Boston-based Mass General Brigham’s Heart and Vascular Institute is changing its approach to care, workforce relationships and research to innovate on the model inside of an academic medical center.
The institute brings together cardiology, cardiac surgery and vascular surgery, all of which are typically separate departments under medicine and surgery, respectively, Patrick Ellinor, MD, PhD, executive director of the Heart and Vascular Institute, told Becker’s. The institute goes beyond a clinical service line by spanning all four parts of the system’s mission: clinical care, research, education and care for those in the community.
“Anything that touches heart and vascular care, both at our academic medical centers and anywhere in our community setting, including our community hospitals, is included in this institute framework,” Dr. Ellinor said.
Building seamless care
The system is working to make heart care easier across all of its 60 locations, to provide seamless services across New England. Efforts include consolidating 12 hospital websites into one, combining intensive care unit coverage for heart and vascular patients and streamlining care for aortic emergencies.
Before the institute model, hospitals would play “telephone” trying to find a cardiac or vascular surgeon to help someone with an aortic emergency, such as aortic dissection or rupture. But with the new institute, all aortic surgeons have come together across the system.
“We have a single point of entry, and the physician who picks up the phone, talking to the emergency room physician at a local community hospital, can skip every step in between,” Dr. Ellinor said. “They can look at the scans and talk to the doctors who are taking care of the patient. The scans can be texted to them or sent digitally and securely, and then they can take the patient from that community hospital directly into an operating room and go to work. Just doing that increases the likelihood of survival, and we’re already seeing it have a pretty profound effect. It’s such a deadly condition that minutes matter. If you can shorten that time, even chop an hour off of the chaos and confusion, more people will survive.”
Improving working relationships
The institute model has also focused on improving cooperation and working relationships among its physicians and surgeons.
“In many places, it’s actually a competition over who’s going to do the procedure, the cardiologist or the cardiac surgeon,” Dr. Ellinor said. “We try to get rid of that and just ask what’s best for the patient. And what we find is that everyone just gets busier. So it’s less about competition and more about how you get to the right solution for each patient.”
Leaders also apply this mindset to recruitment and retention. The system has been integrating educational programs across its locations, including combining its about 16 heart and vascular residencies and fellowships. This means, for the first time in the system’s history, there is a single point of entry.
“Instead of fighting with each other for the same small talent pool, we’ll be able to focus our efforts on creating the best educational offerings,” he said. “My competition shouldn’t be Brigham or MGH. It should be the rest of the world beyond our walls. When a trainee comes through our program with the viewpoint of being from Mass General Brigham, they’ll keep an open mind about which campus they’re on and where the needs are. I think it makes it much more comfortable for people to feel like they could have a home anywhere in our system.”
Advancing research
Mass General Brigham is the largest recipient of NIH dollars for heart and vascular research and has more than 500 clinical trials running in the cardiology space at any given time.
“We view it as not just translating results, but bringing that research mindset to care, what we describe as research-infused care,” Dr. Ellinor said. “It’s also important that we have providers like myself. When I started, I was 50-50 between clinical care and research. I treated heart rhythm disturbances, and then I went and studied them in a research lab to try to identify their genetic basis. I think that brings a different mindset to the day-to-day care of patients.”
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