"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 firstname.lastname@example.org.
This article appears in the March 2013 issue of HealthLeaders magazine.