EVALUATING AND IMPROVING THE DELIVERY OF HEART CARE - THE UNIVERSITY-OF-MICHIGAN EXPERIENCE

With increasing pressure to curb escalating costs in medical care, the re is particular emphasis on the delivery of cardiovascular services, which account for a substantial portion of the current healthcare doll ar spent in the United States, A variety of tools were used to improve performance at the University of Michigan Health System, one of the o ldest university-affiliate hospitals in the United States. The tools i ncluded initiatives to understand outcomes after coronary bypass opera tions and coronary angioplasty through use of proper risk-adjusted mod els. Critical pathways and guidelines were implemented to streamline c ave and improve quality in interventional cardiology, management of my ocardial infarction, and preoperative assessment of patients undergoin g vascular operations. Strategies to curb unnecessary costs included c ompetitive bidding of vendors for expensive cardiac commodities, pharm acy cost reductions, and changes in nursing staff. Methods were instit uted to improve guest services and partnerships with the community in disease prevention and health promotion.