESULTS*
FY2010 FY2011 FY2012
Helpfulness of registration person 93.1 94.2 92.3Friendliness of nurses 94.8 95.6 96.5Information day of surgery 92.2 92.7 94.6Nurses concern for comfort 92.1 93.4 94.7
Nurses courtesy toward family 92.5 93.7 95.1
Confidence in skill of nurses 92.5 93.8 94.8Std Physician 92.5 93 94.2Physician 92.5 93 94.2Friendliness of physician 94.5 94.4 95.3Confidence in skill of physician 95.5 96 96.6Comfort of your room/resting area 93.4 94.1 94.8Cleanliness of center 94.1 95 95.4Std Overall Assessment 94.4 95 96.3Overall Assessment 94.4 95 96.3Overall rating of care 94.2 94.6 96.1Degree staff worked together 94.3 94.9 96.2Likelihood of recommending center 94.9 95.6 96.7Anesth/Anesthesiologist 92.1 92.8 94.3Friendliness of anesthesiologist 93.6 94 95.5Rate overall anesthesia experience 92 92.9 94.3Intensive/Critical Care 96.0 96.7
Friendliness/courtesy ICU nurses 96.0 97.0ICU nurse help understand T&T/cond 95.1 96.3
Attention special/personal need ICU 96.6 96.9
Skill of ICU/CCU nurses 96.2 97.6
Operating/Recovery Room 94.0 93.5
Friendliness/courtesy of anesthesia 94.5 94.2
Explanation by anesthesia staff 93.6 92.9
*Note: This is a new survey for the hospital as of January 2010
AMBILATORY SATISFACTION SURVEY RESULTS*INPATIENT SATISFACTION SURVEY RESULTS
mean score on a scale of 100
Preventative Health Education
Pre
vent
ativ
e H
ealth
E
duc
atio
n
2726 SERVICE | MEASURING INNOVATION IN HEART AND VASCULAR CARE BAYLOR JACK AND JANE HAMILTON HEART AND VASCULAR HOSPITAL
Caring Hearts®
Emotional support is an important part of recovery, and we think
that it’s important for patients in cardiac rehabilitation to learn from
the experiences of those who have already completed the program.
In the Caring Hearts® program, people who are a year past their
own cardiac event volunteer to visit a patient and their family before
or after a procedure, offering empathy and support. Caring Hearts
volunteers also support waiting room staffs. Caring Hearts volunteers
are cardiac patients or family members of cardiac patients.
LINK: Connecting Cardiovascular
Health and Wellness Across
Generations
LINK is a monthly meeting for heart and
vascular patients and their family members
to hear a staff member or physician on
the medical staff at Baylor Heart and Vascular Hospital speak on a
variety of topics. Guests are encouraged to bring friends and family
members to the meeting to gain knowledge that heart disease does
spread across generations.
DATE SPEAKER TOPIC NO. OF ATTENDEES
7/23/11 Deborah Suderman & Lucille Enix Mind and Body: The Heart Connection 27
8/17/11 Bobbi Leeper, MN, RN-BC, NE-BC, CCRN, FAHA Women and Heart Disease 10
9/21/11 Jenny Adams, PhD Heart Research at Baylor Heart & Vascular Hospital 14
10/22/11 Shelly Hall, MD Introduction to LVADs 14
11/16/11 Brian Hardaway, MD Advances in Heart Failure 19
12/21/11 Tammy Cohen, PharmD, RPh, FASHP A Personal Talk with a Pharmacist 29
1/18/12 William Roberts, MD How Heart Health Has Progressed Over the Past 50 Years 7
2/18/12 Rafic Berbarie, MD Know Your Numbers 9
3/21/12 Mae Centeno, DNP, RN, CCRN, CCNS, ACNS-BC Partners in Heart Failure Care: Patient and Family Members’Role 16
4/18/12 Bobby Whisnad, BS It’s All Heart 14
5/19/12 Emily Malorzo, RD, LD Alphabet Soup: Compounds That Can Help Your Heart 32
6/20/12 Jenny Adams, PhD The Truth About Food Addiction 36
TOTAL: 347
LINK: CONNECTING CARDIOVASCULAR HEALTH AND WELLNESS ACROSS GENERATIONS
Leap For Life®
Take the first leap toward a
healthier lifestyle with Baylor Health
Care System’s Leap (Lifestyle
Education Awareness Program)
for Life® program. Designed to
meet the needs of patients and their families with heart
disease, Leap for Life teaches what you can do now
to manage your disease and possibly improve your
health. It’s a wellness and disease prevention program
available to heart patients, their family members and
the community that empowers individuals with physical,
dietary and stress education to achieve better health.
Wired For Life
Baylor Hamilton Heart and
Vascular Hospital has teamed
up with past implantable cardioverter defibrillator (ICD)
recipients to provide future ICD recipients with support,
comfort and answers to their questions. Volunteers meet
with the future recipients and their families before and
after the ICD procedure.
Preventative health education groups are one of the best resources for people who have experienced heart and vascular disease. Share your experience and learn from others in one of Baylor’s ongoing groups.
Com
mun
ity O
utre
ach Community Outreach
2928 SERVICE | MEASURING INNOVATION IN HEART AND VASCULAR CARE BAYLOR JACK AND JANE HAMILTON HEART AND VASCULAR HOSPITAL
Peripheral Vascular Disease Screenings
If you’re experiencing cramping, burning or
tingling pain in your legs, it could be that you have
peripheral artery disease (PAD). The discomfort
is the result of decreased blood flow caused by
the narrowing of the arteries. Left untreated, PAD
can pose serious risks to your health. The good
news is that this disease can be diagnosed using
a simple, painless test. Baylor Hamilton Heart
and Vascular Hospital has an entire PAD program
staffed by specialists who can offer you a variety
of treatment options, along with ongoing care.
Baylor Hamilton Heart and Vascular Hospital is committed to providing opportunities to be actively involved in the community. Community involvement suggestions have been received from our team members in our Advisory Council and Leadership Council.
200+Baylor employees attended the 2012 Heart Walk
Women and Heart Disease (Screening Cards)
Mention the term “heart attack” and most people imagine a pudgy,
middle-aged man drenched in sweat and clutching his chest.
Few people seem to consider cardiovascular disease (CVD) as a
woman’s disease. But according to the American Heart Association,
cardiovascular disease is the leading killer of women over age 25. It
kills nearly twice as many women in the United States than all types
of cancer, including breast cancer. Only 13 percent of women think
heart disease is a threat to their health.
The misleading notion that heart disease is not a real problem for
women can be blamed in part on medical research. For a very long
time, heart disease studies have focused primarily on men. Changes
are under way, but some doctors still fail to recognize the warning
signs displayed by female patients.
Baylor Hamilton Heart and Vascular Hospital has implemented
screening cards for certain decades of age for women. Each card
can help the patient start 12 months of healthy living. Their physician
can recommend self-tests and screening tests than can help the patient
uncover health problems early, when they’re most treatable. The physi-
cian may also recommend earlier or more frequent screenings, based
on family history or other risk factors.
OTHER FEMALE FOCUSED SCREENINGS
DATE OF EVENT NAME OF EVENT NO. OF ATTENDEES
November 2011 For Women For Life 284
American Heart Association:
Heart Walk
Each year Baylor Hamilton Heart and
Vascular Hospital supports the American
Heart Association’s Mission to “Build healthier lives, free of
cardiovascular diseases and stroke” by raising donations through
a series of activities and events. Our employees, their families and
pets participate in a fun-filled, non-competitive three-mile walk
through downtown Dallas. Over 200 Baylor employees attend this
annual event.
Continuing Education
Baylor Hamilton Heart and Vascular Hospital hosts and sponsors
four all-day events throughout the calendar year. These programs
are created and managed by our clinical team and are made
available to the staff and community. Each year attendees travel as
far as other states to attend our seminars.
In addition to the seminars and symposiums, Baylor Hamilton Heart
and Vascular Hospital offers preceptor and charge nurse classes in
addition to other on site continuing education opportunities.
CONTINUING EDUCATION
CY 2007
CY 2008
CY 2009
CY 2010
CY 2011
CY 2012
Cardiovascular Symposium 420 460 550 403 450 370
Vascular Seminar 117 126 74 n/a 128
EP/Non Invasive Seminar 170 185 191 137 190
Cardiovascular Summit 118 100 75 86 49
SVT-AFIB n/a n/a n/a n/a 35
Em
plo
yee
Ince
ntiv
es
3130 PEOPLE | MEASURING INNOVATION IN HEART AND VASCULAR CARE BAYLOR JACK AND JANE HAMILTON HEART AND VASCULAR HOSPITAL
tuition reimbursement
401(k) THRIVE wellness program
child care benefits2-day alternate work schedule
health screenings
PTO(paidtimeoff)
SEGMENT NEEDS POLICIES, SERVICES, BENEFITS
Safety Safe Choice, Violence Prevention, Defensive Driving
Health Health Screenings, THRIVE Wellness Program, Health Club Discounts
Career Oriented Career Development, Clinical Coaches, Tuition Reimbursement, Leadership Development Programs, Internships, ASPIRE
Family Oriented 2-Day Alternate Work Schedule (TDA), Adoption Assistance, Discounted Childcare Programs
Personal Emergencies Paid Time Off (PTO), Employee Assistance, Employee Trust Fund, Personal/Funeral Leave, Family Medical Leave Act (FMLA)
Civic Minded Jury Duty, Military Leave, Paid Time Off (PTO)
Security Insurance, Short Term/Long Term Disability, 4 Medical Plan Options, 3 Dental Plans, Life Insurance
Long Term Financial Goals Credit Union, 401K Plan, Retirement Plan
Short Term Financial Goals Credit Union, ATM
POLICIES, SERVICES AND BENEFITS TAILORED TO STAFF SEGMENTED BY NEEDS
Employee Incentives
Em
plo
yee
Ret
entio
n Em
ployee A
ward
s and
Accolad
es
3332 PEOPLE | MEASURING INNOVATION IN HEART AND VASCULAR CARE BAYLOR JACK AND JANE HAMILTON HEART AND VASCULAR HOSPITAL
Employee Retention
Retention is a focus for our team. Retention metrics
are also hardwired into the performance appraisals
of the leadership team. Special classes are required
for the leadership team on Retention.
