Winfield, Ill.-based Bluhm Cardiovascular Institute at Northwestern Medicine Central DuPage Hospital might be a community hospital, but it has one of the nation’s top heart programs.
It ranks among prestigious systems such as Cleveland Clinic for lowest 30-day mortality and lowest 30-day readmission rates for CABG, and has been named a top cardiology program by Fortune for five years running. So how did this small program become so mighty?
“You have to do the small things right,” Nauman Mushtaq, MD, medical director of the institute, told Becker’s. “You can’t build complex programs or offer advanced therapies if the fundamentals aren’t strong. This has been a multiyear journey.”
The Bluhm Cardiovascular Institute has spent more than 10 years getting the little things right. It started with the physicians it hired. The institute has gone from 12 physicians to 34, with many recruited from top systems such as Baltimore-basedJohns Hopkins Medicine and Boston-based Brigham and Women’s Hospital.
“There’s no compromise on talent,” Dr. Mushtaq said. “We provide a clinical environment where they can practice what they’ve trained to do. If you don’t offer that, you won’t recruit or retain top talent.”
But care is not provided only by individuals, it is a team effort. Dr. Mushtaq said the institute is intentional in creating the right teams, and not only for cardiologists.
“You cannot build a high-functioning, complex cardiac program if your ICU, OR staff and support services aren’t operating at the same level,” he said. “Our anesthesiologists, critical care physicians, hospitalists and nursing staff all handle that level of complexity. That’s essential to achieving these outcomes.”
With the right teams in place, Dr. Mushtaq has worked to ensure the system gets the best outcomes for patients. His master’s in healthcare quality and patient safety came in handy when building an incentive structure.
“Every part of the team must share the same incentives, anchored around the patient,” he said. “It sounds simple, but you have to say it — and then make sure every operational decision flows from that philosophy.”
Dr. Mushtaq said the next step was designing clinical workflows that reduce variation while allowing flexibility for efficiency. This process became standardized based on data around processes and outcomes. Then Bluhm resourced the processes appropriately.
This has led to a number of improvements, including a new procedure to prioritize time-sensitive care. The institute has created a system that flags patients with certain heart-related complaints to be automatically routed to an expedited slot. This allows them to be evaluated quickly and into treatment.
“There’s no point seeing someone quickly if you can’t get them to ablation, valve surgery or bypass promptly,” he said.
This set number of expedition slots per week per cardiologist allowed the institute to increase its surgery volume without creating new bottlenecks or burning out staff. The quick process has also made them a go-to for referrals across their market.
Their system for cardiovascular care is now being integrated across nine hospitals and multiple ambulatory sites across Northwestern. The integration is overseen by system committees for interventional cardiology, structural heart, heart failure, electrophysiology and ambulatory care. These committees, led by physicians from both the academic medical center and health network, meet to discuss and diffuse best practices. This has led to quick adoption for efficiency and quality wins, as well as informed budget planning so sites are resources properly.
“Learning goes both ways,” he said. “Community hospitals are often more operationally efficient. Academic centers bring research rigor. The exchange strengthens both.”
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