Cardiovascular Rounds

News, resources, and analysis from the Cardiovascular Roundtable

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Pharmacists: The player you need on your CABG readmission team

by Julie Bass April 4, 2016

A recent study in the Journal of Evaluation in Clinical Practice reported that over one-third of seniors are given improper prescriptions upon hospital discharge for cardiology and internal medicine services. As if that’s not concerning enough, another study in the American Journal of Health-System Pharmacy found that as of 2014, only 18% of pharmacy teams played a role in post-discharge medication management or reconciliation—the comprehensive evaluation of a patient’s medication regimen at care transitions (e.g., admission, transfer, discharge).

Effective medication reconciliation (med-rec) is critical for patient safety, appropriate medication use, improving medication adherence, and reducing preventable readmissions. Recognizing an opportunity to boost medication management and adherence in CV surgery patients, New Hanover Medical Center in Wilmington, N.C., developed a strategy to hardwire pharmacist support pre- and post-discharge.

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JAMA reports tool for predicting avoidable readmissions works

by Julie Bass March 21, 2016

Risk stratification can be a very valuable tool in the fight against readmissions, enabling programs to provide patient-centered, appropriate care interventions in a resource-efficient manner. However, many existing readmissions risk prediction models are not easy to use in practice, are not externally validated, and do not distinguish readmissions that are avoidable.

In response, lead researcher Jacques D. Donze, MD and colleagues created the HOSPITAL score—a simple readmission prediction model that can be used at the point-of-care and targets the readmissions that are potentially avoidable.

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Use data to solve your greatest readmission mysteries

by Julie Bass March 9, 2016

When developing a readmission reduction strategy, one of the greatest challenges for CV leaders can be knowing where to focus their limited resources.

For CV procedural readmissions, the medical evidence is largely consistent on the root causes driving patients back to the hospital, giving CV leaders at least a starting point for where to target their efforts. However, for medical and procedural readmissions alike, there is no silver bullet readmission reduction strategy.

Programs must therefore use a data-driven approach to identify the greatest opportunities for improvement across the care continuum at their own institution, and use proven strategies to target these gaps in care.

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Q&A: Inside New Hanover's CABG readmission reduction program

by Julie Bass February 29, 2016

New Hanover Regional Medical Center, a 650-bed teaching hospital in Wilmington, N.C., has developed a comprehensive cardiac surgery readmission reduction initiative that is data-driven, multidisciplinary, and resource-efficient. And not to mention effective: in the first year since implementing its targeted strategy, the organization reduced 30-day, same-site CABG readmissions from 10% to 6.9%.

At the recent Cardiovascular Roundtable national meeting in Chicago, three members of NHRMC’s CABG readmission reduction leadership team—David Parks, VP of Cardiac and Clinical Support Services, Janet DeLucca, Administrator for Cardiac Services, and Dr. Peter Kane, CV Surgeon—joined us for a panel discussion to discuss their efforts and answer your questions.

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How intensive cardiac rehab can impact your patients—and your bottom line

by Marissa Schwartz and Jodi Askew February 24, 2016

In our last post, we introduced intensive cardiac rehab (ICR), a more rigorous and frequent form of traditional cardiac rehab that must be proven effective in improving clinical measures and reducing costs to receive Medicare reimbursement. While our first post focused on reimbursement, in this post we’ll address the impact ICR could have both on your patient population and your CV service line.

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What remote patient monitoring means for heart failure

by Jodi Askew February 10, 2016

Now more than ever, cardiovascular service line leaders are expressing interest in deploying telemonitoring technology to remotely manage their CV patients. Remote patient monitoring, or RPM, enables providers to virtually collect and transmit a patient’s data for the purposes of clinical assessment and care management. The health care IT community is largely in agreement about RPM’s potential to expand the geographic reach, clinical scope, and capacity for quality care—isn’t it about time our CV service line leaders joined the conversation?

We say "yes." Just last year, our Health Care IT Advisor research team suggested that providers should deploy RPM for chronic disease patients. This has become more important in the last year, with mounting pressure from CMS and private payers to expand the timeframe for long-term accountable care management in the CV service line and escalating penalties associated with excess readmissions.

With this in mind, we examined the recent literature on the clinical and financial impacts of RPM for heart failure (HF) patients in five high-impact areas—length of stay, mortality, readmissions, cost effectiveness, and reimbursement—and have reported our most interesting findings below.

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Improper ICD implants cost hospitals $250 million

by Julie Bass January 11, 2016

Five years ago, the Department of Justice (DOJ) started an investigation on the potential misuse of implantable cardioverter defibrillators (ICDs). In October 2015 the DOJ announced it had settled with 457 hospitals in 43 states for a total of $250 million for improper implantation of ICDs in Medicare patients.

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Need pre-admission testing done? Have the caregivers come to the patient.

by Marissa Schwartz January 5, 2016

Access is a buzzword throughout health care these days, and the CV service line is no exception. Improving patient access can differentiate your CV program—and a critical element of this is a flexible, convenient, and patient-focused schedule.

Here's how Elmhurst Memorial deployed dedicated CV schedulers and a streamlined scheduling process with promising results.

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