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Save the Date – Closed Active Medical Staff Meeting

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When Only the Best Will Do: Two Sutter Hospitals Earn Highest Quality Honor for Heart Bypass Surgery | Newsroom | Sutter Health

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When Only the Best Will Do: Two Sutter Hospitals Earn Highest Quality Honor for Heart Bypass Surgery

Alta Bates Summit Medical Center and Sutter Medical Center, Sacramento are two of only four in state to earn three-star rating

(OAKLAND, Calif.) –Two members of the not-for-profit Sutter Health network, Alta Bates Summit Medical Center in Oakland and Sutter Medical Center, Sacramento (SMCS) have earned the distinguished three-star rating from the Society of Thoracic Surgeons (STS) for patient care and outcomes in isolated coronary artery bypass grafting (CABG) procedures—the most commonly performed open-heart surgery. The three-star rating, which denotes the highest category of quality, places Alta Bates Summit and SMCS among the elite programs for heart bypass surgery in the United States and Canada. Only four hospitals in California achieved a three star rating in CABG for 2018.

Junaid Khan, MD

Junaid Khan, MD, director of Cardiovascular Services for Alta Bates Summit Medical Center

This is the second time in three years Alta Bates Summit has achieved the three star rating.

“The three star rating is a testament to the expertise of our surgeons and the commitment of our physicians and staff to provide the highest quality and excellence to our patients,” says Junaid Khan, MD, director of Cardiovascular Services for Alta Bates Summit Medical Center.

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 across the United States and Canada. The star rating is calculated using a combination of quality measures for specific procedures performed by an STS Adult Cardiac Surgery Database participant.

Historically, about 6–10 percent of participants receive the three-star rating for isolated CABG surgery. The latest analysis of data for CABG surgery covers a 1-year period, from January 2018 to December 2018.

“Participation in the Database and public reporting demonstrates a commitment to quality improvement in health care delivery and helps provide patients and their families with meaningful information to help them make informed decisions about health care,” said David M. Shahian, MD, chair of the STS Task Force on Quality Measurement.

CABG is a surgical procedure in which one or more blocked coronary arteries are bypassed by a blood vessel graft to restore normal blood flow to the heart in people with coronary artery disease (narrowing of the coronary arteries due to fatty deposits) or angina (pain or discomfort in the chest due to narrowed arteries.) CABG reduces chest pain and risk of death from heart attack. Isolated CABG means that only a CABG surgery is performed on the patient without any other procedure.

Bioethics Service

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HIM Interim Supervisor

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Alisa Stinn, HIM Manager will be on extended LOA from 9/30/2019 through 1/1/2020.   For all HIM operational issues please contact:

Angel Zheng
HIM Interim Supervisor
Alta Bates Summit, Ashby, CCC
E-mail: zhenga@sutterhealth.org 
Phone: 510-204-1390
Fax: 510-204-6421

 

Extended Duration Beta Lactam Infusions

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Extended Duration Beta Lactam Infusions

Beta-lactam antibiotics exhibit bactericidal activity when the concentration of free antibiotic in the plasma exceeds the minimal inhibitory concentration (MIC) of the organism for extended periods of time. Extending the infusion duration beyond the standard 30-60 minute duration optimizes the time-dependent bactericidal activity of beta-lactam antibiotics leading to improved efficacy by maximizing the exposure of the antibiotic.1 Piperacillin/tazobactam (Zosyn), cefepime, and meropenem are the three beta-lactam antibiotics that have options for extended infusion at ABSMC. Target populations who may benefit most from extended infusion are patients who present critically ill with deep seated or severe infections, hospital acquired pneumonia (HAP), ventilator-associated pneumonia (VAP), suspected P. aeruginosa infection and those who are infected with organisms with high MICs.2 Studies of all 3 antibiotics have demonstrated that the use of extended duration infusions is associated with clinical benefit and improved outcomes.3,4,5 Prolonged infusions do not appear to increase the risk of acute kidney injury (AKI) compared to intermittent infusions.6 Extended infusion order panels are available in EPIC with the option of selecting a bolus dose plus maintenance infusion. A loading dose infused over 30 minutes should be given prior to extended infusion to achieve adequate drug concentrations.7 If a renal dose adjustment is required, please consult pharmacy.

References:

  1. Lodise TP, et.al. Application of antimicrobial pharmacodynamic concepts into clinical practice: Focus on beta-lactam antibiotics. Pharmacotherapy 2006; 26:1321-1332.
  2. Cutro SR, Holzman R, Dubrovskaya Y, et al. Extended-Infusion versus standard-infusion piperacillin-tazobactam for sepsis syndromes at a tertiary medical center. Antimicrob Agents Chemother. 2014;58(8):4470–4475. doi:10.1128/AAC.02759-14
  3. Prolonged versus short-term intravenous infusion of antipseudomonal β-lactams for patients with sepsis: a systematic review and meta-analysis of randomized trials. Lancet Infect Dis 2018; 18(1):108-120.
  4. Yu Z, Pang X, Wu X, Shan C, Jiang S. Clinical outcomes of prolonged infusion (extended infusion or continuous infusion) versus intermittent bolus of meropenem in severe infection: A meta-analysis. PLoS One. 2018;13(7):e0201667. Published 2018 Jul 30. doi:10.1371/journal.pone.0201667
  5. Bauer KA, West JE, O’Brien JM, Goff DA. Extended-infusion cefepime reduces mortality in patients with Pseudomonas aeruginosa infections. Antimicrobial agents and chemotherapy. Jul 2013;57(7):2907-2912.
  6. Cotner SE, Rutter WC, Burgess DR, Wallace KL, Martin CA, Burgess DS. Influence of Beta Lactam Infusion Strategy on Acute Kidney Injury. Antimicrobial agents and chemotherapy. Oct 2017;61(10).
  7. Rhodes NJ, MacVane SH, Kuti JL, Scheetz MH. Impact of loading doses on the time to adequate predicted beta-lactam concentrations in prolonged and continuous infusion dosing schemes. Clin Infect Dis. 2014;59:905-907

ABSMC Earns Highest Honor for Heart Bypass Surgery

Posted on Oct 1, 2019 in Announcements | 0 comments

https://newsplus.sutterhealth.org/east-bay/2019/09/23/alta-bates-summit-earns-highest-quality-honor-for-heart-bypass-surgery/