Q&A
Q.
Would you expect to top the NY State list again?
A.
Yes we do hope to top the NY State 30day RAMR chart for the years half 2020-2021. If it happens, then will a consecutive 25yrs in a row, a remarkable achievement (‘silver jubilee’)!
Q.
How hard is it to remain proficient in all three areas of coronary, structural and peripheral interventions?
A.
To remain on top of the field in all 3 aspects of Interventional cardiology (PCI, PTA, SHDI) in terms of volume and quality, is a very difficult feat. As to our knowledge, no other cathlab in USA has shown consistent growth in 3 fields except Mount Sinai.
Q.
On a day to day basis, which of these three disciplines requires greatest oversight?
A.
Structural heart interventions requires extra oversight for the minute details of the procedure as a small deviation can cause a major complications and even pts demise.
Q.
Please provide a synopsis of your QA setup for us to gain a perspective
A.
We have a very strict policy to follow up of any procedural complications and deviation. A pre printed detailed form is filled describing all the procedural events and inhospital course. Then a possible action plan to identify and avert that complication in the future, is also recommended. We have a system wide monthly QA discussion 1st Monday of the month (7-8am). In addition, we have an open dialogue about the complication at the morning board round so that all faculty, fellows and Cath lab staff are in tune with the issues and future action items to avert the adverse outcomes.
Q.
How do you ensure errors are not made by a constantly changing group of fellows?
A.
Aggressive methodical plan of protocols teaching and didactic discussion of various procedures in every July helps to prepare all new incoming fellows for the complex interventions. This is a continuous process during which the fellowship year.
Q.
I believe to keep high quality in a training program is even more difficult?
A.
Yes, to keep high quality in the training program year after year, is difficult but is possible, as being done at Sinai. It just requires lot of dedicated teaching in the classroom setting as well as teaching in the Cath lab during procedures.
Q.
Whom would you consider your closest rival in quality and volume in NY state?
A.
Our closest rival in volume is St Francis Hospital of Long Island and in quality is NYU. But so far we have excelled all in both the aspects.
Q.
What are some areas where you receive the most relevant institutional support at your hospital?
A.
To achieve the results we have at Sinai, is only possible by the great institutional support for the space, equipments, NPs and fellows.
Q.
How do high rankings relate to patient care?
A.
High quality and safety ranking equates simply the better interventional pt care. Also it helps to attract more high risk internet savvy pts.
Q.
Should other states and other countries follow the lead of NY State in reporting of data?
A.
Agree that all US states should be transparent in their outcomes for public reporting. But the process is very expansive, time consuming and complex. Therefore no other US States has developed this public reporting so far.
