Scheinerman S Jacob, Dlugacz Yosef D, Hartman Alan R, Moravick Donna, Nelson Karen L, Scanlon Kerri Anne, Stier Lori
Cardiothoracic Surgery, Long Island Jewish Medical Center, New Hyde Park, New York, USA.
Jt Comm J Qual Patient Saf. 2015 Feb;41(2):52-61. doi: 10.1016/s1553-7250(15)41009-8.
In 2006, leadership at Long Island Jewish Medical Center (New Hyde Park, New York) noted significantly higher cardiac surgery mortality rates for isolated valve and valve/coronary artery bypass graft procedures compared to the New York State Department of Health's Cardiac Surgery Reporting System statewide average.
Long Island Jewish Medical Center, a 583-bed nonprofit, tertiary care teaching hospital, is one of the clinical and academic hubs of North Shore-LIJ Health System. Senior leadership launched an evaluation of the cardiac surgery program to determine why cardiac surgery mortality rates were higher than expected. As a result, the cardiac surgery program was redesigned, and interventions were implemented related to preoperative care, intraoperative monitoring, postoperative care, and the cardiac surgery quality management program.
According to the most recent New York State Department of Health reporting period (2009-2011), Long Island Jewish Medical Center had the lowest risk-adjusted mortality rate in New York State for adult patients undergoing surgeries to repair or replace heart valves and for adult patients in need of valve/coronary artery bypass graft surgery. The medical center has sustained significantly lower mortality rates compared to the statewide average for the past three cardiac surgery reporting periods.
Cardiac surgery mortality rates can be significantly reduced and sustained below comparative norms when the organization is committed to clinical excellence and quality and is involved in continuously assessing organizational performance. The evaluation launched at Long Island Jewish Medical Center led to the redesign of the cardiac surgery program and prompted widespread improvement efforts and cultural change across the entire organization.
2006年，长岛犹太医疗中心（纽约州新海德公园）的领导层注意到，与纽约州卫生部心脏手术报告系统的全州平均水平相比，单纯瓣膜手术以及瓣膜/冠状动脉搭桥手术的心脏手术死亡率显著更高。
长岛犹太医疗中心是一家拥有583张床位的非营利性三级护理教学医院，是北岸-长岛犹太医疗系统的临床和学术中心之一。高级领导层对心脏手术项目展开评估，以确定心脏手术死亡率高于预期的原因。结果，对心脏手术项目进行了重新设计，并在术前护理、术中监测、术后护理以及心脏手术质量管理项目方面实施了干预措施。
根据纽约州卫生部最新的报告期（2009 - 2011年），长岛犹太医疗中心在纽约州接受心脏瓣膜修复或置换手术的成年患者以及需要进行瓣膜/冠状动脉搭桥手术的成年患者中，风险调整后的死亡率最低。在过去三个心脏手术报告期内，该医疗中心的死亡率持续显著低于全州平均水平。
当组织致力于临床卓越和质量，并持续评估组织绩效时，心脏手术死亡率可显著降低并维持在可比标准之下。长岛犹太医疗中心开展的评估导致了心脏手术项目的重新设计，并促使整个组织进行广泛的改进努力和文化变革。
