January 16, 2007
HOUSTON - Last week, the Michael E. DeBakey Veterans Affairs Medical Center (MEDVAMC) received praise from the Department of Veterans Affairs Continuous Improvement in Cardiac Surgery Program (CICSP) for decreasing its already exceptionally low cardiac surgery mortality rate under unique and challenging circumstances.
After Hurricane Katrina, the MEDVAMC became the primary provider of tertiary services for veterans who had received health care at the New Orleans VA Medical Center. More than 120 veterans from the hurricane-affected areas were admitted to the MEDVAMC in one week in September 2005. Hundreds others turned to a newly opened VA clinic inside the MEDVAMC gymnasium for outpatient care.
The CICSP report examined a total of 422 cardiac surgery cases performed in a two year time period at the MEDVAMC. From August 29, 2004 to August 28, 2005 with 132 cases, the operative mortality was 3 percent or an observed-to-expected mortality ratio of 0.79. From August 30, 2005 to August 29, 2006 with 290 cases, the operative mortality was 2.8 percent or an observed-to-expected mortality ratio of 0.56.
To achieve these remarkable results and handle the increase in surgical volume, the MEDVAMC created a dedicated transfer center to facilitate patient referral and transfer, developed greater flexibility in its operating room scheduling, and opened a new surgical step down unit to improve patient throughput from the Surgical Intensive Care Unit.
“While Hurricane Katrina resulted in a sudden and unexpected increase in the number of cardiac surgery cases performed at the Michael E. DeBakey VA Medical Center, excellent surgical outcomes were maintained by using an effective team approach focusing on providing consistent, outstanding care to our veterans. The entire surgical team, including surgeons, anesthesiologists, nurses, and our support staff should be proud of their hard work,” said Joseph Huh, M.D., MEDVAMC Cardiothoracic Surgery chief.
Since 1987, the CICSP has produced risk-adjusted mortality and morbidity reports for cardiac surgery teams and VA Cardiac Surgery Consultants Committee (CSCC) for continuous quality improvement purposes. The CSCC is responsible for reviewing the quality of cardiac surgical treatment at the VA cardiac surgical centers around the country. It does so by reviewing both the unadjusted and risk-adjusted operative mortality data and the incidence of perioperative complications.
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