Heart and Vascular Services Service Line Review Session #1 Dean’s Meeting – January 6, 2010

1. Eric Powers, MD Medical Director Heart and Vascular ServicesService Line Review Session #1Dean’s Meeting – January 6, 2010 William Spring Administrator

2. Tab 1 • COM Departments involved in SL • SL Strategic Goals (3-5 year big bets) • 2010-2011 Progress towards Strategic Goals • What is going well in SL? • Opportunities for improvement in SL • SL Leaders input on SL as a structure Tab 2 – SL Dashboard Tab 3 – SL Goal (LEM) Performance • Executive Summary – Annual LEM Performance • Executive Summary – 2011 Pillar Performance YTD • 2011 LEM Monthly Report Card Tab 4 – SL 5/10 Plans • Performance YTD towards goal • Plan Tab 5 – SL Miscellaneous Reports

3. COM Departments involved in SL • Significant • Anesthesia • Medicine • Radiology • Surgery • Others • Pediatrics

4. South Carolina Arrhythmia Center Congestive Heart Failure/Ventricular Assist/Transplant South Carolina Heart Valve Center Prevention Acute Coronary Syndromes Adult Congenital Heart Disease Imaging Peripheral Vascular Disease and Cardiology Special Procedures SL Big Bets (3-5 year strategic goals)

5. 2010-2011 Progress towards Big Bets • South Carolina Arrhythmia Center • Recognized regional, state, national and international leadership in arrhythmia management • Full funding of Center and establishment of Endowed Chair • Significant volume growth and development of referrals • Initiation of new procedures • Expansion of research and educational programs • Congestive Heart Failure/Ventricular Assist/Transplant • Recognized state leadership in advanced heart failure management, ventricular assist and transplant • Approval for destination LVAD program • Initiation of percutaneous ventricular assist program • South Carolina Heart Failure Collaborative launched • Michael Craig MD and Darcy Kalles RN leading state efforts • 2 Nurse Practitioners hired • Expansion of CHF service to Main Hospital • South Carolina Heart Valve Center • SC Heart Valve Center launched • Collaborative CT Surgery and Cardiology practice initiated and growing • Percutaneous valve treatment program begun • Participation in “Partner” Phase II trials being pursued. • Prevention • Maturation of the Seinsheimer Prevention Program • Development of services • Diet, lipid management, hypertension, diabetes, lipid apheresis • Extension of prevention initiative to additional outpatient clinics • Multi-Divisional collaborations • Business plan and funding development

6. Acute Coronary Syndromes Leadership in regional, state and national STEMI management initiatives Advanced intracoronary imaging and physiologic assessment Completion of funding of the Gazes endowed chair Collaborations with interventional cardiologists in Georgetown and Beaufort Adult Congenital Heart Disease Recognized state leadership in he management of adult congenital heart disease Expansion of referral network Development of Cardiology/Pediatrics collaboration Nurse practitioner hired Imaging Faculty recruitment Expansion of collaborative relationships Clinical, Research, Educational Specific program development MR 3D Cardiac Echo Peripheral Vascular Disease and Cardiology Special Procedures Faculty recruitment completed Initiation of Cardiology endovascular program Planning of infrastructure Planning of training component Discussions of collaborative endeavors 2010-2011 Progress towards Big Bets

7. Effective collaboration between Medical Director and Service Line Administration Continued and accelerating program development Collaborative efforts – Arrhythmia management , CHF/Transplant, Valve disease, Prevention, Imaging, Acute Coronary Syndromes Patient Satisfaction Quality programs Mortality initiative - #2 in UHC in 2009 Recognized excellence in CAD and CHF State leadership (Dr. Powers) in SC Mission: Lifeline Financial performance Contribution to margin, cost control /savings Procedural volumes What is going well in SL?

8. Increased physician collaboration Increased financial control and flexibility Gain sharing Discretionary resources Increased expectations and accountability Balance between Rigor and Accommodation is too low (comfortable) Opportunities for improvement in SL

9. Positives Improved alignment between hospital and physicians Has allowed for substantial accomplishments Challenges Inefficiencies of working in a “Matrix” with sometimes ambiguous chains of command, and inconsistent alignment of responsibility and authority Alignment of goals of Departments and Service Line Developing a structure to allow for increased Service Line potential to affect clinical practice Input on SL as a structure

10. Tab 2SL Dashboard • November 2010 dashboard from Enterprise Analytics

11. Click on image to open PDF

12. Tab 3Goal Performance • Executive Summary – Annual LEM performance • Executive Summary – 2011 Pillar performance YTD • 2011 LEM Monthly Report Card

13. SLL Goal (LEM) PerformanceExecutive Summary - Annual Green – 4; Yellow – 3; Red - <2.5 Scale 1-5; 4 is goal attainment

14. SLL Goal (LEM) PerformanceExecutive Summary – YTD Green – 4; Yellow – 3; Red - <2.5 Scale 1-5; 4 is goal attainment

15. Click on image to open PDF

16. Tab 4SL 5/10 Performance YTD • 5/10 Performance YTD • 5/10 Plan Executive Summary

17. Missing 5/10 Performance YTD dashboard

18. SL 5/10 Performance YTD

25. SL 5/10 plan executive summary