Site Spotlight - Corewell Health East Dearborn Hospital
Corewell Health East Dearborn Hospital's structural heart team is committed to doing everything possible to improve outcomes for the patients in their care. The group respects the roles of each player and fosters effective communication. “There is a strong collaboration with all team members," said Dennis Hoy, MSA, BSN, RN, Director, Cardiovascular Services. "The team follows the model of high reliability with open and effective communication where anyone can speak up, with special attention when something may not seem or sound right.”
Previously, the Structural Heart Program recognized opportunities in multiple areas related to documentation. These included the 5-meter walk, the MISHC KCCQ, and the NYHA heart failure class documentation VBR goals.
The Corewell Health East, Dearborn Hospital team, comprising of Dennis Hoy; Nurse Navigator Structural Heart Program, Karen Cooley, BSN, RN; Business Office Associates Cardiac Surgery: Jennifer Tidrick and Heather Hildebrand-Fears; and Advanced Practice Providers: Sara Young, NP and Andrea Clegg, NP, initiated a project to improve performance on these measures.
They focused on effective communication and developed spreadsheets for KCCQ, 5-meter walk, and STS score documentation. Processes were set up to complete documentation at various points in the patient workup: cardiac surgery consults, imaging appointments, pre-anesthesia screening, and inpatient setting, when applicable. Physicians were contacted directly when the team identified missed documentation; thereby, reinforcing the new processes.
The team implemented a hard stop to hold TAVR case boarding (in the absence of emergencies) when the KCCQ and 5M walk test was not completed. Multiple layers of coverage and accountability help ensure source documentation is complete and include using the Director of CV Services to complete 5-meter walk tests, KCCQ, and cover the Nurse Navigator when out of the hospital.
They overcame resource and space limitations by collaborating with members in the Ambulatory setting and utilizing staff within the Heart & Vascular Service line. They utilized patient space in Non-Invasive Cardiology for follow-up testing, and outside resources for blood draws. They also relied on Radiology to help support coronary CT angiography reads for TAVR patient presentations.
Corewell Health East, Dearborn Hospital had a goal of 100% documentation, and they achieved excellent results. The NYHA heart failure classification documented at 30 days of 98.2%, exceeded the collaborative goal of ≥92%. The 5-meter walk test and the KCCQ matched pairs at baseline and 30 days had 100% documentation. Moving forward, the team is committed to maintaining continuity and vigilance.
Hospital Team
Corewell Health East Dearborn Hospital has a cohesive and engaged structural heart team that has used quality improvement and best practices to drive meaningful change in their structural heart program. “MISHC and TVT reports are reviewed, and data is presented monthly at structural heart meetings,” said Clinical Quality Improvement Lead, Sheryl Fielding, BSN, RN. “They also have a process for real-time data tracking on benchmarked fields. They have a thorough process for ensuring they collect this important data. The team is performing at a top level and greater than the collaborative in MISHC quality goals and measures.”
“We have an amazing team that works very closely with each other on every single case," said Dr. Joseph Chattahi, Medical Director Structural Heart Program. We collaboratively implemented strict workflows for the management of every structural heart patient resulting in outstanding procedural and patient outcomes. Complication rates are performing better than the collaborative rate in areas of stroke, contrast-induced nephropathy, bleeding, pacemaker, and readmission. I am extremely proud of every member of our structural heart team.”
“This all works to provide patients with excellent outcomes and improved quality of care,” says Dennis Hoy.
The team at Corewell Health Dearborn Hospital includes:
(Sitting from left to right)
- Dr. Joseph Chattahi, Interventional and Structural Heart Cardiologist, Director Structural Heart Program
- Dr. Rita Coram, Interventional and Structural Heart Cardiologist, Medical Director Cath Lab
- Dr. Samir Dabbous, Interventional and Structural Heart Cardiologist
(Standing from left to right)
- Roger Claypool, BSN, RN, Clinical Manager Cath Lab
- Dr. Phillip Camp, Cardiac Surgery
- Dennis Hoy, MSA, BSN, RN, Director of Cardiovascular Services
- Sara Young, FMP-C, RN
- Karen Cooley, BSN, RN, Nurse Navigator Structural Heart Program
(Not pictured)
- Dr. Timothy Sell, Medical Director CV Surgery
- Dr. Omar Ali, Interventional and Structural Heart Cardiologist