Mending Broken Hearts
“They are doing a lot of work to improve the last two years,” he said. “I give Tory (Starr) and the hospital a lot of credit.”
The key: introducing standardized processes developed from evidence-based guidelines. “Once there’s a protocol, a system in place, it creates a repetitive model,” Postel said. “If you have complications — problems — then it’s much easier to look back and detect or manage them. If something didn’t work, it can be changed.”
Writing out a protocol challenges a physician’s thinking and knowledge, Postel said. “You have to look in the literature to create guidelines,” he said. “It’s no longer about everyone doing something in their own way.”
When he arrived, there was no protocol for diabetics, despite the fact that high blood sugar correlates with infections, he said. He’s built a system of algorithms and procedures that brought statewide recognition for good outcomes to a cardiac surgery program that got off to a rocky start in the early 1990s, when a much higher than expected mortality rate prompted an investigation and a temporary shutdown.
Since 2000, statistics reported to the Society of Thoracic Surgeons and the California Coronary Bypass Outcome Report credit Postel with 785 cardiac surgeries and an unadjusted mortality rate of 1.5 percent. He hasn’t lost a single patient in 122 valve and aorta surgeries, despite the 3.5 to 4 percent mortality for the simplest aortic valve replacement and 8 to 12 percent for the most difficult.
“That’s where you separate the men from the boys,” Postel said with a precise German accent and a hint of pride.
“He’s an excellent surgeon who follows his patients like a mother hen before they come in until the day they leave and after,” Donahue said. “He couldn’t do that anywhere else, where the surgeons are relieved after the surgery. But we don’t have a high volume of patients, maybe one or two a week, so that’s made that possible.”
Postel told the hospital board recently that the cardiac team’s work and refined protocols have dropped the percentage of complications in coronary bypass surgery from 8.2 percent in 2006 to 4.8 percent in 2007 to 0 percent last year. In comparison, he said statewide and national numbers for complications exceed 27 percent.
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on the cover
Railroad!
Proposed lines ‘set rich blood a-tingling’ in early 1900s
Some Other Proposed North Coast Railroads
Choo-choo Fantasies
Exposing this east-west rail nonsense
seven-o-heaven
Undeterred Will
Will chides Andrew for lack of attention to detail and makes plans for his inevitable victory.
Recent on the cover
May 17
Ring of Fire
Sun and moon will perform a rare pas de deux in Humboldt skies on Sunday
May 10
District Soup
Racing for the top county seat in the 1st, 2nd and 3rd districts
May 3
A Place in the Woods
As park closure deadline nears, a scramble to save what we can
Today
44th Annual Kinetic Grand Championship Race
STAFF PICK / events, art, outdoors, sports, for kids, free / 9 a.m.-6 p.m. A 3-day, 42-mile kinetic sculpture race over land, sand, mud and water! LeMans start at the Noon Whistle on the Arcata Plaza. Follow the race through Manila, Eureka and into Ferndale on Memorial Day for the Glorious Finish. kineticgrandchampionship.com. 889-3024.
Flow 2012 Fashion Show
STAFF PICK / events / 8 p.m. Arcata Theatre Lounge, 1036 G St. Student designed and produced clothing. Fundraiser for Arcata Arts Institute. $35/$25 students. artsinstitute.net. 822-1220.
Woodside Preschool's Rummage/Bake Sale
events / 8 a.m.-noon. Woodside Preschool, 900 Hodgson St, Eureka. www.woodsidepreschool.com. 445-9132.
Lanphere Dunes Restoration
STAFF PICK / outdoors / 9:30 a.m.-12:30 p.m. Meet at Pacific Union School. Help remove non-native invasives at the Lanphere Dunes Unit of the Humboldt Bay National Wildlife Refuge. Tools and gloves provided, wear work clothes and bring water. Carpool to the protected site. 444-1397.
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FIVE Comments
Comment / By Marc Levin / Feb. 13, 2009, 9:15 a.m.
