Carol Mascioli, vice president of clinical services at the 680-bed Baptist Hospital in Miami, explains how inclusion helps her organization earn buy-in from a 100% voluntary cardio physician team. Baptist Hospital is developing a protocol for patients arriving at the emergency department with atrial fibrillation. Baptist wants to identify which patients with the condition can be treated or observed in the ED and sent home, instead of being admitted as a matter of course. The effort started with a broad clinical team, including nursing leaders, the ED medical director, the clinical cardiology medical director, the electro physiology medical director, hospitalists, and the anesthesia medical director.
"Our goal was to tackle the reason they came to the emergency department, correct that, and then get the patient back to their primary care physician or cardiologist for additional evaluation," Mascioli says. Being inclusive about developing such a protocol "may slow down some processes, but if it's related to quality improvement, we make sure we have participation across the spectrum." She predicts complete buy-in to the atrial fibrillation effort because the same clinical team has accepted a jointly developed chest pain process and heart failure process. She observes that all of the 30 or so doctors on the cardio team are voluntary. "It doesn't require an employment model to get collaboration. We do it."
As healthcare leaders look to enhance their cardio services and expand their reach, though, they should keep in mind an important customer dynamic about visits to the doctor. As Kirschner explains, "A patient doesn't mind driving a long distance for a unique service, as long as routine care is local." Indeed, because 75% of respondents want to be a regional cardio destination center or local cardio leader, their current challenge will be to offer a competitive set of subspecialties while increasing their outpatient services.
Michael Zeis is research analyst for HealthLeaders Media. He may be contacted at email@example.com.
This article appears in the March 2013 issue of HealthLeaders magazine.