FY2011BAYLOR
HEALTH CARE SYSTEM
BAYLOR HEART AND VASCULAR
HOSPITAL
All Employees
89.8% 95.2%
Direct Patient Care RNs
87.4% 95.6%
Allied Health 92.0% 97.3%
Direct Patient Care UAPs
88.1% 92.6%
BAYLOR HAMILTON HEART AND VASCULAR HOSPITAL NURSING RETENTION, NEW HIRE RETENTION AND VACANCY DIRECT PATIENT
CARE, ROLLING 12 MONTHS
97.6%satisfaction skill rating of ICU/CCU nurses
all employee retention rate:
95.2%
Al Booker was nominated for
Dallas-Ft.Worth Hospital Council
Employee of the Year
Sandra McLeroy-DeJong BSN,
RN-BC, was honored as one of
the Great 100 Nurses of Dallas-
Ft. Worth
Mark Sanders, MSN, RN, NEA-BC,
was nominated for D Magazine
Nurse of the Year
Mindy Smart BSN, RN-BC,
was honored as one of the
Great 100 Nurses of Dallas-
Ft. Worth
Ravi Vallabhan, MD, was
nominated for Dallas-Ft.Worth
Hospital Council Doctor of
the Year
Nur
se C
ertifi
catio
nWE WOULD LIKE TO RECOGNIzE OUR NATIONALLY CERTIFIED RN’S:
3534 PEOPLE | MEASURING INNOVATION IN HEART AND VASCULAR CARE BAYLOR JACK AND JANE HAMILTON HEART AND VASCULAR HOSPITAL
Baylor Hamilton Heart and Vascular Hospital has a
program in place for certification reimbursement. A
nurse may request up to $500 in reimbursement for
the certification exam, a review course, and review
course materials.
Nurse Certification
56%of eligible RNs are
certified RNs 70certified
RNson BHVH staff
Abraham, Cetty, CCRNAdkins, Jeanine, CNORAllen, Beverly, CPHQ, CPHRMAndrews, Rose, CCRN, RN-BCAntony, Manju, RN-BCAsbury, Crystal, RN-BCAtkins, Maryanna, RN-BCBallesteros, Barbara, RN-BCBarta, Laurie, CEPS, CCDSBass, Bethany, RN-BCCarroll, Sharon, CEPSChandani, Niamat, RN-BCChurch, Millie, CCRNColeman, Holly, CCRN Darst, Valerie, RN-BC, RCISDodd, Lisa, RN-BCEaso, Mini, RN-BC Edelstein, Jacie, CCRN Ellis, Meridith, RN-BCFletcher, Vicki, RN-BC Flick, Charlene, CPHQ Florez, Samuel, CCRN Fowler, Stacy, CCRNFuller, Nicole, RN-BC Geddie, Jackie, RN-BC Glasgow, Josh, RN-BC Grayson, Gabriell, RN-BC Harris, Michael, RCISHarry, Chloe, CCRNHesson, Jade, RN-BC Holmes, Paige, RN-BC Kirkpatrick, Sandra, CCRN, TNCCLawrence, Anne, RN-BC Lenge, Jennifer, RN-BC Maguigad, Kristine, RN-BC
Maninang, Jennifer, CNOR Maninang, Ron, TNCCMarenah, Mariama, RN-BC McCord, LeAnn, CCRNMcCray, Stephanie, RN-BC McDonald, Paz, CCRN, RN-BC McKethan, JoAnn, RN-BCMoore, Renita, CMSRNMuldoon, Mary, RN-BC, CEPSMurphy, Kate, RN-BCNaffe, Aster, CCRNParise, Annette, RN-BC Pinaga, Kelly, RN-BCRenbarger, Tara, RN-BC Resurreccion, Romeo, RN-BCRowan, Cheryl, TNCC, RN-BCRoyer, Sarah, CCRNRury, Angela, RN-BCSalas, Erica, CNORSimmons, Cynthia, RN-BCSmart, Mindy, RN-BCSmith, Daphne, RN-BCSolomon, Tonja, RN-BCSt. Laurent, Paul, CCRN, ACNP-BCSta-Maria, Rodrigo, CCRNSwaner, Gary, RN-BCThomas, Jennifer, CCRN Ticzon, Araceli, CMSRN Tidmore, Allison, CCRN Valles, Joy, RN-BCWade, Courtney, CCRNWu, Bo, CMSRN, CCRNYohannan, Stacy, RN-BC York, Denise, PCCN, Zhou, Shannon, CNOR, CCRN
Sha
red
Gov
erna
nce Shared Governance
3736 PEOPLE | MEASURING INNOVATION IN HEART AND VASCULAR CARE BAYLOR JACK AND JANE HAMILTON HEART AND VASCULAR HOSPITAL
The STARRS Committee continues to play a very important
role in satisfaction. STARRS stands for Service, Training,
Accountability, Recruitment, Retention and Satisfaction.
As a standing agenda item, the STARRS Committee has an
open discussion period where representatives may bring up
issues that require clarification, problem solving, process
improvement or administrative support. Issues brought to
this council over the past twelve months have led to higher
levels of employee satisfaction. Their focus has moved from
environmental improvements to staff teamwork. Initiatives
include meet and greet breakfasts for new employees,
employment anniversary cards and a focus on improving
team work and recognition.
Chair – Daphne Smith, RN
Co-Chair – Leigh Ann Ward, RT(R), ARRT
FY2012 ACCOMPLISHMENTS INCLUDE:
• Habitat for Humanity
• Christmas for the Dallas Children’s Advocacy Center
• Diversity Projects
• Anniversary Cards
• Thank You Cards
• Guiding STARR
“Collaboration is at the heart of everything we do.” – Nancy Vish, President
and CNO
HOUSEWIDE STARRS COMMITTEE
The Standards and Measure Committee focuses on patient and family satisfaction. When it comes
to service, Baylor employees often go above and beyond what’s expected – on the patient floor, in
administrative offices, in clinics and elsewhere. We want to make sure those efforts are recognized
and rewarded. The Standards and Measures Committee helps identify those staff members who
should be recognized for their efforts.
Chair – Scotty Pate, RT(R), ARRT Co-Chair – Lisa Dodd, ADN, RN-BC
FY2012 ACCOMPLISHMENTS INCLUDE:
Implementation of the BHVH service signature: “Is there anything else I can do for you?”
Press Ganey staff monthly notification and poster boards
Language interpretation initiatives enhancement
IV start trending stats
Patient family communication enhancements – chart label (with family contact information) used during procedures to inform family of progress
BHVH Service Signature: “Communication Connection”
Post procedure meal delivery time improvement (decrease of over 15 minutes)
Patient care delivery model improvement – 4SCU open longer for post procedure patients to return to the same floor
Training and coaching on communication delivery – verbal and non verbal
BHVH Service Signature: “Every Patient, Every Encounter”
A service tool kit (box) placed in all the units so RNs and CCTs are able to do service recovery.Boxes include multiple items: hairdryers, meal coupons, parking tokens, game books and movie tickets
BHVH Service Signature: “Memory Moments”
New departure checklist put into action and is utilized on all patients
Service Alert notifications implemented for procedural wait times longer than three hours
Non-Invasive Department - restructure guest waiting protocol and area
All patients receive personal escort from registration to pre-procedure floor
Scripting for patient privacy awareness
Non-Invasive post discharge phone calls
Television added in Radiology guest waiting area
HOUSEWIDE STANDARDS AND MEASURE COMMITTEE
Shared Governance
3938 PEOPLE | MEASURING INNOVATION IN HEART AND VASCULAR CARE BAYLOR JACK AND JANE HAMILTON HEART AND VASCULAR HOSPITAL
The CEO Awards of Excellence is presented quarterly to outstanding employees, chosen from among the top monthly award recipients.
Each quarterly honoree receives a $3,000 cash payment and a small keepsake, presented by Baylor CEO Joel Allison at Leadership
Development Institute meetings. The FY2012 CEO Award of Excellence winners were:
Jenny Adams, PhD, Research Associate,
Cardiac Rehabilitation
Jenny Adams was instrumental in developing the Return to Work
Lab in Cardiac Rehabilitation at the Baylor Heart and Vascular
Hospital. The use of this lab recently helped get a firefighter
back on the job. Jenny used data from nursing assessments
to apply specific exercise physiology knowledge and skills in
the firefighter’s rehabilitation program that simulated actual
experiences he would face once back on the job. This program
included exercises in climbing stairs with fire hoses and other
firefighter equipment in a safe environment to prepare his
heart for the intense work a firefighter faces. Jenny submitted
the idea for improving cardiac care in 2008, and her idea for
the Return to Work Lab was accepted and given a $250,000
grant for the development and implementation of the idea. The
cardiac rehabilitation center at BHVH has won a national award
from the American Cardiovascular Association and Pulmonary
Rehabilitation organization for this level of innovation treating
those with intense job demands such as firefighter, police officers
and athletes.
Niamat Chandani, RN, Specialty Care Unit
You know you are doing something right when you consistently
receive Five Star Spirit feedback. Niamat has received not one,
but six Five Star Spirit submissions from her patients and their
family members. There is a common theme in these submissions
– Niamat is professional, knowledgeable and provides excellent
customer service and advice to her patients. She’s also been
described as attentive, gentle and as “providing some of the best
care I’ve had” by one of her patients. Helping to make our patients
feel warm, welcome and cared for during uncertain times of illness
is why Niamat goes above and beyond on a daily basis. Niamat is
an invaluable member of the Baylor team and most importantly, to
her patients.
Megan Linker, RN, Recovery Room
Megan joined the Recovery team as a patient care technician in
February 2009 while she was a student nurse. She obtained her
nursing license in June 2010. Megan is an excellent bedside nurse
and is open and receptive to learning from others. She doesn’t
hesitate to ask questions. Because patients are usually sedated or
anesthetized for their procedures, they’re usually sleepy or drowsy
during their time in Recovery. So, any time a patient remembers
the wonderful care they received during their recovery, it says the
nurse made an above-and-beyond impression on that patient.
Megan has done that on several occasions. Besides caring for
patients, Megan also runs the hospital’s house-wide Clinical
Practice Council and is a very effective co-chair of her unit-based
System Nurses Council. She has taken on the daily schedule
and the on-call schedule in PACU and ensures that all shifts are
CEO AWARDS OF EXCELLENCE
covered while her co-workers have an opportunity for time off.
Megan has taken on the duties of a unit secretary when needed.
Everything she does is with a very pleasant attitude and a very
willing heart.
Lacy McMillon, RN, Specialty Care Unit
(Excerpt from patient family letter)…Lacy - I saved her for last because
she made such a lasting impression on me. Lacy cared for my Mom
one night, but she also was the charge nurse the night of her death.
Lacy is a compassionate, professional nurse who others should
emulate. She is knowledgeable, truly listens to what the family is
saying and answers all questions thoroughly (even the tough ones).
She took the time to address some of my concerns and reviewed
information in the chart so she could answer questions. On the night
of my Mom’s death, Lacy was willing to “go over the resident’s head”
when we had some difficulty and was able to get Dr. Grimsley on the
phone for us at two in the morning. She is a warrior with a strong and
caring human touch. It meant a great deal and allowed us to honor
my Mom’s wishes timely when we had to make hard decisions. She is
not afraid to be an advocate for the patient and the family. For this we
are eternally grateful. Lacy also made a point to find my Mom’s online
obituary and leave us all a note. This was a wonderful surprise in a
time of sorrow and was greatly appreciated.
