Surgery News - November 2007 - (Page 5)

NOVEMBER 2007 • SURGERY NEWS 5 THE THE E Teamwork Rewards Patients and Physicians BY JANE ANDERSON Else vier Global Medical Ne ws urgeons at the University of Michigan Cardiovascular Center in Ann Arbor say the new facility offers an original model of how physicians and surgeons can work closely together to improve patient care. The 3-month-old, 325,000-squarefoot, $220-million facility, which emphasizes and rewards cooperation among specialties, incorporates cardiac surgeons, vascular surgeons, cardiologists, interventional radiologists, thoracic imaging radiologists, and cardiac anesthesiologists, along with clinical support staff. It includes eight operating rooms, two interventional rooms, 48 hospital beds (among them 24 intensive cardiac care beds), and offices for all specialists, and it is linked by a bridge to the main university hospital. No matter where they are treated, patients are cared for by teams that include members of different medical and surgical specialties. The model “fits an academic health system that has made a part of its focus clinical excellence in cardiovascular care,” said Dr. Richard Prager, chief of the division of adult cardiac surgery and one of the four directors of the cardiovascular center. “Our mission is to create best processes. We’re not trying to disrupt departmental hierarchies—we’re trying to create a different paradigm. “Part of the intellectual decision to move ahead with shared spaces is we believe that, given the opportunity, we could create a collaborative environment that could cross disciplines and could cross departments,” said Dr. Prager, an ACS Fellow. “We could end up improving the care we provide to our patients.” This is already happening, said Linda Larin, chief administrative officer of the center. She described cases in which patients saw specialists in minutes instead of weeks because the treating physician had immediate access to colleagues. Similarly, some patients have had work-up and procedures within a day that otherwise might have taken weeks to organize and schedule. The proximity of their offices to one another encourages physicians from different specialties to communicate and collaborate, she said. “They’re all sharing these staff rooms in the clinic now,” Ms. Larin said. “The challenge isn’t to get the doctors to work together—the challenge is to get it to work within the traditional system we’ve all grown up with.” The center’s design fosters cooperation, not competition, among the specialties, said Dr. Gilbert Upchurch, Jr., a vascular surgeon and associate professor of surgery at the S university. “We’re salaried employees, and we focus on the best patient outcome rather than on fiscal gain and ego. We have very few turf battles,” he said. In fact, newcomers who promote turf battles tend to become isolated quickly, he said, adding that residents and fellows training in one specialty at the center are expected to rotate through the others. Those who want to collaborate more closely with other specialists should meet as a multidisciplinary group to discuss patient management issues, said Dr. Upchurch, an ACS Fellow. He added that fiscally merging into a multispecialty group can help align incentives and lead to better outcomes. Ms. Larin also said that the center’s administrative structure—it’s run by four directors, each in different specialties—is responsible in part for its success. “Those four—while they will disagree 20/20 / 0/20 V SION O SIO SION IO on several fronts—they very much respect and like each other. And they’re committed to the greater calling of the center, they really believe in what we’re doing. If some of the junior faculty don’t see eye to eye, they’re kind of brought along, and they’re starting to see the vision, too.” ■ http://www.InfoVACTherapy.com

Table of Contents Feed for the Digital Edition of Surgery News - November 2007

Surgery News - November 2007 Contents Black Patients Fare Worse Than Whites After Liver Surgery Survey Suggests Need For Acute Care Surgery New Law Bolsters FDA Funding, Authority Working Together Oncology: Marginal Evidence? Trauma: Screening Scrutinized News From the College: Healy Takes Helm

Surgery News - November 2007

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