FREQUENTLY ASKED QUESTIONS
(FAQ’S)
ABOUT THE HEART CENTER OF GREATER WATERBURY
BACKGROUND:
When the Heart Center of Greater Waterbury was first approved to offer angioplasty and open heart surgery services, it was granted a three year program under what is called a ‘demonstration project.’ This meant that during the initial three years of providing services, the Heart Center had to meet certain criteria as outlined by the Office of Health Care Access (OHCA). These criteria were to assure OHCA that patient safety and the quality of care to be offered were of acceptable standard, and all that was available as a proxy for determining quality at the time. At the end of the three year period, it was understood that the Heart Center would need to formally request what is called ‘permanent status’ for the program. The members of the Heart Center of Greater Waterbury -- Waterbury Hospital, Saint Mary’s Hospital and the University of Connecticut Health Center -- are exceedingly proud of the accomplishments of the program since its inception in 2005. During that period, the Heart Center successfully treated more than 2,400 hearts.
QUESTION:
I have heard that it is because our heart surgery volumes are low and not meeting benchmarks that our Heart Center is facing closure. How many open heart surgeries have the two hospitals performed?
ANSWER:
Since the program began three years ago, The Heart Center of Greater Waterbury has performed over 1,800 angioplasties and more than 600 open heart surgeries. However, the cardiac surgery program has increased volume during the initial three year period. This was achieved despite state and national trends of decreasing volume.
All of the criteria outlined by OHCA for the program have been met or exceeded with the exception of one: the volume targets for open heart surgery. When the program was first approved by OHCA, the Center was assigned open heart surgery volume targets that were based on research from the year 1975. The Heart Center was not afforded an opportunity to negotiate those numbers. More recent and relevant research indicates that in fact, the Heart Center’s open heart procedure volume is sufficient not only to have a quality program, but an efficient one as well.
An important factor for quality outcomes is individual physician procedure volume. Heart Center patients can rest assured that the interventional cardiologists and cardiothoracic surgeons are very experienced, each having performed hundreds, and in some cases, thousands of procedures in their respective specialty. Moreover, the Center’s cardiothoracic surgeons operate at four hospitals - UCONN John Dempsey Hospital, Hartford Hospital, Waterbury Hospital and Saint Mary’s Hospital.
QUESTION:
I have heard that the Heart Center is a quality program. What are the benchmarks used to demonstrate that?
ANSWER:
Residents of the Greater Waterbury Area can and should be very proud of the Heart Center’s advanced cardiac services! Consider the following exceptional outcomes:
* In the last three years, Waterbury Hospital and Saint Mary’s Hospital
have performed over 600 open heart surgeries and 1,800 angioplasties.
* Both hospitals have had excellent clinical outcomes conforming to
national quality standards.
* Residents of the Center’s primary market clearly show a preference for
Waterbury Hospital and Saint Mary’s Hospital. Statistics show 84 percent
market share for coronary artery bypass surgery and 80 percent market
share for angioplasty services. These are excellent statistics!
* The volume of angioplasties is more than 50 percent above the benchmark
of 1,200 (over a three-year period) that OHCA established when it
approved the program.
* Overall patient satisfaction ratings in both hospitals’ Cardio Vascular Units (CVU’s)
are above the 98th percentile.
* The Heart Center is opening the arteries of patients having a heart attack
in an average of 66 minutes. Since delay in treatment of acute heart attack
(due to the transfer of a patient to a hospital in another city) can lead to
increased mortality and disability, the door-to-balloon time is critical.
The Heart Center’s average of just over an hour is significantly
better than the national benchmark of 90 minutes.
QUESTION:
I have heard that both hospitals waited too long to file appropriate paperwork seeking permanent status for the Heart Center. Is this true, and if so, why did you wait so long to deal with this? Have we missed deadlines with OHCA?
ANSWER:
No, this is not true. It is important to note that all of the filings have been submitted in a timely fashion and in compliance with the appropriate regulatory guidelines. It was clear when the program was approved that it was given ‘demonstration project’ status. The ultimate objective has always been to convert the program to permanent status at the end of the three year demonstration period. The Heart Center was offered an opportunity to file documentation with OHCA early, but after the Center’s teams discussed many possible strategies, it was determined that the announcement of a completed merger agreement would be a compelling argument for granting the program permanent status. However, the complexity of the merger talks has delayed that process. Therefore, it was decided to pursue a dual strategy of modifying the existing approval while simultaneously requesting a new Certificate of Need (CON) with permanent status.
