Duke University Hospital Program Earns Distinguished Three-Star Ratings

By Tracey Koepke, Duke Heart Center

We are pleased to share with you that our Adult Cardiac Surgery program at Duke University Hospital has, for the first time, earned three simultaneous distinguished three-star ratings from The Society of Thoracic Surgeons (STS) for its patient care and outcomes in the following areas: isolated coronary artery bypass grafting (CABG) procedures; isolated aortic valve replacement (AVR) surgery, and isolated mitral valve replacement and repair (MVRR) surgery. The three-star rating, which denotes the highest category of quality, places our program among the elite for CABG, AVR and MVRR in the U.S.

“This is a significant validation of the quality and performance that we are able to deliver in cardiac surgery — the three-star rating means that our outcomes are in the top 10 percent of all centers in the United States,” said Peter K. Smith, MD, chief of the division of Cardiovascular and Thoracic Surgery and co-director of Duke Heart Center. “That we have achieved this within each of the three most important domains of cardiac surgery — bypass surgery, aortic valve replacement, and mitral valve repair or replacement – is a tribute not just to the surgeons but our entire team of dedicated health care professionals in our Operating Room, Intensive Care Unit, and Step-down Units.”

The STS star rating system is one of the most sophisticated and highly regarded overall measures of quality in health care, rating the benchmarked outcomes of cardiothoracic surgery programs in the U.S. The star rating is calculated using a combination of quality measures for specific procedures performed by an STS Adult Cardiac Surgery Database (ACSD) participant. We achieved a two-star rating in each of the remaining two areas of reporting: AVR+CABG and MVRR+CABG.

“Any scoring system has its limitations, but this is one of the most scientifically validated systems for heart surgery. It involves a huge amount of data from almost all centers in the U.S. and a very complicated and well thought out risk-adjustment model,” according to Carmelo Milano, MD, Chief of the Section of Adult Cardiac Surgery in the division of Cardiovascular and Thoracic Surgery. “Not only are they looking at raw outcomes like survival, but they take into consideration the pre-operative conditions that may make certain cases much higher risk. This is a very well respected grading system for heart surgery.”

The latest analysis of data for CABG covers a 1-year period, from January 2019 to December 2019; the analysis of data for isolated AVR, isolated MVRR, AVR+CABG and MVRR+CABG surgeries covers a 3-year period, from January 2017 to December 2019.

Mihai V. Podgoreanu, MD

Mihai V. Podgoreanu, MD

“Achieving the elite STS three-star rating, one of the most sophisticated and highly regarded overall measures of quality in health care, is a testament to our program’s commitment to quality improvement and safety across the cardiac surgical patient journey – from careful preoperative planning and optimization, to relentless attention to detail and coordination of intraoperative and postoperative decision making among multi-disciplinary heart team members,” added Mihai Podgoreanu, MD, chief of Cardiothoracic Anesthesiology and Critical Care. “In these unprecedented times, we are united in our dedication, resilience, compassion, and innovative spirit to continue pursuing our highest purpose – excellence and quality care for patients in need of cardiac surgery and their families.”

“As an organization and a group – the STS three star rating is evidence of the dedication of our entire Heart Center around how we care for our patients with multi-disciplinary teams that start with the evaluation and identification of patients needing coronary revascularization or valve surgery all the way through recovery, rehab, and return to life,” said Manesh Patel, MD, chief of the division of Cardiology and co-director of Duke Heart Center. “I am excited that during these challenging times our teams have continued the dedication and work to stay focused on patient outcomes.”

The STS National Database was established in 1989 as an initiative for quality improvement and patient safety among cardiothoracic surgeons. The STS ACSD houses approximately 6.9 million surgical records and gathers information from more than 3,800 participating physicians, including surgeons and anesthesiologists from more than 90 percent of groups that perform heart surgery in the US. The Database includes three other components: the Congenital Heart Surgery Database (CHSD), the General Thoracic Surgery Database (GTSD), and the mechanical circulatory support database (Intermacs). Duke has participated in the STS National Database since its inception.

