Success key No. 4: A new building, new imaging
As soon as the University of Buffalo Medical Center and Kaleida Health teamed up to build the new, 10-story Gates Vascular Institute, which includes the Kaleida Health Gates Stroke Center, the turf wars started deteriorating, says Elad Levy, MD, FACS, FAHA, director of the endovascular stroke service for the Gates Stroke Center.
It began with a new structure, and also with new imaging technology improvements.
Having a new building adjacent to the 610-licensed-bed Buffalo General Hospital made it easier to develop multidisciplinary approaches and overcome turf wars. The building features four floors dedicated to surgical and interventional management of cardiac, vascular, and neurological conditions, as well as interventional labs, CT scanners, and MRIs.
"Doctors are working right next to each other and it forces doctors to work together from different disciplines. We are constantly interacting all day long," Levy says. "Before, you'd be in silos. In the old hospital, the physicians would be on a different floor. We have multidisciplinary work on a daily basis."
Imaging technology improvements also were important to not only bring the team members together, but also for better patient outcomes, according to Levy.
"Cardiologists have been using stents in the heart for a decade before we have begun to use it in the brain," he says. "We were seeing how we could adapt that for a stroke. Out of that has come new stroke technology."
A Kaleida Health Gates Stroke Center study found more than $2 million in annual cost savings with installation of a new CT system that dramatically reduced the time it takes to diagnose stroke symptoms. Patient length of stay also was reduced, through advanced imaging technology, improved training, and multidisciplinary approaches, according to the hospital system. The study had compared inpatient data before and after installation of the imaging technology.
The most advanced CT scans can take in an entire brain in a single pass, producing videos that show the brain's structure, movement, and blood flow, whereas previous CT scans can only capture a portion of the brain. Levy credits the new technology—known as Toshiba Aquilion ONE—with allowing hospital physicians to perform whole brain perfusion and digital angiography more efficiently.
The hospital reported a decreased length of stay from six to five days for a stroke. The hospital also reported a 14.8% improvement among patients discharged to their homes, and a 48% reduction in patients discharged to skilled nursing facilities.
Every day, Levy finds that multidisciplinary teams, working together, are overcoming the turf wars for meaningful returns.
In one incident, "we were doing a brain procedure and the patient was having a heart attack on the table," Levy recalls. "Normally, that would be a disaster, but right next door to us was the interventional cardiologist. He did what he had to do with the patient's heart. There was no lag time. He was 10 feet away. He saved the patient's life."
This article appears in the August 2012 issue of HealthLeaders magazine.