Winning outcomes: Indiana hospitals that rank in the top 10 percent nationally in nine specialty areas of patient care.

Author:Held, Shari
Position:Clarian Health's Methodist Hospital - Cover story

EVERY YEAR HEALTHGRADES ratings announces the hospitals that are in the top 10 percent nationally in specialty areas. Indiana has many outstanding facilities performing some of the most up-to-date procedures and providing excellent care to their patients. Many of them are repeat honorees.

The following is just a sampling of hospitals listed on page 12 that were recognized as providing excellent care in specific areas of expertise by the annual HealthGrades ratings.

St. Vincent Heart Center of Indiana, Indianapolis--Cardiac Care, Cardiac Surgery

St. Vincent Heart Center of Indiana was ranked as the leading provider of overall cardiac care in Indiana. The hospital handles some of the most complex cases in the state--including a very high volume of valve cases and a considerable amount of congenital heart defect repairs.


"We have a very simple mission statement," says John Stewart, president and CEO, "and that is to provide the highest quality cardiovascular care for our guests. We want to do so with the highest customer satisfaction as possible. So we start with that mission and then we have a quality-improvement process that permeates throughout the entire organization--from the board all the way to every nurse and every technician who provides care."

The cardiac surgery performance team, led by Dr. David Heimansohn, looks at all aspects that go into a cardiovascular surgical case, such as the timing of medications and lab tests, blood utilization, length of time patients are on a respirator, how quickly patients are out of bed and length of stay. Each area within the hospital has a performance-improvement team chaired by a physician.

"The question is, how do you learn from your historical information," Stewart says. "You look at where your opportunities are to improve."

The St. Vincent Heart Center works with the 17 facilities within St. Vincent Health, as well as other hospitals outside the system, to help them manage heart-attack patients for optimum results.

"With the Indiana Heart Attack Network we have one of the best and largest heart attack networks in the nation," Stewart says. "We help them provide the best in immediate care and when they need to be transferred to Indianapolis to either our 86th Street or our 106th Street location, we work with them to make sure that that transportation happens as quickly as possible. With heart attacks, time is muscle. The faster you get an intervention done, the better the outcome."


Clarian Health--Critical Care, Stroke Care

For nearly 100 years Clarian Health's Methodist Hospital has been providing critical care to Hoosiers. "Everything we have done here in the last five years is based on the tradition of being the hospital for the sickest of the sick for the state of Indiana," says Dr. Michael Niemeier, medical director, adult critical care unit at Methodist Hospital. "Every hour, every day of the year, we have a collaborative, multi-professional team that is here in-house. No one else in the state has the entire team represented (24/7)." Within the next five years, Methodist will be expanding its large 115-bed critical care facility to better accomplish its mission of service.

One of only two Level One trauma centers in the state, the facility is in the forefront when it comes to the latest technology Its eICU, a remote monitoring station, is unique to the region.


The eICU links each adult critical-care bed in the Clarian system via computer to provide audio and video "virtual" supervision by ICU nurses and physicians. "They monitor those patients on a 24/7 basis from that command center," Niemeier says. "So we are basically adding another level of oversight to ... the bedside."

Niemeier also credits the "smooth handoff" of patients--from the ER to the operating room, to the critical care unit, to rehabilitation and the continuum of care by professional teams at each step along the way--for the unit's excellent outcomes. Methodist is a magnet facility for nursing, and its nurses, pharmacists and other staff actively participate in professional organizations.

"We are not only involved locally, and I think doing a good job, but involved nationally and even internationally in the practice of critical care," he says. "I'm kind of proud of it, actually."

Methodist Hospital was recently accredited as a primary stroke center by the Joint Commission.

"Clarian administration has decided that neuroscience, and along with that comes stroke, is a priority," says neurologist James Fleck, director of Clarian's stroke program."

"The stroke program at Methodist Hospital meets once a month," Fleck says. "We review every patient that receives acute treatment with thrombolytic medicine. We go over the productivity and see how, as a group, we can make things better for the patient. It takes a lot of effort and a lot of people are involved."

Acute stroke treatments include administering clot-busting medications via IV (within three hours) or via catheter (within six hours). The MERCI Retriever is one of the newest interventions for stroke and extends the treatment time to within eight hours of the stroke. The device, inserted via a catheter, penetrates the clot so it can be removed. "These are interesting procedures to talk about, but the real key is to get people to the hospital ASAP because we can't do these procedures 12 or 25 hours after the stroke begins."

While the organization received good marks in mortality outcomes, Fleck says focusing on those outcomes is just part of the overall picture. "Stroke is one of the leading causes of disability in our country," he says. "We like to make people better or at least give them the opportunity to get better from their stroke. There is much more to it than saving a life."


Community Hospital North, Indianapolis--Gastrointestinal Care

Part of the reason Community North excels in gastrointestinal care is talented surgeons and physicians who are board-certified in their areas of specialty. The hospital has surgeons experienced in using the da Vinci surgical robotic system to...

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