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 Multiple options for cardiac care in the metro area create competition for Kansas City health care facilities.
“There is competition, but competition is good because it really keeps you on your toes,” said John Florio, executive director of the cardiovascular program at the University of Kansas Hospital. “The people in Kansas City are very, very fortunate to have so many places that provide quality care.”
Marketing to patients
People who drive on any interstate in the area will likely see a billboard that promotes an area cardiac program.
Many health care providers say these billboards help inform patients.
“It is important for people to know and understand and choose their hospital and choose their providers,” said Donna Cash, RN, MPH, director of cardiovascular critical care and emergency services at North Kansas City Hospital.
Cash said one reason hospitals often advertise cardiac programs is because patients need to know where they can go to get the quickest care in an emergency.
“The goal is to get blood flow restored in under 90 minutes,” Cash said.
North Kansas City Hospital provides a full range of cardiac services, with 14 cardiologists, five cardiothoracic surgeons and almost 350 full-time employees in its cardiac and step down units.
“Cardiac services is one of our big programs here,” Cash said. “We just celebrated our 20th year of open-heart surgery, so we’ve had a lot of experience and a lot of open-heart surgeries.”
Florio lists experience as one of the things patients should look for when they select a cardiac program.
“Some of the things we do are very, very tough. We do them day in and day out and think they are routine,” Florio said.
KU has received national recognition for its full-service cardiac program. KU has 37 cardiologists, four cardiac surgeons and 197 nurses working in its cardiac units.
“It’s certainly one of the largest programs in the region,” Florio said. “One of the things that’s unique about that is that it really got revitalized in the last 10 years.”
When a patient does experience a heart attack or cardiac symptom he or she needs to act fast. Michele Faris-Rowe, RN, BSN, MBA, FABC, cardiothoracic service line director for Providence Medical Center and St. John Hospital, said marketing tools can help people make a choice about cardiac care before symptoms occur.
“If you start having a heart attack, you need to seek attention immediately,” Faris-Rowe said. “If it’s an elective surgery you can take you time and have a conversation with your physician. If you have a heart attack you need to go right away.”
Faris-Rowe said Providence and St. John, located in Kansas City, Kan., and Leavenworth, Kan., provide a small-town feel for patients.
“We are very, very patient focused,” Faris-Rowe said.
Pat Kueny, vice president of physician services for HCA Midwest Health System, said he expects cardiac ads to continue as the population ages.
Kueny said HCA likes to market its “door to balloon time,” which is the time it takes for a patient to enter the emergency room and receive a catheter. Last year all five of the health system’s hospitals achieved door to balloon time of less than 90 minutes 100 percent of the time, Kueny said.
“We have a very incredible door to balloon time for heart patients,” said Phyllis Vos, RN, MSN, CCRN, director of cardiovascular services at HCA hospital Research Medical Center.
Not all health care providers agree with the marketing strategies that hospitals use to promote their heart programs.
Olathe Medical Center Chief Imaging Officer Lucretia Craig, RN, MSM, said she thinks patients should discuss their health care concerns with a primary care provider, instead of relying on billboards or advertisements to make health decisions.
“The dollars that are spent competing should be spent on patients,” Craig said. “It comes from the networking. …I don’t go where the billboard tells me.”
Craig said competition can cause confusion and stress for patients.
“My personal opinion is that where patients need care, competition should be cautious,” Craig said. “In cardiology there is no room for stress.”
Olathe Medical Center does advertise its cardiology program, which provides a full range of services.
Children’s Mercy offers specialized pediatric cardiac services. Kristina Handley, RN, BSN, CRNFA, manager of cardiac services at Children’s Mercy, said because the hospital offers such specialized care it does not have to market its services much.
“Not every place is going to be able to do pediatric cardiac surgery,” said Pam Barham, RN, BSN, CPN, manager of the cardiac cath lab at Children’s Mercy. “We have a catchment area of all of western Missouri, eastern Kansas, parts of Iowa and Nebraska.”
Bringing in the money
Insurance companies typically reimburse for cardiac care, so every cardiac patient in the door means money for hospitals.
“Cardiac services generally reimburse well,” Cash said.
Across the board, hospital administrators said money from cardiac services helps supplement other areas in the hospital and funds uncompensated care.
“That’s true every place,” Florio said.
Kueny agrees.
“They are kind of the mainstay of any hospital,” he said. “It’s significant regardless of whatever side of the non-profit, for-profit side you fall on.”
While the cardiac program brings in money, it also requires expensive, ever-changing technology.
“We’re very strategic to plan for what our patient population needs,” Craig said. “Together we work with our patient population to determine what is best for the patient population.”
Every cardiac program must decide what equipment to purchase.
“We like to use our evidence-based practice,” Cash said. “You want it to have several years of life and usefulness.”
Florio said it is a challenge to keep up with the latest technology.
“Nothing is cheap in the cardiology world,” he said. “There are literally new things coming out every day.”
Striving for the best
While technology, reimbursement and competition surround cardiac care, patients remain at the heart of the matter.
And nurses are at the center of patient care.
“Cardiology (care) is something that a high percent of the population will have,” Craig said.
Olathe Medical Center’s cardiology team has a low turnover rate.
“We have a very stable program with a very high retention rate,” Craig said. “Because of the high retention rate we don’t have a high turnover, so it really does take awhile to get into the group that we have.”
Cash said North Kansas City Hospital’s cardiology department is currently hiring nurses.
Cash said competition from nearby programs keeps her team on their toes.
“I see it as a positive thing,” she said.
Providence Medical Center and St. John Hospital have minimal openings. Faris-Rowe said the nurses hired for cardiology tend to stay in that specialty.
“Once you find your niche you tend to then delve in and learn,” she said. “We have great physicians who like to teach.”
Kristin Fieger, vice president of quality and risk for HCA Midwest, said quality care is the focus at HCA Midwest.
“We are consistently looking at ways of improving the care we are providing,” Fieger said.
Florio said good physician-nurse relationships are a key component of quality care.
“Within the heart center we have a great team of nurse managers. We meet on a very regular basis,” he said. “This is a great place to grow. It’s especially exciting when I go onto the floor and visit with nurses.”
Whether it’s a scheduled procedure or a cardiac emergency, when it comes to quality care in the Kansas City area, patients have several options. And cardiac nurses have an abundance of opportunities to strive for excellence.
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