(Team leader survey comment) Lacy McMillon – she is always pleasant
and seems to focus on what is best for the patient anytime I’ve taken a
patient to her or heard anything about her. The last PACU/SCU Patient
Centered Council meeting we had, she attended, and her ideas and
responses were genuinely patient centered and team oriented. She
is respectful to her co-workers, and is spoken of highly by leadership
that knows her. Another role model of our BHVH Values.
Annette Parise, RN, Pacemaker/Electrophysiology
Annette’s reputation for flexibility and teamwork was evident
one day when she took it upon herself to start the transthoracic
echocardiogram (TTE) for a physician who needed to quickly
verify whether a patient was suffering from an accumulation of
fluid.
Annette has extensive experience in non-invasive treatment
and is known as the super-trainer because of her knowledge
in intracardiac echocardiography (ICE) cath and her problem-
solving skills. Whenever there is an issue with ICE, it’s Annette to
the rescue. Her team and the physicians, greatly appreciate her
expertise. There are several people on the Non-Invasive team
who are cross trained to do transesophageal echocardiograms,
but Annette is the only one who can also do stress test. She often
volunteers to float to Non-Invasive whenever there is a need.
Shared Governance
4140 PEOPLE | MEASURING INNOVATION IN HEART AND VASCULAR CARE BAYLOR JACK AND JANE HAMILTON HEART AND VASCULAR HOSPITAL
The Housewide Professional Development Council focuses
on education. They meet monthly to address continuing
education events and planning for CEUs and NOW
cards. The council addresses competencies and orientation
programs, as well as, policy education.
Chair – Laura Linker, BSN, RN, CNOR
Co-Chair – Tonja Solomon, RN, RN-BC
FY2012 ACCOMPLISHMENTS INCLUDE:
• Wound Program will be presented by KCI in October (Wrn Program)
• Epidural In-services held for ICU staff
• Monthly Learning needs assessments conducted for all units
• Non-Invasive has established their own CME program ASE
• Cardiac Rehab recently had an LVAD in-service
• Patient Care Tech Annual Skills revamped and completed independently
• Multiple housewide and unit based inservices throughout the year
• Three annual seminars organized and led by staff members: – Cardiovascular Symposium – Vascular Seminar – EP/PM Seminar
• Ethics Lunch and Learns held for all staff members
• Online Journal club continued
• Annual staff BLN modules
• Diversity 101 events held
• Annual Skills Week for clinicians
The Housewide Clinical Practice Council focuses on
improving patient care and education. The council monitors
compliance with The Joint Commission, reviews ethics,
implements and maintains practice guidelines consistent
with national, regional and community standards and
recommends improvements to the Practice Model. The
council also updates the staff on drug administration,
pharmacy and medication updates, notices staffing patterns
and assists in the policy and procedure development.
Chair – Megan Linker, RN
Co-Chair – Erica Salas, ADN, CNOR
FY2012 ACCOMPLISHMENTS INCLUDE:
• Multiple evidence based articles presented to staff
• Bedside Shift Report implemented
• Improvement of hypoglycemia scores
• RRT card developed for patient and family education
• Service Alert for procedural area patients implemented
• 4 Specialty Care Unit discharge video developed to improve patient discharge teaching
• Policy and Procedures updated
• New consents implemented
• Task forces created to reduce costs and wastage
• “Buddy System” initiative created for RNs
• New Diabetic Education booklet created for newly diagnosed patients
• Increased IV time from 72 to 96 hours
• “Hand Off” tool created to follow patient throughout hospital stay
HOUSEWIDE CLINICAL PRACTICE COUNCIL HOUSEWIDE PROFESSIONAL DEVELOPMENT COUNCIL
Chair – Jennifer Adams, MT, MPH, CIC Chair – Mary Muldoon, RN, RN-BC, CEPS
Co-Chair – Tar Byxbe, RN-BCFY2012 ACCOMPLISHMENTS INCLUDE:
• Utilized “flu buggy” to encourage staff flu vaccination
• BLN module on “Infection Control”
• Monthly staff and physician hand hygiene audits performed
• Infection Prevention Fair
• Received Silver Level achievement for Joint Commission regarding flu vaccinations
FY2012 ACCOMPLISHMENTS INCLUDE:
• Ongoing studies carried over from 2011 into 2012: PCI/Web Study, BLAH Study, Depression Study, Sneeze Study, PIV Study
• Ended PIV Study in Feb 2012
• Conclusion of Data collection for BLAH study
• Closure of Systematic Review - Awaiting Publication
• Closure of Sneeze Study - Awaiting Publication
• Revision of Depression Study July 2012 - Awaiting Publication in Baylor Proceedings
• Sent two staff RNs to TCU-JBI Systematic Review Training Feb 2012
• Sent one staff RN to TCU-EBP Fellowship Sept 2011 - Sept 2012
• First BHVH Research Fair May 2012
• Began break-off sessions/mini-working research meetings
• New “Blinded” study in the works
• BHCS is officially an ESG for JBI
• 2 Posters accepted for National Convention (Sneeze and HR in Rehab)
• Mechanic paper accepted in Occupational Medicine
• Data collection finished on the Highland Park Study 16. Data collection completed on the Farmer study
• Firefighter case series submitted to the American Journal of Cardiology
• Paper submitted to the Journal of Cardiopulmonary Rehab and Prevention on Stress Testing in Cardiac Rehab
• Moral distress accepted into Journal of Clinical Ethics
• Decisional Involvement into JONA
• Tara Renbarger graduated from the TCU Evidence-Based Practice Fellowship program with a poster and podium presentation “Vascular Access Carepath: Improving Outcomes for the Vascular Patient”
Chair – Paz MacDonald, BSN, RN, CCRN
Co-Chair – Julie Gonzalez, RN, CRN
FY2012 ACCOMPLISHMENTS INCLUDE:
• August 2011, BHVH and ASPMN, Introducing Capnography
• September 2011, Using IV Acetaminophen for Pain Management. Using Capnography Patient Monitoring during BLS and ACLS
• October 2011, Update from BHCS Pain Task Force, Review of appropriate Pain Scales for different patient and procedures.
• November 2011, Paz represented BHVH at ASPMN Day Seminar, and presented to BHVH “Role of the Nurse in Pain Assessment and Management of Individuals Affected by Pain.”
• January 2012, along with ASPMN North Texas, “IV Acetaminophen”
• February 2012, Defined Nurses Roles in Pain Management from all Nursing Units”; Paz lectured on Pain Management to new Nurses
• March 2012, along with ASPMN North Texas, “Hospice 101” by Candace Baker, RN CHPN, Vitas
• April 2012, ordered more “Patient Guide to Pain Management” brochures, Pasero Opioid Sedation Scale, approved for the BHCS
• May 2012, Review of Oxygen protocol
• June 2012, Review Pain management, pre-med before wound vac application and dressing change. Pain brochures distributed to 2, 3 and 4 SCU. (Doris in-charge)
HOUSEWIDE INFECTION PREVENTION COUNCIL
HOUSEWIDE PAIN MANAGEMENT COMMITTEE
HOUSEWIDE RESEARCH COMMITTEE
4342 INNOVATIONS | MEASURING INNOVATION IN HEART AND VASCULAR CARE BAYLOR JACK AND JANE HAMILTON HEART AND VASCULAR HOSPITAL
Real Patients. Real Stories.
Baylor was the best thing that ever happened to my heart.”
– RAMIRO ROMO
“RAMIRO ROMO
Ramiro Romo, 76, thought he would have to live with the fatigue that
resulted from a leaky mitral valve. His cardiologist in East Texas prescribed
medication that had no real effect. When his grandson saw Ramiro’s
condition, he brought him to Baylor Jack and Jane Hamilton Heart and
Vascular Hospital for a second opinion.
Because he was too weak to undergo open-heart surgery, Ramiro decided
to participate in a clinical research study of the MitraClip®, a minimally
invasive surgical approach to repair the leaky valve. The procedure may
offer less pain, shorter hospital stays and faster recovery times. “I feel 100
percent better than I did before,” Ramiro says. “I was walking the second
day after the procedure, and I could feel the difference right away.”
Cen
ter
for
Com
ple
x A
rrhy
thm
ias Center for Complex Arrhythmias
4544 INNOVATIONS | MEASURING INNOVATION IN HEART AND VASCULAR CARE BAYLOR JACK AND JANE HAMILTON HEART AND VASCULAR HOSPITAL
Center for Complex Arrhythmias
The Baylor Hamilton Heart and Vascular Hospital Center for
Complex Arrhythmias (CCA) was established in 2009 with the
goal of being North Texas’ premier center for patients with cardiac
arrhythmias, such as atrial fibrillation and ventricular tachycardia.
Designed as a one-stop shop for diagnostics, education, treatment
and ongoing disease management for North Texans suffering from
a wide range of arrhythmias, the CCA’s quality care and outstanding
reputation quickly made it a destination treatment clinic for patients
from across the country.
“Each and every patient who comes to our facility represents
a unique clinical problem and is treated with a care plan and
recommendations customized to his or her specific problems,” says
Kevin Wheelan, MD, FACS, medical director of electrophysiology
and chief of staff. “These recommendations are based upon the
knowledge and expertise of a physician team that has a national
reputation with exceptional outcomes and a high safety profile.”
The CCA’s team of highly skilled cardiologists and nurses, who
specialize in electrophysiology, provide patients with the diagnosis
and treatment of abnormal heart rhythms using advanced
technology.
One of the latest advancements in the treatment of atrial fibrillation
is cryotherapy – also known as cryoballoon ablation. An alternative
to radiofrequency ablation, which uses heat delivered to heart tissue
via cathether to correct the condition, cryotherapy uses extremely
cold temperatures applied through a balloon catheter to alter
cardiac cells’ capacity to conduct electrical impulses.
The cryoballoon is an efficient approach associated with successful
outcomes and low complication rates. Our electrophysiology
department was the leading research site in the Unites States for the
cryoballoon and performed the first procedure in the North Texas.
2.2 millionamericans have a-fib
In addition to cryotherapy, we offer
several other treatment options
for arrhythmias:
• Medications to control rate and rhythm
• Anticoagulation medication therapy
• Radiofrequency ablation
• Surgical maze
Inno
vatio
nsInnovations
4746 INNOVATIONS | MEASURING INNOVATION IN HEART AND VASCULAR CARE BAYLOR JACK AND JANE HAMILTON HEART AND VASCULAR HOSPITAL
Aortic Endograft | CoreValve®
Radial Artery CatheterizationSTEMI and NSTEMI System of Care Development
Thoracic Outlet Syndrome Treatment
CoreValve®
Approximately 300,000 people worldwide suffer from severe aortic
stenosis, which occurs when the heart’s aortic valve is narrowed,
restricting blood flow from the heart to the body. Traditionally, the
most effective treatment option has been replacing the aortic valve
through open-heart surgery.
Unfortunately, open-heart surgery carries many risks and, in fact,
approximately one-third of severe aortic stenosis patients are not even
candidates for the procedure. Research shows that left untreated,
severe aortic stenosis has a 50 percent mortality rate at one year.
