Heart Surgery at Cabarrus Memorial Hospital

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cardiac unit includes a Chest Pain Unit, a Cardiac Catheterization Lab, a state-of-the-art cardiovascular operating team and the Cardiac Rehabilitation Center, highly skilled and trained physicians, nurses and clinicians diagnose and treat heart patients ("Healthy beginnings for," 2011).

From a competitive standpoint, the hospital needs to supply this service before the other hospitals in the area do. As noted in the chapter 19 case study, demographic projections are pushing the hospital management staff in this direction. These include a general population increase in the six county and surrounding area and an increase in the local at risk population in the 45 to 64 year old age category is expected to 38.3 percent in the next ten years (Swayne, Duncan, & Ginter, 2007, 803-811).

In addition, while there are 16 other open heart surgery centers in North Carolina located in 11 counties, but none are in the Cabarrus Memorial Hospital area. The closest to the hospital service area is in Charlotte, including Mercy Hospital, Presbyterian Hospital and Carolinas Medical Center. These hospitals are all about 25 miles from Cabarrus, a dangerous situation for area residents that now have to go that far for life giving heart surgery. Also, one of the state's 16 heart surgery programs had claimed Cabarrus County in its primary service area.

Admittedly, this has not been the case until recently. Historically, the CMH board considered that Cabarrus patient volumes claimed eight years earlier when it opened its heart center. Further, the committee considered that a mere 5.6 percent of the CMH patients hailed from Cabarrus County were included in the Carolinas Medical Center's primary service coverage area (ibid, 812).

The three Charlotte programs had reported previous year operating room utilization for cardiac surgery with the following statistics: Mercy Hospital at 36.3 percent, Presbyterian Hospital 78.5 percent and Carolinas Medical Center at 84.5 percent. Procedure volume increased yearly at both the Carolinas Medical Center and Presbyterian hospital. The two hospitals open heart surgery suites operated 78.5 percent of nominal capacity (ibid, 812).

The Carolinas Medical Center has six rooms that were classified at were  open heart surgery/thoracic suites, submitted a CON application for an additional open heart surgery room. Unfortunately, earlier in the year Carolinas Medical Center withdrew their application their CON application since the Department of Facilities Services requires a rate of 80 percent or higher (ibid).

This is also the case with Mercy Hospital whose heart program has not followed a year-to growth utilization pattern. Room utilization had been under 50 percent each year for the previous ten years. Also, Mercy Hospital did not appear to reach the proposed CMH open heart service area. In the previous year only 9% of the 174 people from Cabarrus County and none from Rowan County received open heart surgery at Mercy Hospital. Due to this , the pattern poses a perceived as well as a real barrier to access at Mercy for people in the Cabarrus Memorial Hospital area counties. Moreover, it appears that Mercy Hospital appeared to serve an actual population that was much more south and east of Charlotte (ibid).

Given the projected demographic trends and the actual statistics from the surrounding hospitals considered above, it is obvious that the  business for open heart surgery is moving into the Cabarrus Memorial Hospital area. In the interim however, the hospital administrators on the Board will have to consider possible alternative strategies before making a  go/no-go decision on the possible addition of the open heart program. Unfortunately, a helicopter medevac average price is $7,500-$8000. This will of course vary based upon the medications and supplies used during trip ("How much does," 2011).

First of all, in the opinion of the author, we have identified an access problem for the present CMH area residents to the existing open heart surgery facilities at the surrounding hospitals. As noted in the case study text, driving to Charlotte is a major problem. The immediate issue will be relieving this before an open heart surgery center is functioning at CMH (ibid, 812-813). This is a very sticky problem with few immediate alternatives short of a full open-heart surgery program.

Also, it will be the continued gradual expansion of open heart surgery programs at the CMH, such as the cardiac catheterization program that was started two years earlier. Even with the success of the program, CMH 82 patients to outside hospitals for angioplasty as well as 117 to open heart surgery. To make matters worse, Rowan Memorial Hospital which is located a half-hour's drive to the north in Salisbury opened its own cardiac catheterization service and might compete in the future for the cardiac catheterization  market (ibid, 813-814). If Rowan provides open heart services the results are clear, the hospital desperately needs to provide full service cardiac services, including open heart surgery to its patients.

This primarily leaves financial considerations. Capital costs will $3, 273, 180. The hospital had sufficient reserve funds to cover this. Significantly, there will need to be an increase in 23 new staff employees for the new open heart surgery unit and a need for ten new beds to become operational as coronary care beds and one new open heart operating suite. The clinical personnel will cost $711, 793 (Ibid, 815-816).

Survival rates go up significantly for patients at hospitals with open heart surgery centers. A comparison 19 hospitals found that risk algorithms showed superior performance

and accuracy in survival 30 days and one year after being treated in hospitals in open-heart surgery programs in-house, and EuroSCORE, NYS, and Cleveland Clinic in CABG-only surgery (Nilsson, Algotsson, Hoglund, Luhrs, & Brandt, 2006).

In the opinion of this author, the hospital needs to go for the application for a license for an open heart surgery unit and needs to open. For Cabarrus Memorial Hospital to continue to have a positive reputation as a progressive teaching hospital and to grow with the region's population this not just a nice to have thing. It is the next item that is necessary for the hospital's survival and the health and well-being of the population it serves. Otherwise, we will loose out to those hospitals that are stepping forward to provide these services and people will use their services instead.

Works Cited

Heart. (2011). Retrieved from http://www.cmc-northeast.org/body.cfm?id=51.

How much does a ride in a medevac helicopter cost? (2011). Retrieved from http://answers.yahoo.com/question/index?qid=20100329055051AAbYeqW.

Nilsson, J., Algotsson, L., Hoglund, P., Luhrs, C., & Brandt, J. (2006). Comparison of 19 pre-operative risk stratification. European Heart Journal, 27, 867 874.

Swayne, L.E., Duncan, W.H., & Ginter, P.M. (2007). Strategic management of health c are organizations. Malden, MA: Blackwell, MA[continue]

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"Heart Surgery At Cabarrus Memorial Hospital" (2011, August 08) Retrieved May 25, 2016, from http://www.paperdue.com/case-study/heart-surgery-at-cabarrus-memorial-hospital-43842

"Heart Surgery At Cabarrus Memorial Hospital" 08 August 2011. Web.25 May. 2016. <http://www.paperdue.com/case-study/heart-surgery-at-cabarrus-memorial-hospital-43842>

"Heart Surgery At Cabarrus Memorial Hospital", 08 August 2011, Accessed.25 May. 2016, http://www.paperdue.com/case-study/heart-surgery-at-cabarrus-memorial-hospital-43842

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