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St. Luke's Heart: 'We do great work here.'

By Dr. David C. Pate, News and Community
April 25, 2013

Our improved metrics and transparency efforts are proving beneficial in all sorts of ways and all across St. Luke’s Health System.

At St. Luke’s Heart, efforts to combine outcomes and other data for a first-ever report on our cardiac, thoracic, and vascular services prove what our talented physicians and staff members in those areas have known for some time: We’re doing outstanding work on behalf of our patients and the communities that we serve.

Dr. Marshall Priest, executive medical director of St. Luke’s Heart, and his team have put together the first of what Dr. Priest envisions will be a series of updates issued every two years regarding our heart work.

The “Programs, Services, Outcomes, and Referral, 2013” report is patterned on similar information Dr. Priest had seen from the Mayo Clinic, Cleveland Clinic, and other highly reputable health organizations and systems.

“I thought, ‘You know, we do great work here. Why don’t we put it out?’” he said.

This first report was more an affirmation than it was a surprise. We had the data, but aggregating it allowed Dr. Priest and the team to really get a sense of their performance.

“What it did was bring to light and reinforce how well we do things compared with our peers nationally,” he said. “We did a deep dive into all the things we do here, in terms of our workflows and our outcomes.

“I think transparently, we put out there exactly who we are and what we do.”

Among the takeaways:

  • Our surgical aortic valve replacement outcomes are among the best in the country.
  • Our “door to balloon time” in treating heart attacks is about half the national standard. St. Luke’s is averaging 48 minutes; the national standard is 90 minutes.
  • Our vascular surgeons are among the top 5 percent in the nation.
  • Our new Transcatheter Aortic Valve Replacement (TAVR) procedure is yielding excellent outcomes. St. Luke’s is one of only four hospitals in the Pacific Northwest, and the only hospital in Idaho, to perform the procedure. Dr. Robert Duerr, TAVR program director, and his team have seen terrific results with the 14 patients to date.
  • Dr. Matthew Schoolfield, surgical director of St. Luke’s Thoracic Oncology program, is seeing equally strong outcomes with his video-assisted thoracic surgeries (VATS). Dr. Schoolfield, who also conducts endobronchial ultrasound diagnosis procedures, and his group are the only team in Idaho performing this type of surgery.
St. Luke’s, it turns out, is a great place to be a heart patient. And that’s no accident; it’s the result of strategic hiring, tight teamwork, long-term relationships, and passionate and committed physicians who have wanted to be part of what St. Luke’s has built over time.

Dr. Priest is himself an example of the building of St. Luke’s Heart and the evolution of heart care in Idaho and nationwide. He came west from the University of Alabama, Birmingham, in 1979. St. Luke’s was then only the downtown Boise site; the hospital doors weren’t locked and there was one security guard. And then there are the changes in treatment.

“We have recognized in that period of time that a blocked artery causes a heart attack. We did not know that when I came here,” he said. “There have been remarkable improvements in anesthesia, the techniques of heart surgery, the outcomes are better …”

Dr. Priest helped to found the Boise Heart Clinic with Dr. J.W. Smith, then Idaho Cardiology Associates, which became part of the St. Luke’s Health System in 2007. That alignment and the efforts of previously unaffiliated specialists who have joined up with St. Luke’s have been a boon for the region’s heart patients.

“We came to St. Luke’s to ask for it,” Dr. Priest said. “It wasn’t that St. Luke’s put out tentacles to grab us.

“That brought the heart surgeons and the vascular surgeons to the table,” he said. “There’s a huge trust factor across the specialties.”

The System’s resources have allowed St. Luke’s Heart to provide services that wouldn’t otherwise be possible, including Dr. Andrew Chai’s Heart Failure Clinic. Such a clinic would not have been possible for Dr. Chai to establish outside a system setting. And St. Luke’s patients are experiencing better health and better outcomes, and patients, providers and St. Luke’s Health System are seeing lower costs, as the result of Dr. Chai’s work and that of Dr. Schoolfield.

System resources also support a fall educational conference. This year, about 200 primary care physicians attended the conference, which is free to them, and had the opportunity to hear from specialists and receive continuing education credits close to home.

Alignment has improved care through both educational efforts and tighter relationships among physicians.

“We have been able, and we continue, to standardize our care processes, and if people aren’t aligned, you can’t do that,” Dr. Priest said. “Without question, what we have been able to do in our service line, we would not have been able to do if we had not integrated.

“It’s not that we don’t have vigorous discussion about these things, but by and large, people are all aligned. There are a number of leaders,” he said. “We really have an aligned group.”

This week, Dr. Priest and St. Luke’s Heart will hear from Dr. Brent James, the chief quality officer at Intermountain Healthcare who has pioneered the types of improvements that St. Luke’s is interested in adopting. It’s the sort of change Dr. Priest and the team welcome and are documenting.

“I’m really proud to be part of this system,” Dr. Priest said. “The more we dive into this, the more pride I have in this organization. I love this organization. I love the people I work with.”

About The Author

David C. Pate, M.D., J.D., is president and CEO of St. Luke's Health System, based in Boise, Idaho. Dr. Pate joined the System in 2009. He received his medical degree from Baylor College of Medicine in Houston and his law degree from the University of Houston Law Center.

Related Specialty

Cardiology

Diagnosis and treatment of heart diseases, abnormalities, and related conditions.

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Thoracic Oncology

Advanced treatment for cancers occurring in the chest, such as esophageal, lung, and thymic cancers, and chest wall tumors.