Baylor Hamilton Heart and Vascular Hospital is participating in a
clinical trial studying Medtronic’s CoreValve® transcatheter aortic
valve replacement system as a treatment alternative to open-heart
surgery. This artificial valve is made of natural tissue with “leaflets” that
control the flow of blood secured to a flexible, self-expanding frame
for support. Baylor Hamilton Heart and Vascular Hospital is one of 45
national CoreValve sites, and we have been awarded the next phase of
the study called SURTAVI which looks at the valve in lower risk patients.
With CoreValve, an incision is made in the femoral artery and the new
aortic valve is delivered via a catheter threaded up to the heart. Since
2010, we have successfully implanted 30 CoreValves through this
minimally invasive approach.
“Our patients who have undergone a CoreValve procedure have seen
phenomenal results,” says Robert Stoler, MD, co-medical director of
cardiology, and medical director of interventional cardiology services.
“Their length of hospital stay is shorter. Their rehabilitation and
recovery process is faster and easier, and many of them have gone
on to live active, symptom-free lives.”
Potential benefits to patients participating in the study include:
improved heart valve function and blood flow; the possibility of
improved survival; and reduced symptoms of aortic stenosis such as
chest pain, feeling faint, dizziness, fatigue, shortness of breath, heart
palpitations and heart murmurs.
Aortic Endograft
One of the most dangerous of all cardiovascular conditions is an
aortic aneurysm. Aortic aneurysms can develop slowly over time
or happen suddenly, often as the result of a physical trauma such
as a car accident.
Treatment for aortic aneurysms and other aortic pathologies was
once limited to open-heart surgery, which involves stopping the
flow of blood through the aorta and replacing the diseased section
with a tube. While many hospitals still focus on using an open
technique, Baylor Hamilton Heart and Vascular Hospital takes
a minimally invasive approach whenever possible, through an
endovascular procedure using the TAG® Thoracic Endoprosthesis.
This endovascular graft is guided via imaging technology and
guidewires through the femoral artery to the aorta where it is
“deployed” to create a tight fit against the aortic wall. The metal
endograft seals off the lesion or aneurysm, creating a new path
for blood to flow.
Outcomes using this less invasive approach have been impressive.
Endovascular repair has resulted in lower mortality and lower
complication rates than traditional open-heart surgery.
“The recovery process is much easier for patients treated
endovascularly,” says Gregory Pearl, MD. “Rather than a lengthy
stay in the hospital, which also may include time in the ICU,
patients with an endograft are typically discharged within a few
days.”
Dr. Pearl says that patients who have open-heart surgery to repair
their aorta typically take three to six months to fully recover.
Meanwhile, patients who have been treated endovascularly can
typically return to life as usual within two to six weeks of the
procedure, depending on other health conditions.
Innovations
4948 INNOVATIONS | MEASURING INNOVATION IN HEART AND VASCULAR CARE BAYLOR JACK AND JANE HAMILTON HEART AND VASCULAR HOSPITAL
Radial Artery Catheterization
Coming up with new and better ways to diagnose and treat blocked
arteries has long been a focus of professionals in the field of
cardiovascular medicine. For well over a decade, cardiologists have
relied on cardiac catheterization as the gold standard for minimally
invasive angiography and angioplasty to diagnose and remove
blockages. Cardiologists on the Baylor Hamilton Heart and Vascular
Hospital medical staff also have long relied on the technique,
successfully treating thousands of patients over the years.
Recently, we have begun using a new technique to perform cardiac
catheterization in certain cases that’s improving both safety and
patient satisfaction.
During most traditional cardiac catheterization procedures, a
cardiologist uses the femoral artery in the leg as the entry point for
a catheter tube, which is guided through the body’s arteries to the
heart. The relatively new radial artery approach allows cardiologists
on our medical staff to insert the catheter through the radial artery in
the wrist.
Once the catheter has reached the heart, a contrast dye is injected
through the tube, which identifies cholesterol deposits in diseased
arteries that may be blocking blood flow. After the blockage is
identified, angioplasty can be performed to reopen the artery.
“The radial artery approach has been shown to be especially useful
in treating some of the sickest patients–such as those who have
suffered acute myocardial infarction or who are most heavily anti-
coagulated,” says Jeff Schussler, MD. “There is a movement in both
Europe and the United States to expand the use of catheterization
through the wrist.”
“Regardless of the patient’s status, though, there are significant
benefits to this approach,” says Dr. Schussler, “and I think it’ll be used
more and more often at Baylor and throughout the nation. Nearly
all of my patients, who have had a heart catheterization both ways,
strongly preferred having it performed through the radial artery.”
Radial artery catheterization offers patients several benefits:
• Fewer complications at the access site
• Less bleeding, meaning less chance of needing a blood
transfusion
• Less risk of nerve trauma
• Lower rates of complication
• Shorter recovery/more comfortable (patients can move around
immediately after the procedure rather than having to stay in bed
for several hours)
To view the full publication on radial artery angiography, visit:
http://www.baylorhealth.edu/Documents/BUMC%20
Proceedings/2011%20Vol%2024/No.%203/24_3_Schussler.pdf
STEMI and NSTEMI System of Care Development
Survival rates of patients with cardiovascular disease in Dallas
County are lower than the national average. Thanks to a $3.5
million grant from the W. W. Caruth Jr. Foundation of Communities
Foundation of Texas (CFT) to the SouthWest Affiliate of the American
Heart Association, work is underway to improve those numbers.
Baylor Hamilton Heart and Vascular Hospital partnered with the
SouthWest Affiliate American Heart Association, 14 other Dallas-
area hospitals and 25 EMS agencies in Dallas County to accelerate
the STEMI and NSTEMI system of care development. The regional
project is aimed at forming an integrated heart attack emergency
care system in Dallas County.
Although the project is ongoing, the preliminary results are
promising. The collaboration has led to greater consistency by
Dallas-area hospitals in handling heart attack patients, lower door-
to-bed times and a drop in mortality rate.
Thoracic Outlet Syndrome Treatment
Baylor Hamilton Heart and Vascular Hospital is not only a
destination treatment facility for conditions directly impacting
the heart and chest, but also for vascular conditions that can be
debilitating to other parts of the body as well.
Thoracic outlet syndrome is a condition wherein the nerve, artery
and vein get compressed as they wind from the chest and down
the arm, by getting pinched between the collarbone and first rib.
While anyone can be at risk, it is most common among athletes and
others who practice repetitive arm motions. Symptoms include pain,
numbness, tingling and weakness in the arm, chest and/or neck.
Some forms of the condition are more serious and can include,
aneurysms and blood clots.
Since we have gained a national reputation for expertise in the
treatment of thoracic outlet syndrome, athletic trainers and
physicians nationwide refer patients to us for treatment. Over the
past year, we have managed more than 118 cases.
“Some people with a milder form of the syndrome can be treated
with a conservative approach – generally physical therapy, working
on posture and creating a more ergonomic work area,” says Gregory
Pearl, MD, department head of vascular surgery. “If a patient still
has problems or has the vascular form of the disease, we can take a
more aggressive approach and correct the problem surgically.”
Surgical treatment typically involves freeing and excising the scaling
muscle, which is attached to the first rib. Sometimes, the first rib is
removed as well, along with any scar tissue that might have resulted
from injury.
Dr. Pearl specializes in the management of thoracic outlet syndrome
and has treated scores of high school, college and professional
athletes from many sports from all across the country.
“The goal is getting the patient back to full activity and doing
whatever they want to do,” Dr. Pearl says.
“The goal is getting the patient back to full activity and doing whatever they want to do.” – Gregory Pearl, MD
Car
dia
c R
ehab
Clinical Trials and
S
tudies
5150 INNOVATIONS | MEASURING INNOVATION IN HEART AND VASCULAR CARE BAYLOR JACK AND JANE HAMILTON HEART AND VASCULAR HOSPITAL
Cardiac Rehab
Our program draws on a multidisciplinary team that
includes internal medicine physicians, registered nurses,
exercise specialists, registered dietitians and social
workers in a carefully designed program that is tailored
to your specific needs. Offered in three phases, our
program features monitored physical activity in which
you gradually increase the efficiency of your heart and
lungs, strengthening your body’s muscles while gaining
the confidence you need to return to daily life.
Return to Work Lab™ – Live Your Action Potential
The only one of its kind in
North Texas, the Return
to Work Lab™ follows
industrial athletes and
those with jobs that require
higher intensity levels
after heart procedures to
evaluate when their heart is physically ready to return
to work. The goal of the Return to Work Lab is to train
patients to achieve the fitness level necessary for them
to safely perform required job duties upon return to
work and/or activities of daily living.
Typical cardiac rehabilitation programs advise
participants to perform lower levels of activity by
using equipment such as the treadmill, bike and
light hand weights. Our program uses real-life tools
and equipment that our participants might use – fire
hoses, industrial tools, simulated radar guns – that
weigh the same as their real life counterparts.
We also use training materials taken from these
professions, stairways, stairmills, slideboards, agility
equipment, simulated lawn equipment and a weighted
workstation.
After successfully completing this program,
participants are confident that they are ready for
the demands of their job – and so are their family
members, physicians, employers and coworkers.
