Evaluating and improving the delivery of heart care: the University of Michigan experience.
With increasing pressure to curb escalating costs in medical care, there is particular emphasis on the delivery of cardiovascular services, which account for a substantial portion of the current healthcare dollar spent in the United States. A variety of tools were used to improve performance at the University of Michigan Health System, one of the oldest university-affiliated hospitals in the United States. The tools included initiatives to understand outcomes after coronary bypass operations and coronary angioplasty through use of proper risk-adjusted models. Critical pathways and guidelines were implemented to streamline care and improve quality in interventional cardiology, management of myocardial infarction, and preoperative assessment of patients undergoing vascular operations. Strategies to curb unnecessary costs included competitive bidding of vendors for expensive cardiac commodities, pharmacy cost reductions, and changes in nursing staff. Methods were instituted to improve guest services and partnerships with the community in disease prevention and health promotion.
Eagle
K A
KA
Division of Cardiology, University of Michigan, Ann Arbor, MI 48109, USA.
Moscucci
M
M
Kline-Rogers
E
E
Chaffee
B W
BW
Barry
P A
PA
Roberts
S
S
Froehlich
J
J
Cornish
L A
LA
Wurster
H
H
Deeb
G M
GM
D016507:Cardiology Service, Hospital / Q000191:economics / Q000458:organization & administration / Q000592:standards*; D002318:Cardiovascular Diseases / Q000601:surgery / Q000628:therapy*; D017046:Cost Savings; D019091:Critical Pathways; D017598:Efficiency, Organizational; D017052:Hospital Mortality; D006785:Hospitals, University / Q000191:economics / Q000458:organization & administration / Q000592:standards; D006801:Humans; D006278:Medicare; D008824:Michigan / Q000453:epidemiology; D015397:Program Evaluation; D020379:Risk Adjustment; D019616:Thoracic Surgical Procedures / Q000401:mortality; D017749:Total Quality Management; D014481:United States