Institute paves way for other health-care gains
Already a model for other communities, the Mohawk Valley Heart Institute's success is fostering greater collaboration between local hospitals in other health-care specialties.
This spirit of collaboration has allowed St. Elizabeth Medical Center and Faxton-St. Luke's Healthcare, to treat two of the nation's deadliest, most expensive diseases -- heart disease and cancer -- without launching an expensive medical arms race, hospital officials said.
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<td>"AN INCREDIBLE ATMOSPHERE"</td>
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<td>Cardiothoracic surgeon Dr. Frederic Joyce arrived at St. Elizabeth Medical Center when the Mohawk Valley Heart Institute first opened in October 1997.
He was sent by the Albany Medical Center, which was helping the fledgling open-heart program establish itself. Joyce ended up staying.
"It was, you know, an exciting new challenge," Joyce said of those early days. "It was a lot of enthusiasm ... It was really an incredible atmosphere."
He found the heart institute more than willing to update its technology. "They've been very liberal as far as letting us spend money on training and equipment. So we're very pleased with that," Joyce said.
Surgeons were able to introduce a minimally invasive vein harvest bypass surgery, which reduces the incision in the leg to remove a section of blood vessel from half or more of the leg to only one inch, Joyce said. It also lowered complications from more than 10 percent to less than 1 percent, he said.
- Amy Neff Roth</td>
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"It's definitely a model. It's a successful model," said Neil Benjamin, director of the division of health facility planning at the state Department of Health.
"We think it's something that, going out into the future, represents, if not the exact construct for other services, certainly the concept of communities right sizing their own health services - cooperative as opposed to cut-throat competition," Benjamin said.
The heart institute, a collaboration between St. Elizabeth Medical Center and Faxton-St. Luke's Healthcare, celebrated the 10th anniversary of its first open-heart surgery on Wednesday. The institute is a licensed hospital for cardiac care that operates without its own facility.
Surgery and scheduled angioplasty take place at St. Elizabeth, catheterizations and emergency angioplasty are at St. Elizabeth and Faxton's St. Luke's Campus, and inpatient and outpatient rehabilitaton occur at the Faxton Campus.
Forms of cooperation The model of collaboration used to create the full-service, state-of-the-art cardiac effort has also been used to form other joint ventures between St. Elizabeth and Faxton-St. Luke's. The two collaborate on:
* The Regional Cancer Center.
* A palliative-care consultation service.
* A community diabetes education program.
* And, as of July, an integrative medicine and acupuncture clinic. They also joined forces on campus tobacco bans, implementing them on the same day last November.
The cancer center and the diabetes program - the only one approved by the American Diabetes Association in Oneida and Herkimer counties - began before the heart institute but have thrived since then as the hospitals have strengthened their collaborative efforts.
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<td>"I HAVE HUGE PRIDE"</td>
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<td>Debra Roberts has had a front-row seat for all the changes brought to cardiac care by the opening of the Mohawk Valley Heart Institute 10 years ago.
Roberts, a nurse and manager of the cardiac catheterization and electrophysiology labs at St. Elizabeth Medical Center, has worked in the cath lab for 23 years.
Roberts said she gets satisfaction from being able to meet patients' needs right in their hometown now.
"I have huge pride … I still go to the floor and do patient care … Yes, I just have a swollen heart the whole time," she said.
- Amy Neff Roth</td>
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"I think any time you have an opportunity to share information among professionals, that it can only improve the outcome," said Caroline Jacobus, a nurse and certified diabetes educator at Faxton-St. Luke's.
"When we collaborate, it's to increase efficiency and the use of limited health-care resources and to provide a higher level of service to our community. If we do things together, we can do more," cancer program director Mary Kate Schuster said.
Difficult decisions But all this collaboration hasn't come without pain. It's involved some tough decisions, too. When the heart institute was set up, it was decided that St. Elizabeth would do the open-heart surgeries because it did a higher number of diagnostic heart catheterizations. That killed St. Luke's dream of offering the surgery itself.
On the other hand, St. Luke's delivered more babies than St. Elizabeth. So St. Elizabeth, a Catholic hospital, agreed to give up its obstetrics program, giving St. Luke's a larger stream of revenue and making space for the open-heart program.
It was a difficult decision, said St. Elizabeth vice president-medical affairs Dr. Albert D'Accurzio.
"This was a long part of the tradition of the hospital," he said. "It required a lot of discussion with the Sisters of St. Francis, with the bishop of the diocese. So this was not a decision that was arrived at lightly."
"But the eventual decision was that it was in the best interest of the community and of the hospital to go in this direction," he said.
Looking ahead Financially, both D'Accurzio and Faxton President/CEO Keith Fenstemacher say hospital officials are pleased with how things have worked out. Heart institute revenues are split 70-30 between St. Elizabeth and Faxton-St. Luke's, based on each hospital's share of cardiac catheterizations before the institute opened.
Given financial realities and regular meetings between hospital leaders, there might be more collaboration yet to come.
"We have one shot at making them work, and if it means you have to pool resources to get it done, then that's the reality of it," Fenstemacher said.