CLINICAL TRIALS AND STUDIES
CLINICAL DIVISION
STUDY TITLE PI
Cardiology
Nursing and Clinical Observation: Femoral Access Risk Factors During Left Heart Catheterizations Leading to Additional Hospitalization and Vascular Surgical Intervention
Gonzalez, Julie, RN
Comparison of Intrathoracic Pressure Exerted on Sternum During Low, Medium and High-Intensity Bench Press Resistance Exercise vs. a Sneeze
Adams, Jenny, PhD
Medtronic CoreValve® U.S. Pivotal Trial Stoler, Robert, MD
IRrigated Ablation System Evaluation for AF (IRASE AF) Wheelan, Kevin, MD
Medtronic StarFix® Left Ventricular Lead Extraction Study Assar, Manish, MD
A Randomized, Double-Blind Parallel-Group Study of Cardiovascular Safety in Osteoarthritis or Rheumatoid Arthritis Patients with or at High Risk for Cardiovascular Disease comparing Celecoxib with Naproxen and Ibuprofen (PRECISION)
East, Cara, MD
Endeavor Drug Eluting Stenting: Understanding Care, Antiplatelet Agent and Thrombotic Events – EDUCATION
Stoler, Robert, MD
A Multicenter, Randomized, Double-Blind, Parallel Group, Active-Controlled Study to Evaluate the Efficacy and Safety of Both Aliskiren Monotherapy and Aliskiren/Enalapril Combination Therapy Compared to Enalapril Monotherapy, on Morbidity and Mortality In
Kuiper, Johannes, MD
Adapative CRT Study Wells, Peter, MD
Xience V Everolimus Eluting Coronary Stent System (EECSS) USA Post-Approval Study Choi, James, MD
The Vest Prevention of Early Sudden Death Trial (VEST) Franklin, Jay, MD
Natural History of the Bicuspid Aortic Valve Roberts, William, MD
The Effect of Oral S-adenosylmethionine (SAMe) on Blood Levels of Homocysteine and Methylation Metabolites in Patients with Renal Insufficiency
East, Cara, MD
A Randomized, Controlled Trial of the Medtronic Endeavor Drug (ABT-578) Eluting Coronary Stent System versus the Taxus Paclitaxel-Eluting Coronary Stent System in De Novo Native Coronary Artery Lesions
Stoler, Robert, MD
Surgical Treatment for Ischemic Heart (STICH) Failure Trial Grayburn, Paul, MD
Endeavor Drug Eluting Stenting: Understanding Care, Antiplatelet Agent and Thrombotic Events - EDUCATION
Stoler, Robert, MD
A Double-blind, Randomized, Placebo-controlled, Multicenter Study to Assess the Efficacy and Safety of Darbepoetin alfa Treatment on Mortality and Morbidity in Heart Failure (HF) Subjects with Symptomatic Left Ventricular Systolic Dysfunction and Anemia
Hall, Shelley, MD
Evaluation of Sodium Bicarbonate to Reduce Contrast-Induced Nephropathy (CIN) in Subjects with Advanced Chronic Kidney Disease (CKD) who are Undergoing Angiography
Stoler, Robert, MD
Total Visits
FY2007 FY2008 FY2009 FY2010 FY2011 FY2012
Phase II*
5,419 4,583 4,253 4,874 4,869 5,082
Phase III**
2,830 2,930 3,326 3,308 3,185 2,444
*Phase II is a supervised outpatient program of individually prescribed exercise with continuous or intermittent ECG monitoring.
**Phase III is a long-term program generally including both clinical supervision by an exercise professional or nurse and intermittent ECG monitoring.
CARDIAC REHAB PROGRAM
Clinical Trials and Studies
5352 INNOVATIONS | MEASURING INNOVATION IN HEART AND VASCULAR CARE BAYLOR JACK AND JANE HAMILTON HEART AND VASCULAR HOSPITAL
CLINICAL TRIALS AND STUDIES
CLINICAL DIVISION
STUDY TITLE PI
Cardiology
Aortic Valve (in Repeat Cardiac Operation) Morphology Study Hamman, Baron, MD
Advisa MRI System Study Kowal, Robert, MD
Catheter Ablation Versus Anti-arrhythmic Drug Therapy for Atrial Fibrillation (CABANA) Trial Kowal, Robert, MD
A Randomized, Double-Blind, Placebo-Controlled, Event Driven Trial Of Quarterly, Subcutaneous Canakinumab in the Prevention of Recurrent Cardiovascular Events Among Stable Post-Myocardial Infarction Patients with Elevated hsCRP: the CANTOS Trial
East, Cara, MD
A Randomized, Double-Blind, Placebo-Controlled, Parallel-Group Study to Determine Whether, in Patients with Type 2 Diabetes at High Risk for Cardiovascular and Renal Events, Aliskiren, on Top of Conventional Treatment, Reduces Cardiovascular and Renal Mor
East, Cara, MD
Natural History of Aortic Dissection Roberts, William, MD
A Randomized, Double-blind, Placebo-Controlled, Event-Driven Trial of Quarterly Subcutaneous Canakinumab in the Prevention of Recurrent Cardiovascular Events Among Stable Post-Myocardial Infarction Patients With Elevated hsCRP
Brown, David, MD
Clinical and Pathologic Evaluation to Determine the Causes of Aortic Dissection Roberts, William, MD
Gene Expression Profiling of Mitral Valve Prolapse Smith, Robert, MD
Determination of EFfectiveness of the SilverHawk®PerIpheral Plaque ExcisioN System (SIlverHawk Device) for the Treatment of Infrainguinal VEssels / Lower Extremities (DEFINITIVE LE)
Johnson, Kenneth, MD
Satisfaction Outcome Comparison Between Subjects Who Receive Usual Care Versus Those Who Receive Activity Discharge Instructions from a Clinical Exercise Specialist
Adams, Jenny, PhD
Intramyocardial Delivery of Autologous Bone Marrow Cells in Patients with Heart Failure Due to Dilated Cardiomyopathy Hamman, Baron, MD
High-Intensity, Occupation-Specific Training for Firefighters in a Phase II Cardiac Rehabilitation Program Adams, Jenny, PhD
Evaluation of a New Method of Relieving Pain Associated with Interpleural Tubes following Thoracic or Cardiac Surgery Hebeler, Jr., Robert, MD
CRYptogenic STroke And underLying AF (CRYSTAL AF) Assar, Manish, MD
Evaluation of the Safety and Efficacy of Short-term A-002 Treatment in Subjects with Acute Coronary Syndromes: VISTA-16 (Vascular Inflammation Suppression to Treat Acute Coronary Syndrome for 16 Weeks) A-002
East, Cara, MD
A Prospective, Single-Blind, Randomized, Multi-Center Study Comparing the CYPHER ELITE to the CYPHER Bx VELOCITY Sirolimus-Eluting Stent Systems
Stoler, Robert, MD
Feasibility Study of Autologous Concentrated Bone Marrow Nucleated Cell Therapy for Congestive Heart Failure Patients Undergoing Treatment with Coronary Heart Failure Patients Undergoing Treatment with Coronary Artery Bypass Grafting (CABG) Surgery
Hamman, Baron, MD
SOX9 Expression in Pancreatic Islet Cells Grayburn, Paul, MD
Evaluation of a New Method of Relieving Pain Associated with Interpleural Tubes following Thoracic or Cardiac Surgery Hebeler, Jr., Robert, MD
RELY-ABLE Long Term Multi-Center Extension of Dabigatran Treatment in Patients with Atrial Fibrillation who Completed the RE-LY trial and a Cluster Randomised Trial to Assess the Effect of a Knowledge Translation Intervention on Patient Outcomes
East, Cara, MD
CLINICAL TRIALS AND STUDIES
CLINICAL DIVISION
STUDY TITLE PI
Cardiology
Prospective Randomized EVAluation of Warfarin Therapy In Atrial Fibrillation Patients Versus WATCHMAN LAA Closure Technology (PREVAIL)
Wheelan, Kevin, MD
Causes of Bioprosthetic and Mechanical Prosthetic Dysfunction in the Mitral and Aortic Valve Positions Roberts, William, MD
Mitral Valve Ring Removal and Mitral Regurgitation Roberts, William, MD
Post-MI Remodeling Prevention Therapy Study Franklin, Jay, MD
Prevalence of Renal Artery Stenosis in Patients with Refractory Hypertension Stoler, Robert, MD
A Clinical Evaluation of the Medtronic Endeavor® Resolute Zotarolimus-Eluting Coronary Stent System in the Treatment of De Novo Lesions in Native Coronary Arteries with a Reference Vessel Diameter of 2.25mm to 4.2mm
Stoler, Robert, MD
JOSTENT Coronary Stent Graft Humanitarian Use Device (HDE) #000001 Stoler, Robert, MD
Amiodarone (PM101), Lidocaine or Neither for Out-Of-Hospital Cardiac Arrest Due to Ventricular Fibrillation or Tachycardia Ramsay, Michael, MD
Descending Thoracic Aortic Aneurysm Endovascular Repair Post Approval Study (THRIVE) Gable, Dennis, MD
SureScan Pacing System Post-Approval Study Kowal, Robert, MD
Pivotal Trial to Evaluate the Safety and Efficacy of the Daimondback 360 Orbital Atherectomy System in Treating De Novo, Severly Calcified Coroanry Lesions (ORBIT II)
Vallabhan, Ravi, MD
A U.S. Post-Approval Study of the TAXUS Liberte Paclitaxel-Eluting Coronary Stent System Stoler, Robert, MD
Comparison Of Clinical and Morphologic Cardiac Findings In Patients Having Cardiac Transplantation at BUMC Roberts, William, MD
Giant Cell Aortitis Roberts, William, MD
Usefulness of Gross and Histologic Examination for Diagnostic Purposes of Excised Circular “Cores” of Left Ventricular Wall to Insert Left Ventricular Assist Devices
Roberts, William, MD
Stability: A Clinical Outcomes Study of Darapladib versus Placebo in Subjects with Chronic Coronary Heart Disease to Compare the Incidence of Major Adverse Cardiovascular Events
East, Cara, MD
Indications for and Results of Combined Mitral and Aortic Valve Replacement at BUMC Roberts, William, MD
A 104 Week, Randomized, Double-blind, Placebo-Controlled, Parallel-group, Multicenter Study to Evaluate the Efficacy of Aliskiren on the Progression of Atherosclerosis in Patients with Coronary Artery Disease When Added to Optimal Background Therapy
Vallabhan, Ravi, MD
USPella: A Multi-Center, Data Registry Study Designed to Collect Data from Subjects that Have Been Treated Using the IMPELLA 2.5 Circulatory Device per Institution’s Standard of Care
Stoler, Robert, MD
A Novel Pleural Air Leak Sealant After Lung Resection Retrospective Study Cheung, Edson, MD
In Patients Referred for Atrial Flutter Ablation, the Long Term Occurrence of Atrial Fibrillation and Atypical Atrial Flutter Is Higher in Those Who Present to the Hospital In Sinus Rhythm: Rationale for a Single Right and Left Atrial Ablation Procedure
Wells, Peter, MD
Physician P
ublications
5554 INNOVATIONS | MEASURING INNOVATION IN HEART AND VASCULAR CARE BAYLOR JACK AND JANE HAMILTON HEART AND VASCULAR HOSPITAL
CLINICAL TRIALS AND STUDIES
CLINICAL DIVISION
STUDY TITLE PI
Cardiology
PLATINUM – A prospective, Randomized, Multicenter Trial to Assess an Everolimus-Eluting Coronary Stent System (PROMUS Element™) for the Treatment of Up to Two De Novo Coronary Artery Lesions
Stoler, Robert, MD
Evaluation of the GORE TIGRIS Vascular Stent in the Treatment of Atherosclerotic Lesions of the Superficial Femoral and Proximal Popliteal Arteries
Gable, Dennis, MD
Zenith TX2 TAA Endovascular Graft Post-Market Approval Study, PMA #P070016 Shutze, William, MD
A randomized, double-blind, placebo-controlled, parallel-group, multicenter study to evaluate cardiovascular outcomes during treatment with lixisenatide in type 2 diabetes patients after an acute coronary syndrome event
East, Cara, MD
A randomized, double-blind, placebo-controlled, event driven trial of quarterly, subcutaneous canakinumab in the prevention of recurrent cardiovascular events among stable post-myocardial infarction patients with elevated hsCRP: the CANTOS trial
East, Cara, MD
Experience with Endovascular Aortic Repairs at BUMC Shutze, William, MD
Evaluation of the GORE ACUSEAL Vascular Graft for Hemodialysis Access Gable, Dennis, MD
Nursing and Clinical Observation: Femoral Access Risk Factors During Left Heart Catheterizations Leading to Additional Hospitalization and Vascular Surgical Intervention
Gonzalez, Julie, RN
Evaluation of the Safety and Efficacy of Short-term A-002 Treatment in Subjects with Acute Coronary Syndromes: VISTA-16 (Vascular Inflammation Suppression to Treat Acute Coronary Syndrome for 16 Weeks) A-002
East, Cara, MD
IVC Filter Placement Using Intravascular Ultrasound (IVUS) Hohmann, Stephen, MD
A clinical outcomes study of darapladib versus placebo in subjects following acute coronary syndrome to compare the incidence of major adverse cardiovascular events: SOLID-TIMI 52 trial
East, Cara, MD
Stability: A Clinical Outcomes Study of Darapladib versus Placebo in Subjects with Chronic Coronary Heart Disease to Compare the Incidence of Major Adverse Cardiovascular Events
East, Cara, MD
Descending Thoracic Aortic Aneurysm Endovascular Repair Post Approval Study (THRIVE) Gable, Dennis, MD
A Randomized, Double-Blind, Placebo-Controlled, Parallel-Group Study to Determine Whether, in Patients with Type 2 Diabetes at High Risk for Cardiovascular and Renal Events, Aliskiren, on Top of Conventional Treatment, Reduces Cardiovascular and Renal Mor
East, Cara, MD
A Randomized, Double-Blind Parallel-Group Study of Cardiovascular Safety in Osteoarthritis or Rheumatoid Arthritis Patients with or at High Risk for Cardiovascular Disease comparing Celecoxib with Naproxen and Ibuprofen (PRECISION)
East, Cara, MD
(Synergy between PCI and TAXUS and Cardiac Surgery) A Multicenter, Randomized Clinical Trial Comparing TAXUS PCI to CABG in Patients Amenable for Revascularization Treatment of 3-Vessel Disease, Left Main Disease or Left Main in Conjunction with One, Two,
Stoler, Robert, MD
A Study of the Evalve Cardiovascular Valve Repair System (CVRS) Endovascular Valve Edge-to-Edge Repair Study EVEREST II Grayburn, Paul, MD
Journal Articles (2011)
1. Ayad RF, Grayburn PA, Ko JM, Filardo G,
Roberts WC. Accuracy of two-dimensional
echocardiography in determining aortic valve
structure in patients >50 years of age having aortic
valve replacement for aortic stenosis. American
Journal of Cardiology 2011;108:1589-1599.
