Collaborating to reduce costs in invasive cardiology: the Partners Healthcare experience. Partners Healthcare Invasive Cardiology Team.
BACKGROUND
As part of the closely watched marriage between Brigham and Women's Hospital and Massachusetts General Hospital, the invasive cardiology team--cardiologists and other staff from the two organizations--began with monthly meetings; its mission is to reduce costs of cardiology services while maintaining or improving patient satisfaction and outcomes.
Joint purchasing efforts have led to substantial price reductions for some supplies, such as pacemakers and balloon angioplasty. However, concern over quality drove cardiologists to choose newer, more expensive models of other supplies, such as implantible cardioverter-defibrillators. Also, the team is studying the actual costs savings that can be achieved by shifting patients undergoing cardiac catheterization to the outpatient setting. In addition, cardiologists recognized an opportunity to decrease length of stay and increase quality by removing the arterial sheath for uncomplicated percutaneous transluminal coronary angioplasty patients on the same day the procedure is performed. Each hospital is developing strategies for this change in procedure. In addition to these improvement efforts, the team is encouraging optimal use of contrast agents and increasing overall efficiency of laboratories. Team members are also sharing guidelines and critical pathways and developing strategies for evaluating new technologies.


CONCLUSIONS
The team has had little difficulty in achieving a collegial atmosphere and consensus around clinical issues and products once clinicians are face-to-face. Announcing bimonthly meetings may overcome meeting scheduling difficulties. The other major stumbling block has been the lack of detailed cost information.
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Brigham and Women's Hospital, Boston, MA 02115, USA.
D001900:Boston; D016507:Cardiology Service, Hospital / Q000458:organization & administration / Q000592:standards*; D017046:Cost Savings; D019091:Critical Pathways; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D017598:Efficiency, Organizational; D017754:Group Purchasing; D006784:Hospitals, Teaching / Q000458:organization & administration / Q000592:standards; D006801:Humans; D007324:Institutional Management Teams; D007857:Leadership; D009935:Organizational Affiliation; D010348:Patient Care Team / Q000458:organization & administration; D017410:Practice Guidelines as Topic; D017749:Total Quality Management / Q000458:organization & administration*