Outcomes

Coronary Artery Bypass Grafting (CABG) Outcomes

The mission of Lexington Medical Center has always been to provide high-quality health care that meets the needs of our communities, and our cardiovascular care continues to be recognized at the highest levels, including receiving three stars from STS for coronary artery bypass grafting, aortic valve replacement and mitral valve surgery. Historically, 4 to 7% of database participants in the United States and Canada achieve this prestigious designation, which recognizes quality patient and clinical outcome excellence. This accomplishment demonstrates the commitment and teamwork by our multidisciplinary Heart team who care for these patients tirelessly daily. LMC patients can expect to receive the most advanced treatments and protocols medicine has to offer. Over the past decade, we have developed a strong heart and vascular program by ensuring we align with the latest practice guidelines, assisting with staff education, and providing support with each new heart procedure performed at LMC.

The entire LMC heart and vascular team is dedicated to ensuring our patients are provided exceptional care. LMC began its complete cardiac care program on March 28, 2012 with expectations to perform about 100 open heart surgeries each year. But the program has far exceeded expectations. To date, LMC has performed more than 4,650 open heart surgeries – an average of nearly 400 surgeries each year. Through the Cardiovascular Services Action Committee (CVASC), a multidisciplinary team of healthcare professionals' reviews quality measures and participates in strategic planning for the organization’s cardiac services. We monitor 100% of our cardiac surgery patients, benchmarking ourselves nationally and responding to any opportunities for improvement and growth.

About the STS Adult Cardiac Surgery Database
This database is the world’s premier clinical registry for cardiac surgery. It houses approximately 8 million surgical records and currently has more than 3,600 participating physicians, including surgeons and anesthesiologists, representing more than 95% of the groups that perform cardiac surgery in the United States. The STS rating system is one of the most sophisticated and highly regarded overall measures of quality in health care, rating the benchmarked outcomes of cardiothoracic surgery programs across the United States and Canada. STS ranked Lexington Medical Center in the highest quality tier after analyzing the latest data for AVR, CABG and MVRR during a three-year period.

“Participation in the Database and public reporting demonstrates a commitment to quality improvement in health care delivery and helps provide patients and their families with meaningful information to help them make informed decisions about health care.” said David M. Shahian, MD, chair of the Task Force on Quality Measurement.

LMC CVOR Volumes
FY 2018-2022

TAVR (Transcatheter Aortic Valve Replacement)

In May of 2014, LMC began to offer Transcatheter aortic valve replacement, known as TAVR, as a less invasive treatment option for patients with aortic stenosis who are at risk for open heart surgery. This state-of-the-art cardiovascular technology allows doctors to replace the aortic valve through a small incision in the groin or chest. During the procedure, a new valve is positioned inside the old, diseased valve while the heart is still beating. The new valve then functions immediately. Patients experience less pain than traditional open heart surgery patients and can have a significantly shorter recovery time.

LMC participates in the Society for Thoracic Surgeons (STS) and American College of Cardiology (ACC)’s national Transcatheter Valve Therapy (TVT) Registry. LMC continues to excel with outstanding patient outcomes compared to other TAVR programs across the nation.

STS/ACC TVT Registry
Volume of Transcatheter Aortic Valve Replacement (TAVR) Procedures

WATCHMAN ™

Lexington Medical Center's heart program continues to grow. The Left Atrial Appendage Occlusion (LAAO) device, WATCHMAN, debuted in March 2017. This innovative one-time procedure is minimally invasive, performed in the Cath Lab, and lasts about an hour. Most patients are discharged home the following day. WATCHMAN has proven to reduce the risk of stroke by preventing blood clots that form during non-valvular atrial fibrillation. This device also eliminates the need for long-term anticoagulation in patients who are at risk for bleeding complications.

MitraClip ®

Beginning in October 2018, LMC continued to expand its cardiovascular services to offer the MitraClip procedure. MitraClip is a less invasive procedure used to treat mitral regurgitation for those patients who are not candidates for surgery. The MitraClip device is a small clip that is attached to your mitral valve. It treats mitral regurgitation by allowing the mitral valve to close more completely, helping to restore normal blood flow through the heart. This procedure is usually performed in the Cath Lab and patients are typically able to be discharged home from the hospital within 2 to 3 days after the procedure. Patients often experience improvement in symptoms and quality of life soon after the procedure is completed.