2. Bhella PS, Pacini EL, Prasad A, Hastings JL,
Adams-Huet B, Thomas JD, Grayburn PA, Levine
BD. Echocardiographic Indices Do Not Reliably
Track Changes in Left-Sided Filling Pressure in
Healthy Subjects or Patients With Heart Failure
With Preserved Ejection Fraction. Circulation-
Cardiovascular Imaging 2011;4:482-489.
3. Bose R, Schussler JM. Use of Angio-Seal
Closure Device When the Arteriotomy Is Above
or Below the Common Femoral Artery. Clinical
Cardiology;34:700-702.
4. Braunlin EA, Harmatz PR, Scarpa M, Furlanetto
B, Kampmann C, Loehr JP, Ponder KP, Roberts
WC, Rosenfeld HM, Giugliani R. Cardiac disease in
patients with mucopolysaccharidosis: presentation,
diagnosis and management. Journal of Inherited
Metabolic Disease 2011;34:1183-1197.
5. Bruckner BA, Ghodsizad A, Hamman BL, Bull DA,
Lattouf OM, Smedira NG, Burchardt E, Patel AN.
IMPACT-DCM: A Randomized, Controlled, Multi-
Center Phase II Trial Utilizing Expanded Autologous
Bone Marrow as Sole Therapy for Dilated
Cardiomyopathy Study Update. Journal of Heart
and Lung Transplantation 2011;30:218.
6. Centeno MM. Pulmonary arterial hypertension.
Critical Care Nursing Clinics of North America
2011;23:645-659.
7. Falcone AM, Bose R, Stoler RC, Kim M, Laible
E, Kang L, Waters K, Dunkerley J, Choi JW.
The AmBulatory Closure Device Percutaneous
Intervention (ABCD-PCI) study: a single-center
experience. Baylor University Medical Center
Proceedings 2011;24:192-194.
8. Filardo G, Nicewander D, Ballard DJ. Changes Over
Six Years in Administration of Aspirin and Beta
Blockers on Arrival and Timely Reperfusion and in
In-Hospital and 30-Day Postadmission Mortality
in Patients With Acute Myocardial Infarction.
American Journal of Cardiology;107:1421-1425.
9. Friedewald VE, Ballantyne CM, Davidson MH,
Gotto AM, Ridker PM, Roberts WC. The Editor’s
Roundtable: JUPITER Follow-Up. American Journal
of Cardiology 2011;107:1549-1557.
10. Friedewald VE, Boden WE, Stone GW, Yancy CW,
Roberts WC. The Editor’s Roundtable: Role of
Percutaneous Coronary Intervention and Drug-
Eluting Stents in Patients With Stable Coronary
Heart Disease. American Journal of Cardiology
2011;108:1417-1425.
11. Friedewald VE, Emmett M, Gheorghiade
M, Roberts WC. The editor’s roundtable:
Pathophysiology and management of hyponatremia
and the role of vasopressin antagonists. American
Journal of Cardiology 2011;107:1357-1364.
12. Friedewald VE, Goldfarb S, Laskey WK, Vetrovec
GW, Roberts WC. The editor’s roundtable: Contrast
agents and risk for contrast-induced nephropathy.
American Journal of Cardiology 2011;107:1848-1855.
13. Grayburn PA. The importance of regurgitant orifice
shape in mitral regurgitation. JACC: Cardiovascular
Imaging 2011;4:1097-1099.
Physician Publications
5756 INNOVATIONS | MEASURING INNOVATION IN HEART AND VASCULAR CARE BAYLOR JACK AND JANE HAMILTON HEART AND VASCULAR HOSPITAL
14. Grayburn P, Kar S, Feldman T, Glower D, Foster E, Mauri L.
EVEREST II High Surgical Risk Cohort: Clinical Benefit by
MR Grade in High Surgical Risk Patients One Year Following
MitraClip Therapy. Journal of the American College of
Cardiology 2011;58:B212-B212.
15. Grayburn PA, Roberts BJ, Aston S, Anwar A, Hebeler RF,
Jr., Brown DL, Mack MJ. Mechanism and Severity of Mitral
Regurgitation by Transesophageal Echocardiography in Patients
Referred for Percutaneous Valve Repair. American Journal of
Cardiology 2011;108:882-887.
16. Grayburn PA, Roberts WC. PAUL A. GRAYBURN, MD, on
Percutaneous Mitral Repair With the MitraClip(TM) Device:
A Conversation With the Editor. The American Journal of
Cardiology 2011;108:277-284.
17. Head SJ, Ko JM, Singh R, Roberts WC, Mack MJ. 43.3-Year
Durability of a Smeloff-Cutter Ball-Caged Mitral Valve. Annals of
Thoracic Surgery 2011;91:606-608.
18. Hicks TD, Kedora JC, Shutze WP. Treatment of an ilioenteric
fistula with an Amplatzer Vascular Plug. Journal of Vascular
Surgery;54:1495-1497.
19. Keithly S, Muldoon M, Cheng D, Vish N, Dejong SM, Adams J.
The preadmission packet: a strategy that benefits patients and
nurses during the admission process. Baylor University Medical
Center Proceedings 2011;24:299-301.
20. Kim MC, Muntner P, Levy ES, Mann D, Choi JW, Farkouh M,
Sharma S, Kovacic J, Krishnan P, Mehran R, Wiley J, Moreno
P, Kini A. Is Same Day Discharge Safe In Elective PCI? Results
from a Randomized Controlled Study. Journal of the American
College of Cardiology 2011;57:E1954-E1954.
21. Leeper B. Diabetes and cardiovascular disease. Critical Care
Nursing Clinics of North America 2011;23:677-685.
22. Leeper B, Cyr AM, Lambert C, Martin K. Acute coronary
syndrome. Critical Care Nursing Clinics of North America
2011;23:547-557.
23. Marichal DA, Anwar T, Kirsch D, Clements J, Carlson L, Savage
C, Rees CR. Comparison of a Suspended Radiation Protection
System versus Standard Lead Apron for Radiation Exposure
of a Simulated Interventionalist. Journal of Vascular and
Interventional Radiology 2011;22:437-442.
24. Muldoon M, Cheng D, Vish N, Dejong S, Adams J.
Implementation of an Informational Card to Reduce Family
Members’ Anxiety. AORN 2011;94:246-253.
25. Muntner P, Mann DM, Woodward M, Choi JW, Stoler RC,
Shimbo D, Farkouh ME, Kim MC. Predictors of Low Clopidogrel
Adherence Following Percutaneous Coronary Intervention.
American Journal of Cardiology; 2011;108:822-827.
26. Potapov E, Meyer D, Swaminathan M, Ramsay M, El Banayosy
A, Diehl C, Veynovich B, Gregoric ID, Kukucka M, Gromann
TW, Marczin N, Chittuluru K, Baldassarre JS, Zucker MJ,
Hetzer R. Inhaled nitric oxide after left ventricular assist
device implantation: A prospective, randomized, double-blind,
multicenter, placebo-controlled trial. Journal of Heart and Lung
Transplantation 2011;8:870-878.
27. Ray MJ, Shaw CJ, Opatowshy MJ, Layton KF. Emergent
surgical and endovascular repair of a level III carotid arterial
gunshot injury. Baylor University Medical Center Proceedings
2011;24:101-103.
28. Reades R, Studnek JR, Vandeventer S, Garrett J. Intraosseous
Versus Intravenous Vascular Access During Out-of-Hospital
Cardiac Arrest: A Randomized Controlled Trial. Annals of
Emergency Medicine;58:509-516.
29. Roberts WC. Natural History, Clinical Consequences, and
Morphologic Features of Coronary Arterial Aneurysms in Adults.
American Journal of Cardiology; 2011;108:814-821.
30. Roberts WC. Prophylactic replacement of a dilated ascending
aorta at the time of aortic valve replacement of a dysfunctioning
congenitally unicuspid or bicuspid aortic valve. American
Journal of Cardiology 2011;108:1371-1372.
31. Roberts WC, Karia SJ, Ko JM, Grayburn PA, George BA, Hall
SA, Kuiper JJ, Meyer DM. Examination of Isolated Ventricular
Noncompaction (Hypertrabeculation) as a Distinct Entity in
Adults. American Journal of Cardiology 2011;108:747-752.