One question not addressed in this article is what would be the mortality rate if St. Joseph had no heart program at all? The delay in treatment because of the need to be transferred to Redding or Santa Rosa, especially with the complications of weather on air ambulance flights, could mean that a program that has room for improvement is better than no program at all.
Comment / By Kathryn Donahue / Feb. 13, 2009, 12:46 p.m.
In all the numbers, and talk about “standardized processes developed from evidenced based guidelines” no one address the elephant in the room, the lack of nurses. It is not the nursing shortage that has produced this effect. It is the working conditions in which nurses are required to function. The words “goal of perfect care” are easy to state. What nurses are demanding….increase nursing staff. The Lean Toyota Model requires minimal staffing, work faster,staff to numbers,(we do have a ratio law in California), not to patient acuity. For each patient added to a nurses’ work load, above what is safe, as determined by the nurse who evaluates the patient’s “acuity” status, mortality goes up. This fact is well documented in scientific studies. The SJHS must include this piece, and staff appropriately, if they expect changes in patient outcome statistics. The SJHS must address the need to restore safe nurse staffing levels to protect patients from risk caused by managed care driven staffing changes.
Comment / By unanonymous / Feb. 14, 2009, 12:57 p.m.
according to the numbers, Redwood Memorial is the best place to get health care. Something that goes against conventional wisdom.
Comment / By loretta JKM / Feb. 20, 2009, 12:12 a.m.
No longer is St. Joes ran the way of the sisters.They risk patients lives to save a buck.Katherine Donahue is correct in her comments about staffing issues and dangers to patients and liability to the nurses, with too many high risk patients to care for at once.
They ask the public for donations,to benefit the community as a whole, Yet behind closed doors, St. Josephs Health care system ,makes decisions that are detrimental to the public their mission statement claims to serve. Poor,disabled, And yes Children. That is most evident in their recent decision to shut down the home health respite program that served medically fragile children.There was no other such nursing program in this county.Their spokes person stated in the Oct. 08 issue of the times standard, that their resources needed to go to a larger community interest.Do we need more medically fragile children for them to be considered worthy of care? who is this larger community interest? the richer? the well insured? Most of these kids funding came from regional center contracts,and some had medical or private insurance. who knows what the children of the future may have had for financial resource. St joes Health system didnt care. Hmmm. They found funds though to match the donated funds ( 2 million) the McClean foundation donated .Look at some of the board members of the McClean foundation youll notice a name on there who happens to be a community services advocate for st. Joes. She refused to return a phone call regarding the closing of the program. Rude Ceos called me instead. Sounding more and more like its all about who,s in who’s pockets like any other corporately corrupt, organization in our society today. They except money from the public under the guise of the sisters mission statement,while they quietly close off the public members it was designed to serve, from receiving the services they deserve from their local health care system. Seems wrong coming from a hospitol that made itself the monopoly in this town. The hospitol and home health network,are under the same umbrella of the st. joes health care system. In reference to the closing program , I was told by CEOs,In sept. 08, that i” wasn’t supposed to know about this”. They’ve Tried to call it Regional centers program, but Regional center(RCRC) was just a source of contracted funds for their(yes St Joes) home health respite nursing program. RCRC has never been in the business of running a nursing program. All hiring and the recent firing of the nurses was done by St. Joes. The program is closing and the nurses are losing their jobs and benefits, some have been loyal employees for over 15 years. The families with severely ill children, are losing their respite nurses and left scrambling,along with RCRC, to find an out of town vendor to come here and set up and hire some nurses to step in and cover the loss of a vital one of a kind service, once offered to the community by st. joes health care system.
Comment / By jac / March 5, 2009, 1:23 p.m.
Does this hospital have care for someone with a Medtronic ICD????? Its a heart device that paces and diffibulates.(sp) Medtronic ICD has been recalled as well. any medtronic icd people or doctors or hospitals to monitor my ICD?