Stacey HiltonDuke University Hospital Program Earns Distinguished Three-Star Ratings
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Friendships Keep Anesthesia Technician at Duke for 40 Years

By Morag Maclachlan, Duke Health

Jessie Swain, CRNAWhen Senior Anesthesia Technician Jessie Swain started at Duke in 1978 he never thought he would stay until retirement.

“You never go anywhere thinking you’ll be there for 40 years,” Swain said. “But when you like what you do, why change?”

Swain retired on July 31 after 42 years at Duke. He spent the majority of those four decades with Duke Anesthesiology. He began his career as a medical supply assembler, turning over rooms after cases and stocking carts. He then became an anesthesia technician, assisting the anesthesiologists with administering medication to patients and troubleshooting equipment. Not only did he enjoy the work, he enjoyed the people.

“The most important part of the job was the friendships I made with the residents, anesthesiologists and surgeons,” Swain said. “We have a responsibility to help patients in their time of need. And we worked together as a family.”

Anesthesiologist Madhav Swaminathan, MD, said Swain always referred to him as “professor,” even early on in Swaminathan’s career. He also always asked how Swaminathan’s family was doing.

“Jessie is the consummate professional and one of the kindest human beings I know. Always working with a smile and a laugh. Eager to help anyone at any time, he simply was the role model and set the bar for professionalism in the OR,” said Swaminathan. “He makes everyone around him feel valued and important. He has probably positively shaped more lives in his 42 years at Duke than he will ever know.”

Swain is hoping to return to his Duke family in a part-time capacity beginning this fall.

“I don’t want to quit anything cold turkey,” he said. “I will come back a couple days a week to keep the camaraderie.”

Stacey HiltonFriendships Keep Anesthesia Technician at Duke for 40 Years
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Frito-Lay Honors Couple’s Sacrifice for Patient Care with 76K Bags of Chips

By Morag Maclachlan, Duke Health

Dr. Melanie Hollidge and her husband, Murray Lubja

Dr. Melanie Hollidge and her husband, Murray Lubja

Melanie Hollidge, MD, PhD, jokes that her anesthesiology and critical care medicine colleagues at Duke University Hospital (DUH) say she’s “all that and a bag of chips.”

The phrase describes someone you believe is all that and more. And in this case, it can also be taken literally as Hollidge’s husband worked with Frito-Lay to surprise Duke Health with a donation of 76,752 bags of chips.

“He knows I like to take a bag of chips with me when I work the overnight shift,” Hollidge said. “He saw an ad on TV from Frito-Lay asking people to share stories of how they are supporting their community during the pandemic. So, he submitted our story.”

76,000 bags of chips from Frito-LayHollidge and her husband, Murray Lubja, are originally from Ontario, Canada. When it became clear in mid-March that COVID-19 was quickly spreading throughout the United States, the couple made a difficult decision. Lubja, who has three chronic immunocompromising conditions, would return to Canada so Hollidge could care for patients with COVID-19 without the risk of exposing him. They haven’t seen each other in person since.

“I am so lucky to have such a supportive partner. Throughout my career, he has never once complained when I’ve worked late or picked up extra shifts,” Hollidge said. “He understood that I wanted to keep him safe and that I needed to be here. I don’t see this as a job. It is a privilege to serve patients in their most vulnerable time.”

The Frito-Lay donation is one of the largest food donations Duke Health has received since the COVID-19 crisis, said Aaron West, CPPS, the administrative director at the DUHS Patient Safety and Quality office. Robin Thomas, executive director of Engineering and Operations at Duke Health, said four members of her team unloaded the shipment of 26 pallets and will assist with distributing the snacks across the health system.

“I’m really grateful to Frito-Lay for responding to Murray’s request with such a big gesture,” Hollidge said. “I hope it brings a smile to people’s faces because I’m sure there are lots of coworkers making sacrifices to put patient care first.”

Stacey HiltonFrito-Lay Honors Couple’s Sacrifice for Patient Care with 76K Bags of Chips
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