32. Roberts WC, Roberts CC, Vowels TJ, Ko JM, Filardo G,
Hamman BL, Matter GJ, Henry AC, Hebeler Jr RF. Effect of
Body Mass Index on Survival in Patients Having Aortic Valve
Replacement for Aortic Stenosis With or Without Concomitant
Coronary Artery Bypass Grafting. American Journal of
Cardiology 2011;108:1767-1771.
33. Roberts WC, Vowels TJ, Kitchens BL, Ko JM, Filardo G, Henry
AC, Hamman BL, Matter GJ, Hebeler Jr RF. Aortic medial
elastic fiber loss in acute ascending aortic dissection. American
Journal of Cardiology 2011;108:1639-1644.
34. Salamah C, Byxbe T, Naffe A, Vish N, Dejong S, Muldoon M,
Cheng D, Adams J. Glucose control and opportunities for
health care improvement in a hospital setting. Baylor University
Medical Center Proceedings 2011;24:3-5.
35. Schussler JM. Effectiveness and safety of transradial artery
access for cardiac catheterization. Baylor University Medical
Center Proceedings 2011;24:205-209.
36. Shimoda M, Itoh T, Sugimoto K, Takita M, Chujo D, Iwahashi S,
Sorelle JA, Naziruddin B, Levy MF, Grayburn PA, Matsumoto S.
An effective method to release human islets from surrounding
acinar cells with agitation in high osmolality solution.
Transplantation Proceedings 2011;43:3161-3166.
37. Shoemake BD, Patterson BA, Schussler JM. Clinical
Significance of a Single Coronary Artery Arising from the Right
Sinus of Valsalva With the Left Anterior Descending Anterior
to the Pulmonary Artery and a Retro-Aortic Left Circumflex.
American Journal of Cardiology;108:1196.
38. St Laurent P. Acute coronary syndrome: new and evolving
therapies. Critical Care Nursing Clinics of North America
2011;23:559-71.
39. Stauffer BD, Fullerton C, Fleming N, Ogola G, Herrin J, Stafford
PMS, Ballard DJ. Effectiveness and cost of a transitional
care program for heart failure. Archives of Internal Medicine
2011;171:1238-1243.
40. Bose R, Schussler JM. Use of Angio-Seal closure device when
the arteriotomy is above or below the common femoral artery.
Clin Cardiol. 2011 Nov;34(11):700-2. doi: 10.1002/clc.20961.
Epub 2011 Nov 6. PubMed PMID: 22057835.
41. Shoemake BD, Patterson BA, Schussler JM. Clinical significance
of a single coronary artery arising from the right sinus of valsalva
with the left anterior descending anterior to the pulmonary
artery and a retro-aortic left circumflex. Am J Cardiol. 2011 Oct
15;108(8):1196. Epub 2011 Jul 26. PubMed PMID: 21798495.
42. Schussler JM. Effectiveness and safety of transradial artery
access for cardiac catheterization. Proc (Bayl Univ Med Cent).
2011 Jul;24(3):205-9. PubMed PMID: 21738292; PubMed
Central PMCID: PMC3124904.
43. Schwartz BG, Schussler JM, Rosenthal RL. Tumor-like
coronary atheroma: a modern coronary evaluation with a
historical perspective. Tex Heart Inst J. 2011;38(3):275-8.
Review. PubMed PMID: 21720471; PubMed Central PMCID:
PMC3113139.
44. Sarmast SA, Schussler JM. Monozygotic twins with identical
cardiac conditions. Proc (Bayl Univ Med Cent). 2011
Apr;24(2):104-6. PubMed PMID: 21566755; PubMed Central
PMCID: PMC3069516.
45. Fazel P, Schussler JM, Berbarie RF, Hamman BL, Fenves AZ.
Embolization of a stent from an arteriovenous graft into the
right ventricle in a patient on chronic hemodialysis. Proc (Bayl
Univ Med Cent). 2011 Apr;24(2):94-5. PubMedPMID: 21566752;
PubMed Central PMCID: PMC3069513.
46. Ayad RF, Bhella PS, Dockery WD, Schussler JM. Patency of
vein graft anastomoses facilitated with the hexalon device. Ann
Thorac Surg. 2011 Mar;91(3):894-8. PubMed PMID: 21353022.
Physician Publications
5958 INNOVATIONS | MEASURING INNOVATION IN HEART AND VASCULAR CARE BAYLOR JACK AND JANE HAMILTON HEART AND VASCULAR HOSPITAL
47. Lilly SM, Schussler JM, Stoler RC. Anomalous origin of the right
coronary artery from the left sinus of Valsalva associated with
syncope in a young athlete. Proc (Bayl Univ Med Cent). 2011
Jan;24(1):13-4. PubMed PMID: 21307970; PubMed Central
PMCID: PMC3012283.
Journal Articles (2012)
1. Benjamin MM, Roberts WC. Fatal aortic rupture from
nonpenetrating chest trauma. Baylor University Medical Center
Proceedings 2012;25:121-3.
2. Boden WE, Roberts WC. WILLIAM EDWARD BODEN, MD: A
Conversation With the Editor. American Journal of Cardiology
2012;110:145-159.
3. Chamogeorgakis T, Lima B, Shafii AE, Nagpal D, Pokersnik
JA, Navia JL, Mason D, Gonzalez-Stawinski GV. Outcomes
of axillary artery side graft cannulation for extracorporeal
membrane oxygenation. Journal of Thoracic and Cardiovascular
Surgery 2012;IN PRESS.
4. Deja MA, Grayburn PA, Sun B, Rao V, She L, Krejca M, Jain
AR, Chua YL, Daly R, Senni M, Mokrzycki K, Menicanti L, Oh
JK, Michler R, Wróbel K, Lamy A, Velazquez EJ, Lee KL, Jones
RH. Influence of Mitral Regurgitation Repair on Survival in the
Surgical Treatment for Ischemic Heart Failure Trial. Circulation
2012;125:2639-2648.
5. Dolmatch BL, Duch JM, Winder R, Butler GM, Kershen M, Patel
R, Trimmer CK, Lopera JE, Davidson IJ. Salvage of angioplasty
failures and complications in hemodialysis arteriovenous
access using the FLUENCY plus stent graft: Technical and
180-day patency results. Journal of Vascular and Interventional
Radiology 2012;23:479-487.
6. Filardo G, Hamilton C, Grayburn PA, Xu H, Hebeler Jr RF,
Hamman B. Established preoperative risk factors do not predict
long-term survival in isolated coronary artery bypass grafting
patients. Annals of Thoracic Surgery 2012;93:1943-1948.
7. Filardo G, Powell JT, Ashley-Marie artinez M, Ballard DJ.
Surgery for small asymptomatic abdominal aortic aneurysms.
Cochrane Database of Systematic Reviews 2012;3.
8. Friedewald VE, Kowal RC, Olshansky B, Yancy CW, Roberts
WC. The Editor’s Roundtable: Medical Management of Atrial
Fibrillation. American Journal of Cardiology 2012;109:563-569.
9. Friedewald VE, Hare JM, Miller LW, Walpole Jr HT, Willerson JT,
Roberts WC. The Editor’s Roundtable: Advances in Stem Cell
Therapy for Treatment of Cardiovascular Disease. American
Journal of Cardiology 2012;110:807-816.
10. Glower D, Ailawadi G, Argenziano M, Mack M, Trento A, Wang
AD, Lim S, Gray W, Grayburn P, Dent J, Gillam L, Sethuraman B,
Feldman T, Foster E, Mauri L, Kron I, Investigators EI. EVEREST
II randomized clinical trial: Predictors of mitral valve replacement
in de novo surgery or after the MitraClip procedure. Journal of
Thoracic and Cardiovascular Surgery 2012;143:S60-S63.
11. Grayburn PA. Interpreting the Coronary-Artery Calcium Score.
New England Journal of Medicine 2012;366:294-296.
12. Grayburn PA. The author replies. New England Journal of
Medicine 2012;366:1551.
13. Grayburn P, Sangli C, Massaro J, Mauri L, Weissman N,
Glower D, Feldman T, Foster E. The Relationship Between
the Magnitude of Reduction in Functional Mitral Regurgitation
Severity and NYHA Functional Class Post-Treatment with the
MitraClip Device. Cardiology 2012;121:104-105.
14. Grayburn P, Sangli C, Massaro J, Mauri L, Weissman N, Glower
D, Feldman T, Foster E. The relationship between the magnitude
of reduction in mitral regurgitation severity and left ventricular
and left atrial volumes post-treatment with the mitraclip device.
Journal of the American College of Cardiology 2012;59.
15. Hall S, Gonzalez-Stawinski G, Meyer D, Bethea B, Kuiper
J, Hardaway B. Unplanned Hospital Readmissions and
Continuous Flow Pump Therapy. Journal of Cardiac Failure
2012;18:S37-S37.
16. Hall S, Hardaway B, Meyer D, Bethea B, Kuiper J. Reducing
Length of Stay in the Heartmate II Era. Journal of Cardiac Failure
2012;18:S46-S47.
17. Hall S, Kuiper J, Grimsley B, Pearl G, Matter G, Hamman B,
Hardaway B. The Use of Impellas 5.0/LD in the Management
of Heart Failure Patients With Cardiogenic Shock: A
Multidisciplinary Team Approach. Journal of Cardiac Failure
2012;18:S47-S47.
18. Kennedy K, Adams J, Cheng D, Berbarie RF. High-intensity
track and field training in a cardiac rehabilitation program.
Baylor University Medical Center Proceedings 2012;25:34-6.
19. Kowal RC. PVI’s inconvenient truths: Lights out for dormant
reconnection? Journal of Cardiovascular Electrophysiology
2012;23:261-263.
20. Leeper B, Centeno M. Disparities in Cardiac Care for Patients
with Complex Cardiovascular Care Needs. Journal of
Cardiovascular Nursing 2012;27:114-119.
21. Libby P, Roberts WC. Peter Libby, MD: A conversation with the
editor. American Journal of Cardiology 2012;110:741-760.
22. Loor G, Gonzalez-Stawinski G. Pulsatile vs. continuous flow in
ventricular assist device therapy. Best Practice and Research:
Clinical Anaesthesiology 2012;26:105-115.
23. McQuillan B, Carter B, Millard-Hasting B, Ayotte K, Jesinger R,
Lichtenberger J. The Interventricular Septum: A Multimodality
Review of Anatomy and Pathology. American Journal of
Roentgenology 2012;198.
24. Murray SS, Smith EN, Villarasa N, Nahey T, Lande J, Goldberg
H, Shaw M, Rosenthal L, Ramza B, Alaeddini J, Han X, Damani
S, Soykan O, Kowal RC, Topol EJ. Genome-wide association
of implantable cardioverter-defibrillator activation with life-
threatening arrhythmias. PLoS ONE 2012;7.
25. Nachimuthu S, Assar MD, Schussler JM. Drug-Induced QT
Interval Prolongation: Mechanisms and Clinical Management.
Therapeutic Advances in Drug Safety 2012;3:241-253.
