Highmark Grant Supports West Penn Hospital — Forbes Regional Campus’ Efforts to Redefine Cardiac Care for the 21st Century

The Highmark Foundation awarded a $262,500 grant to Forbes Health Foundation to support a special program at the The Ed Dardanell Heart & Vascular Center. The program, called Redefining Chronic CARE, uses manufacturing-based quality principles to dramatically change the way heart patients are cared for at The Western Pennsylvania Hospital — Forbes Regional Campus.

Redefining Chronic CARE, is a three-year concentrated effort that is changing the organizational culture by adopting Toyota production system concepts. St. Vincent College’s Kennametal Center for Operational Excellence is teaching, training and demonstrating the concepts.

The effort is timely as the population surrounding Forbes Regional grows older and more vulnerable to heart disease. As of 2006, 47 percent of people in Forbes’ service area are age 45 or older, compared to a national average of 37.6 percent. Congestive heart failure is the leading cause of admissions to Forbes Regional.

“We thank the Highmark Foundation for this grant and their outstanding commitment to partner with us to improve community health,” said Mary Lee Gannon, President of the Forbes Health Foundation. “The goal of this program is to empower a culture of patient-focused problem solvers, resulting in optimal safety, reduced readmissions, a quicker return to productivity, satisfaction with care and prolonged life for patients.”

Forbes Regional is committed to sustaining the program long after the three-year launch period is over, Gannon said. The goal is to eventually replicate Redefining Chronic CARE across other service lines at Forbes Regional, and to other hospitals in the West Penn Allegheny Health System.

“The Dardanell Center already has the best available equipment, facilities and people,” said Michael Culig, M.D., the Center’s Medical Director. “This forward-thinking grant from the Highmark Foundation allows us to build a system aimed at error-free, complication-free care for cardiac patients.”

Forbes Health Foundation has raised a total of $352,000, including physician and community contributions, toward the project. Dr. Culig personally contributed $50,000 to the project. In addition, West Penn Hospital — Forbes Regional Campus agreed to match any funds raised by the Foundation.

Redefining Chronic CARE is pursuing aggressive goals such as zero complications and zero errors, and will aggressively seek very high patient satisfaction rates. Outcomes are tracked and posted on a daily, weekly and monthly basis so that excellence targets become embedded in the minds of the heart care team members.

Improving service delivery and quality are priorities for heart and vascular centers across the country. In addition to performing successful cardiac surgery, heart centers also focus on preventing postoperative complications due to a variety of factors, such as breakdown in communication among medical specialists, lack of continuity in medication management or human error.

Under the Toyota-based system, front-line workers are empowered to make big changes. They can “stop the production line” when small, even trivial-seeming problems are recognized, thus avoiding more serious quality issues. Workers focus on a “value stream,” a series of steps that provide value to the patient. The patient’s progress is tracked with precise benchmarks and measurable outcomes.

At daily meetings, team members evaluate outcomes and change procedures based on staff and patient feedback. Patients, meanwhile, become more deeply involved in their own care. They “own” their medical information with 24-hour access via a USB device and have the option to become part of a web-based community.

The desired outcomes of Redefining Chronic CARE are optimal patient safety, reduced cost associated with repeat and prolonged care, prolonged life, optimal recovery time to return to work, and high patient satisfaction. Such a manufacturing-based quality system is highly unusual in a health care setting.

The Highmark Foundation grant is the largest corporate or foundation grant ever received by the Forbes Health Foundation.