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Case Study

How structural heart programs can reduce time to treatment

20 Minute Read

    Overview

    The challenge

    To meet growing market demand, structural heart (SH) program leaders are focused on optimizing workflows to streamline access to treatment. Traditional workup processes for aortic valve replacement (AVR) procedures leads to an average intake to treatment timeline of 42 days. Treatment delays are associated with increased mortality rates.

    The organizations

    Atrium Health is a 45-hospital, integrated not-for-profit health system based in Charlotte, North Carolina. Its Sanger Heart & Vascular Institute operates from two sites and is currently staffed with three interventionalists, five cardiothoracic surgeons, four advanced cardiac imagers, one APP, four nurse navigators, and two schedulers. They perform ~500-600 SH procedures annually (half of which are TAVRs).

    Sarasota Memorial Hospital is an 839-bed, not-for-profit regional medical center located in Sarasota, Florida. Its valve clinic team is currently staffed with four interventional cardiologists, five cardiovascular surgeons, seven cardiac anesthesiologists, one valve clinic coordinator, one patient care rep, nurses, cath lab staff, and echo techs. They perform 300 TAVRs and 500 other SH procedures annually.

    The approach

    High-performing structural heart programs manage growing procedural volumes while expediting time to treatment. They do this by augmenting their patient intake process, creating streamlined care pathways, tracking and reporting patient throughput, and prioritizing patient accessibility.

    The result

    Implementation of these approaches has resulted in significantly shorter referral-totreatment timelines. Enhanced patient throughput also allows for programs to grow their volumes and improve patient experience and outcomes.

    About the sponsor
    Edwards Lifesciences logo

    This report is sponsored by Edwards Lifesciences. Advisory Board experts wrote the report, maintained final editorial approval, and conducted the underlying research independently and objectively.

     

    Approach

    How Atrium and Sarasota ensure access to timely care

    These organizations recognize that providing high-quality care starts before patients get to procedure day. This case study highlights four imperatives to optimize pre-procedural processes to ensure timely care and accommodate volumes despite throughput and capacity pressures.

     

    The four imperatives

     

    • Imperative

      Expedite the screening process with up-front evaluation

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    • Imperative

      Standardize pre-procedure workflows

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    • Imperative

      Align team members around throughput targets

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    • Imperative

      Equip patients to progress through care pathways

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    Results

    How we know it’s working

    Operationalizing these imperatives has demonstrated benefits in the three key areas:

    1. Appropriate and timely access to treatment: Reducing the time it takes for patients to receive an AVR procedure is essential to ensure the best possible outcomes. Sarasota was able to cut the national average intake to treatment time in half, while Atrium reduced its intake to treatment time by 25 days.

    • National average: 42 days
    • Atrium: 45-50 days
    • Sarasota: 14-21 days

    2. Growth in program capacity: Improving patient throughput allows programs to accommodate higher patient volumes. Standard care pathways help organizations identify and address inconsistences to relieve capacity constraints. Sarasota Memorial Hospital and Atrium Health both have annual TAVR volumes higher than the national average, made possible in part by their optimized workflows.

    • National average: 84 TAVR procedures annually
    • Sarasota and Atrium average: 250-300 TAVR procedures annually

    3. Enhanced patient experience: Streamlining the pre-procedure process reduces the patient burden by limiting time spent attending doctor visits and gets them on the road to recovery sooner. Patients also know what to expect in their care, which supports a better experience.

     

    Appendix

     

    Atrium welcome letter

    Atrium’s welcome letter includes a page to orient patients to the program and set expectations for their visit (included below), and a page that includes photos and job titles to introduce the members of their heart team.

     

    About the sponsor

    Edwards Lifesciences is the global leader in patient-focused medical innovations for structural heart disease, as well as critical care and surgical monitoring. Driven by a passion to help patients, the company collaborates with the world’s leading clinicians and researchers to address unmet healthcare needs, working to improve patient outcomes and enhance lives.

    Learn more

    This report is sponsored by Edwards Lifesciences, an Advisory Board member organization. Representatives of Edwards Lifesciences helped select the topics and issues addressed. Advisory Board experts wrote the report, maintained final editorial approval, and conducted the underlying research independently and objectively. Advisory Board does not endorse any company, organization, product or brand mentioned herein.

    To learn more, view our editorial guidelines.

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