26. Pinard EA, Fazal S, Schussler JM. Catastrophic paradoxical
embolus after hemodialysis access thrombectomy in a patient
with a patent foramen ovale. Int Urol Nephrol. 2012 Feb 25.
[Epub ahead of print] PubMed PMID: 22367171.
27. Roberts WC. Good Books in Cardiovascular Disease Appearing
in 2011. American Journal of Cardiology 2012;109:1236-1237.
28. Roberts WC. Two observations suggesting that we die
in ventricular systole. American Journal of Cardiology
2012;110:915-917.
29. Roberts WC. Formulating an Answerable Question, Displaying
Data, Illustrating, Writing, Reviewing, and Editing Manuscripts
for Publication in Medical Journals. American Journal of
Cardiology 2012;110:290-306.
30. Roberts WC. Determining the Quantity of Alcohol Consumed.
American Journal of Cardiology 2012;110:761.
31. Roberts WC, Janning KG, Ko JM, Filardo G, Matter GJ.
Frequency of Congenitally Bicuspid Aortic Valves in Patients ≥80
Years of Age Undergoing Aortic Valve Replacement for Aortic
Stenosis (With or Without Aortic Regurgitation) and Implications
for Transcatheter Aortic Valve Implantation. American Journal of
Cardiology 2012;109:1632-1636.
32. Roberts WC, Janning KG, Vowels TJ, Ko JM, Hamman BL,
Hebeler RF, Jr. Presence of a congenitally bicuspid aortic
valve among patients having combined mitral and aortic valve
replacement. American Journal of Cardiology 2012;109:263-71.
33. Roberts WC, Roberts CC, Ko JM, Hall SA, Capehart JE. Cardiac
Transplantation in Adults With Aortic Valve Disease With Focus
on the Bicuspid Aortic Valve. American Journal of Cardiology
2012;109:1212-1214.
34. Roberts WC, Roberts CC, Vowels TJ, Ko JM, Filardo G,
Hamman BL, Matter GJ, Henry III AC, Hebeler JRF. Effect of
Coronary Bypass and Valve Structure on Outcome in Isolated
Valve Replacement for Aortic Stenosis. American Journal of
Cardiology 2012;109:1334-1340.
35. Roberts WC, Taylor MA, Shirani J. Cardiac Findings at Necropsy
in Patients With Chronic Kidney Disease Maintained on Chronic
Hemodialysis. Medicine 2012;91:165-178.
36. Roberts WC, Vowels TJ, Ko JM, Guileyardo JM. Acute Aortic
Dissection With Tear in Ascending Aorta Not Diagnosed Until
Necropsy or Operation (for Another Condition) and Comparison
to Similar Cases Receiving Proper Operative Therapy. The
American Journal of Cardiology;110:728-735.
37. Rosenthal RL, Carrothers IA, Schussler JM. Benign or malignant
anomaly?: Very high takeoff of the left main coronary artery
above the left coronary sinus. Texas Heart Institute Journal
2012;39:538-541.
38. Ryan C, Patel M, Menter A. Are drug treatments for psoriasis a
cardiovascular risk? Clinical Practice 2012;9:5-9.
39. Ryan C, Menter A. Psoriasis and cardiovascular disorders.
Giornale Italiano Di Dermatologia E Venereologia 2012;147:179-187.
40. Urschel Jr HC, Urschel BB. Robert R. Shaw, MD: Thoracic
surgical hero, Afghanistan medical pioneer, champion for the
patient, never a surgical society president. Annals of Thoracic
Surgery 2012;93:2111-2116.
41. Benjamin MM, Khetan RA, Kowal RC, Schussler JM. Diagnosis
of left ventricular noncompaction by computed tomography.
Proc (Bayl Univ Med Cent). 2012 Oct; 25(4):354-6. PubMed
PMID: 23077386; PubMed Central PMCID: PMC3448577.
42. Rosenthal RL, Carrothers IA, Schussler JM. Benign or malignant
anomaly? Very high takeoff of the left main coronary artery
above the left coronary sinus. Tex Heart Inst J. 2012;39(4):538-
41. PubMed PMID: 22949773; PubMed Central PMCID:
PMC3423280.
43. Patankar GR, Donsky MS, Schussler JM. Delayed takotsubo
cardiomyopathy caused by excessive exogenous epinephrine
administration after the treatment of angioedema. Proc (Bayl
Univ Med Cent). 2012 Jul;25(3):229-30. PubMed PMID:
22754120; PubMed Central PMCID: PMC3377286.
44. Pinard EA, Fazal S, Schussler JM. Catastrophic paradoxical
embolus after hemodialysis access thrombectomy in a patient
with a patent foramen ovale. Int Urol Nephrol. 2012 Feb 25.
[Epub ahead of print] PubMed PMID: 22367171.
45. Benjamin MM, Filardo G, Donsky MS, Schussler JM. A Pilot
Study of Prasugrel Followed by Post-Procedural Maintenance
with Clopidogrel in Patients Receiving Percutaneous Coronary
Intervention. J Interv Cardiol. 2012 Dec 30. doi: 10.1111/
joic.12008. [Epub ahead of print] PubMed PMID: 23278332.
46. Falcone AM, Matter GJ, Schussler JM. Right Atrial Appendage
Thrombus Found in a Patient in Normal Sinus Rhythm with
Normal Right Ventricular Systolic Function. Echocardiography.
2012 Nov 27. doi: 10.1111/echo.12057. [Epub ahead of print]
PubMed PMID: 23190046.
47. McMaster KS, Tandon A, Schussler JM. Renal infarction
secondary to cortriatriatum sinister. Am J Cardiovasc Dis.
2012;2(4):331-3. Epub 2012 Oct 25. PubMed PMID: 23173108;
PubMed Central PMCID: PMC3499933.
Employee Research and Publications
Ann Lawrence, RN-BC, Danielle Strauss, BS, RN-BC, Jenny
Adams, PhD, Dunlei Cheng, PhD. Task-Specific Cardiac rehabilitation
Training That Safely Exceeds Traditional Heart Rate Limits. A
Retrospective Pilot Study. J Cardiovasc Nurs. 2011 Jul-Aug;26(4):267.
Salamah C, Byxbe T, Naffe A, Vish N, Dejong S, Muldoon M,
Cheng D, Adams J. Glucose control and opportunities for health
care improvement in a hospital setting. Baylor University Medical
Center Proceedings 2011:24(1):3-5.
Adams J, Spencer K, Jordan S, Schneider J, Cheng D, Kennedy
K, Shock T. Assessment of Functional Capacity Requirements
During Simulated Automotive Mechanic Tasks For the Purpose
of Developing an Occupation-Specific Assessment for Safe and
Expeditious Return to Work for Cardiac Patients (abstract). Journal
of Cardiopulmonary Rehabilitation and Prevention 2010;30(4):276.
Accelerating B
est Care
6160 INNOVATIONS | MEASURING INNOVATION IN HEART AND VASCULAR CARE BAYLOR JACK AND JANE HAMILTON HEART AND VASCULAR HOSPITAL
Accelerating Best Care at Baylor (ABC Baylor)
Baylor Health Care System is committed to ensuring
that health care providers have the tools needed to
deliver health care in a safe, timely, effective, efficient,
equitable, and patient-centered (STEEEP™) manner.
Accelerating Best Care is an innovative educational
program focused on health care quality improvement,
outcomes management, and staff development. It
facilitates the enhancement of skills that lead to quality
improvement efforts. ABC courses train participants in
rapid cycle improvement processes, which is based on
the Plan-Do-Check-Act model.
ABC Baylor course objectives are to teach the core
principles of clinical quality improvement and include
rapid cycle improvement, design of data systems,
data management, tools to improve outcomes, clinical
practice guidelines and customer service.
At Baylor Hamilton Heart and Vascular Hospital, it
is a requirement for all nurse leaders/supervisors to
complete the ABC Baylor course. We also included
council chairs to further enhance their knowledge to
assist others in implementing rapid cycle improvement
projects.
The following is a list of completed ABC Baylor projects
for the FY2012:
COMPLETED ABC BAYLOR PROJECTS (FY2012)
DATE OF EVENT
ABC PROJECT TITLETEAM
MEMBERS
September 2011
“Preop for Preop”Lindsey Anderson
“Can We Talk?” Tracy Ordrop
“Noise Pollution” Kristina Hahn
“Patiently...Waiting”Brenda Keeton
February 2012
“Improve Cath Lab Room Turn Around Time ‘Patient Out to Patient In’”
Valerie Darst
“Reducing Time From Bed Assigned to Bedded”
Mark Sanders
“Diabetes Education Documentation”
Julie Gonzalez
“Improving Anticoagulation Therapy Education at Baylor Heart and Vascular Hospital”
Erin Wandry
621 North Hall StreetDallas, Texas 75226
BaylorHeartHospital.com 1.800.4BAYLOR
Notice Regarding Physician Ownership: Baylor Jack and Jane Hamilton Heart and Vascular Hospital is a hospital in which physicians have an
ownership or investment interest. The list of the physician owners or investors is available to you upon request. Physicians are members of the
medical staff at one of Baylor Health Care System's subsidiary, community or affiliated medical centers and are neither employees nor agents of
those medical centers, Baylor Jack and Jane Hamilton Heart and Vascular Hospital or Baylor Health Care System. ©2013 Baylor Health Care
System. BHVH 505 2012 Outcomes Brochure. MOD 12107 3/13. 2,000
OUTCOMES:
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This year the Baylor Jack and Jane Hamilton Heart and Vascular Hospital celebrated its 10th anniversary.
The hospital opened in 2002 as the first in North Texas dedicated
solely to the care and treatment of heart and vascular patients.
Today, BHVH is still the only hospital in Dallas County with that focus.
In the past 10 years, our employees and the physicians on our
medical staff have worked together to provide patients with
outstanding service, quality care, and advanced heart and vascular
treatments. The collaborative focus and commitment to excellence
has again led to impressive results in FY 2012.
all employee retention rate:
95.2%
2012 Magnet award for“Excellence in Nursing”
12,2
70no
n-in
vasi
vepr
oced
ures96.5%satisfactionoverall rate - inpatients & outpatientsad
mis
sion
s&
regi
stra
tions
22,6
25
admissions ®istrations
22,625
frien
dlin
ess
of s
taff:
97.2
%
12,2
70no
n-in
vasi
vepr
oced
ures
post-procedure
mortality rate:0%ICD
96.5%
admissions & registrations22,625
all employee retention rate:
95.2%
2012 Magnet award for“Excellence in Nursing”
12,2
70no
n-in
vasi
vepr
oced
ures96.5%
of inpatients say they’re likely to recommend BHVH
overall satisfaction rateamong inpatients & outpatients
Press Ganey Summit Award, second year in a row
OUTCOMES:
front cover9.5” x 9.5”
spine.25” x 9.5”
interior fold-over (die-cut)9.375” x 9.5”
back cover9.5” x 9.5”
back pocket9.375” x 8”
10.25” total trim height
38.65” total trim width