MDNews - Central New York

New York, St. Joseph's ensures that distance is no obstacle for treatment at one of the nation's top cardiac programs. CYCLE OF SUCCESS The axiom "success breeds success" is especially true when failure can have fatal consequences. In other words, it's no coincidence that St. Joseph's performs about 1,000 cardiac surgeries a year (including the most open-heart procedures in the region, with the lowest risk-adjusted mortality rates) — and that it was named one of the top six hospitals in the nation for heart surgery by The Society of Thoracic Surgeons. "There are many heart surgery programs in Central New York, but there's only one that does more than a thousand cases a year," says Joseph Spinale, DO, MBA, Chief Medical Officer (CMO) for St. Joseph's Health. "That's how we get the outcomes we do." It's a self-perpetuating cycle: More heart valve surgeries than any other provider in the region and more coronary artery bypass grafting (CABG) procedures means more patients referred to St. Joseph's or sent there from places like Watertown, Ogdensburg and Binghamton. Expert providers are key players at St. Joseph's, too, according Ahmad Nazem, MD, FACS, Chief of Cardiac Surgery at St. Joseph's. "The only way you have more cases is to obtain good outcomes — those go hand in hand," Dr. Nazem says. "With that kind of volume, you end up attracting better talent at all levels." Dr. Russell Silverman, MD, FACC, Director of Medical Cardiology for St. Joseph's, sees the same dynamic at work on the interventional side. St. Joseph's is one of the top five producers in the state, with four times more volume than any other hospital is Syracuse. "Our cath lab is available 24/7 for patients with acute problems that we can address," Dr. Silverman says. "It's even available for elective procedures seven days a week, which means we perform inpatient elective procedures on the weekends." The medical helicopter also keeps the cath lab busy. "We transport critically ill patients and perform necessary procedures," Dr. Silverman says. "We have some of the best inter- ventional physicians in the state." BECOMING AN INSTITUTE Dr. Spinale, an invasive cardiologist, suspects his medical specialty is part of what led St. Joseph's to offer him the newly created position of CMO in 2017. He admits that St. Joseph's renowned cardiovascular program, including its impressive new surgical tower, was part of what inspired him to accept the offer. His first goal as CMO was to unite the competing cardiovascu- lar groups upon which the program was built, to create a single enterprise: the Cardiovascular Institute. St. Joseph's Health: Heart History in the Making + The first successful open heart surgery in Syracuse was performed at St. Joseph's Hospital in 1958, and St. Joseph's was the third hospital in the U.S. to perform angioplasty. + Famous physicians who have worked or studied at St. Joseph's include Charles Dotter, MD, a pioneering inter- ventional radiologist who invented angioplasty; Andreas Gruentzig, MD, who expanded Dr. Dotter's angioplasty; Goffredo Gensini, MD, who first identified coronary vaso- spasms (and established St. Joseph's cath lab); and Antonio Colombo, MD, who pioneered the concept of adequate stent deployment and the use of intravascular ultrasound for coronary stenting. " It's a given: When you do more cases, you end up with more experience, and more experience translates into better outcomes." — AHMAD NAZEM, MD, FACS, CHIEF OF CARDIAC SURGERY AT ST. JOSEPH'S HEALTH "One of the biggest sources of waste in health care is clinical variation," Dr. Spinale says. "By pulling everyone together and having one way of managing treatments that are based on best practices and clinical research, we can eliminate that waste and provide quality care with better outcomes at a lower cost." Since then, the Institute has steadily grown. Its team of specialists now includes five cardiac surgeons, 11 cardiac anesthesiologists, five vascular surgeons, six interventional cardiologists, two cardiac electrophysiologists, 16 medical cardiologists, and 22 physician assistants and nurse practitioners. The ultramodern cardiac facilities at St. Joseph's Health in Syracuse were built to accommodate a burgeoning caseload. The $63 million Christina M. Nappi Surgical Tower includes an expansive waiting area and 110 spacious, private rooms that are primarily used by cardiac inpatients. "When the patient feels better in a space, that affects their improvement, and the family feels more at ease with the patient staying there," Dr. Spinale says. Care Flight Helicopter M D N E W S . C O M /// M D N E W S C E N T R A l N E W Y O R K ■ 2 0 2 0 0 7

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