QUESTION:
What are the next steps in the filing process with OHCA?
ANSWER:
The Center is currently working on two parallel tracks. The first path is for a six month extension of the current ‘demonstration project.’ The second path is in the form of a Letter of Intent (LOI) to file a new CON application. The new CON will communicate the successes of the program and seek permanent status for the Heart Center program. The six month extension of the demonstration project affords the Heart Center the appropriate time to work through the CON process while still providing critical services to patients.
The Heart Center has received a response from OHCA regarding its request for a six month extension. The commissioner did not give an unconditional extension, but rather will be calling the matter to a hearing at the end of August before rendering a decision on this request.
QUESTION:
Why can't advance cardiac services be consolidated at one of the two hospital campuses and just have Waterbury Hospital and Saint Mary's Hospital share the revenue?
ANSWER:
The hospitals evaluated several options when first establishing the Heart Center of Greater Waterbury. Along with the Center’s physicians, the hospitals carefully considered that a full service cardiac program includes not only angioplasty and open heart surgery, but patients coming to both hospitals’ emergency departments feeling chest pain, those in need of cardiac catheterizations and other diagnostic services, and those in need of follow-up services such as cardiopulmonary rehabilitation. The original goal, now achieved, was to create the best system of cardiac care for the community, considering patient preferences, local geography and the optimal use of hospital resources. The hospitals invested approximately $7 million in 2004/2005 to create state-of-the-art CVUs and open heart surgery suites. The Center was fortunate to already have excellent emergency departments, cardiac catheterization suites and cardiopulmonary departments.
The current configuration of utilizing both hospital campuses maximizes the excellent resources at both facilities and more importantly, allows hospitals and clinicians alike to provide the best access to quality cardiac services for the communities served. The sharing of revenue between licensed acute care hospitals is a matter that is not easily undertaken, given the legal and financial complexities involved. The Center’s current model with both hospitals billing for their respective services, is the preferred approach.
QUESTION:
Is there the potential that the Heart Center of Greater Waterbury will be forced to close its doors?
ANSWER:
As unthinkable as it may seem, yes, the Greater Waterbury community could conceivably lose the Heart Center program. There is no guarantee at this stage in the process that the program will be awarded permanent status, but staff will certainly exhaust all possible measures to keep the Heart Center open.
In three years, both community hospitals have built and maintained an advance cardiac program with excellent outcomes and extremely satisfied patients and families. The Heart Center of Greater Waterbury has established itself as the provider of choice for cardiac care in Greater Waterbury, and the community depends upon and has developed a significant amount of trust in this program.
Cessation of the Heart Center of Greater Waterbury will have a far reaching, devastating impact on the entire continuum of cardiac care currently provided in our community. It will most assuredly create an immediate and long term public health crisis in Waterbury and surrounding communities. The adverse effects on patients with cardiovascular disease are innumerable and possibly irreparable.
Everyone involved with the program has worked hard to demonstrate the value of having the Heart Center in Waterbury and to show how critical this institution is to saving peoples’ lives. As the hospitals begin filing a new CON to seek permanent status for the program, they will exhaust every possible lead in seeking this status.
QUESTION:
What is being planned to help save the Heart Center of Greater Waterbury? What can I do to help?
ANSWER:
Visible and vocal community support will be essential throughout the filing and hearing process. Please visit the Heart Center of Greater Waterbury’s website at www.heartcentergw.org to show your support. You can also log onto the home page of the Waterbury Hospital and Saint Mary’s Hospital websites where you will see a link to the Heart Center. A third option is to mail your letter of support, testimonial or other support materials directly to the Heart Center at the following address: Heart Center of Greater Waterbury, P.O. Box 2153, Waterbury, Connecticut, 06722.
You will be seeing advertisements in the coming weeks and information will be forthcoming on a Save the Heart Center Public Support Rally which will be held in Waterbury the third week in August. Heart Center and hospital staffs will certainly alert you as to other ways you can help in the coming days and weeks.