Mount Sinai's Cardiac Catheterization Lab wins New York State's highest 'two-star' safety rating

Mount Sinai's Cardiac Catheterization Laboratory has been awarded New York State's highest "two-star" safety rating in every category of case the state tracks for percutaneous coronary intervention (PCI), according to new data released this month that examine patient discharges from 2006 - 2008. This is the first time since New York State began public reporting of statistics for cardiac labs that any hospital has been awarded the two-star safety rating across the board.

Samin K. Sharma, MD, Director of the Cardiac Catheterization Laboratory, was also the only physician in the state awarded the coveted two-star safety rating in both classes of cases the state tracks for individual physician performance. The report, produced by the New York State Department of Health, assessed data for all 54 cardiac catheterization labs in the state.

Remarkably, the Lab achieved these results while also performing the highest number of PCI procedures in the state - 4,577 in 2008, and 13,742 for the entire three-year period from 2006 to 2008.

"Our results can be attributed to continuous improvement achieved by reviewing past cases, incorporating data from those past cases into our lab's rigorous medical protocol, and then communicating that protocol clearly and effectively to every member of our medical team," said Dr. Sharma. "We have shown consistently that teamwork and adherence to meticulous standardized medical protocols can drive complication rates to their minimum."

Valentin Fuster, MD, PhD, Director of Mount Sinai Heart, the Zena and Michael A. Wiener Cardiovascular Institute, and the Marie-Josée and Henry R. Kravis Center for Cardiovascular Health, said, "This is an unprecedented success, made even more notable by the type of complex cases Mount Sinai Heart physicians routinely treat. In addition to the expertise and dedication of our interventionalists, our first-class patient outreach and education programs, as well as affiliate partnerships throughout the region, increase the quality of care and improve patient outcomes."

PCI is a minimally invasive technique used to treat patients with diseased coronary arteries caused by a buildup of plaque and cholesterol. During the procedure, a catheter is threaded through the body, typically from an artery in the groin to a blocked or occluded vessel in the heart. The occlusion is removed and a stent is often inserted to maintain flow within the blood vessel.

The condition of patients entering a cardiac catheterization lab can vary widely, from those experiencing early symptoms of heart disease up to those in the middle of a major myocardial infarction (heart attack). Dr. Sharma stressed that to obtain the highest two-star safety rating from New York State, where data are risk-adjusted to account for the varying level of difficulty involved in treating each patient, a cardiac center has to accept difficult cases and complete them with virtually no complications.

"Our strong leadership team encourages open communication among the medical team so that information flows not just from the top down, but also to everyone involved in patient care," said Dr. Sharma. "We emphasize constant incremental improvement in every area, establishing protocols by teamwork, and an open discussion of policy among clinical staff.

"It is very important that everyone is on the same page in terms of the protocol of the lab so that there is a tested system in place to manage any situation that may occur. We continuously educate staff and change our practices based on available data. We review cases as a group and stay in constant communication. Senior attending interventionalists are present whenever the lab is open, which is six days a week," Dr. Sharma explained.

In December, Mount Sinai expanded the services it offers cardiac patients when it became the first cardiac center in the U.S. to implant the new CoreValve® Transcatheter Aortic Valve Prosthesis in a patient. The device makes it possible to treat patients with severe aortic stenosis in the catheterization lab without open heart surgery, which many aortic stenosis patients are unable to endure.

In addition to supervising Mount Sinai's lab, Dr. Sharma also returns to his native India every six weeks to perform PCI procedures. "My goal is to set the standard of excellence in patient care not just in the U.S. but everywhere I operate," he said.