Hospital emergency rooms are expected to repair a blocked coronary artery in less than 90 minutes from the time the staff is initially alerted of the heart attack. It's known as door-to-balloon time. In recent years, studies have shown hospitals that treat the heart attack, known as a STEMI, in less than 60 minutes can achieve the best possible outcomes.
Mission Hospital achieves a door-to-balloon time lower than both those times, with an average time of 42 minutes.
That's because the hospital staff doesn't have conflicting incentives and isn't interested in being average. “We have a very motivated medical staff and nursing staff,” said Dr. Bill Kuehl, chief of cardiology for Asheville, N.C.-based Mission Health. “We are not paid as physicians on a fee-for-service basis, we are paid salary, and so no one is motivated to do a procedure because of money. They are motivated to do these programs and procedures because they are the right thing to do—we have removed the financial barriers.”
That focus on constantly improving is a major reason why Mission Hospital has been recognized on IBM Watson Health's 50 Top Cardiovascular Hospitals study for the past six years in a row—and 13 times total—even as doing so becomes more difficult. Cardiovascular care overall in the U.S. has improved, so it's more challenging than ever for a hospital to be recognized as top heart facility consistently. New technology, medications and procedures are making it easier for hospitals both big and small to achieve impressive outcomes on heart treatments.
“The bar is raised across all centers—it's harder,” Kuehl said. Indeed, there were a lot of newcomers on Watson Health's list this year while less than half were winners last year, too. Of the 50 hospitals, 23 were on the list last year. Thirteen hospitals are on the list for the first time. The 20th annual report analyzed performance of 1,006 hospitals using Medicare data and recognized 50 hospitals that provide better-than-average cardiovascular care.
The 50 hospitals offered better treatment for heart attack and heart failure treatments, as well as coronary bypass and angioplasty surgeries. The hospitals also performed better on mortality and complications but only performed slightly better on 30-day mortality and readmissions. For instance, the 50 hospitals overall had a median 30-day readmission rate for heart attack patients that was only 0.6% better than their peer hospitals, according to the Watson Health study.