Implantable Cardioverter Defibrillator (ICD)

Did you know that you may be at risk for sudden cardiac death if you have had a myocardial infarction (MI), ventricular arrhythmias, long QT syndrome, Brugada syndrome, congenital heart disease, or you have survived sudden cardiac arrest?

Patients have been evaluated and treated, by the knowledgeable staff Lexington Medical Center (LMC), since 2010 with the implantation of Implantable Cardioverter Defibrillators (ICDs). What is an ICD? An Implantable Cardioverter Defibrillator (ICD) is a battery-operated pulse-generator that is placed in a pocket on the chest, under the arm, or in the abdomen. There are different types of ICDs, but all have leads that connect the heart to the generator which can gather and send electric signals. When the heart rate is too slow (bradycardia) the ICD can send tiny signals that increase the heart rate. If the heart rate becomes too fast the ICD can send an electric impulse to “shock” the heart, correcting the abnormal rhythm.

ICDs can be implanted through a minimally invasive procedure in the Cardiac Cath lab, Electrophysiology (EP) lab, or through open heart surgery in the Operating Room (OR). ICDs assists patients in the management of ventricular arrhythmias which place the patient at risk for sudden cardiac arrest.

Lexington Medical Center participates in the American College of Cardiology’s (ACC) national Electrophysiology Device Implant Registry (formerly ICD) which validates Lexington Medical Center’s excellent patient outcomes compared to facilities across the nation.

ACC / NCDR: ICD Volumes
2019 – 2022

Acute Myocardial Infarction (AMI) (also known as Heart Attack)
ST elevated MI (STEMI) and Non-ST elevated MI (NSTEMI)

"Time is muscle!" Minutes matter during a heart attack since heart muscle is damaged from lack of blood and oxygen. Anyone experiencing the signs and symptoms of a heart attack should contact 911 immediately. Lexington Medical Center and EMS work together to minimize the time between recognition of a heart attack and intervention.

What are some of the signs of a Heart Attack?

• Chest Pain or Pressure
• Pain or discomfort in one or both arms, the back, neck, jaw, or stomach
• Shortness of breath with or without chest discomfort
• Cold sweat (diaphoresis)
• Nausea or vomiting
• Lightheadedness, Dizziness, or Syncope

What is the difference between a STEMI and NSTEMI?

The American College of Cardiology (ACC) and the American Heart Association (AHA) publish guidelines and recommended standards of care for the recognition and treatment of patients experiencing a myocardial infarction or heart attack. A "STEMI" or “ST elevated myocardial infarction” occurs when a coronary artery is acutely blocked off by a thrombus or clot. This blockage can cause the heart muscle supplied by the artery to die. Evidence of the blockage can be seen on an ECG and early recognition enables our team to react swiftly minimizing cardiac damage. A "NSTEMI" or “non-ST elevated myocardial infarction” is a type of heart attack that evolves over a period of time and is the result of gradual damage to the heart. A NSTEMI is usually caused by the build-up and disruption of plaque that can severely narrow a coronary artery. The artery is not completely blocked. While a NSTEMI may not be as time sensitive as a STEMI, it is still a heart attack and results in damage or death of the heart muscle.

Early recognition and timely intervention has a direct impact on the quality of life after a heart attack. An Electrocardiogram (ECG) is key to early identification and intervention. Changes in the heart's electrical conduction, depicted on the ECG, guide our highly trained certified staff to initiate treatment with a goal of removing the blockage and restoring blood flow.

NCDR: Chest Pain - MI
Overall Acute Myocardial Infarction Performance Composite
(Higher = Better)

One proven way to ensure the best outcomes for heart attack patients is to help them reduce their risk factors for additional cardiac events. High blood pressure, high cholesterol, uncontrolled diabetes, lack of exercise, and tobacco use are major risk factor for heart disease. By prescribing appropriate medications at discharge as well as providing educational information and support, Lexington Medical Center is helping to reduce our patient’s risk of further cardiac events.

NCDR: Chest Pain - MI
Acute Myocardial Infarction Discharge Performance
(Higher = Better)

Why should you choose LMC for your heart care?
Our staff strives to provide the best cardiovascular care because your heart matters to us. LMC participates in the National Cardiovascular Data Registry (NCDR) for Chest Pain – MI and the American Heart Association (AHA): Get with the Guidelines (GWTG) Mission Lifeline: Coronary Artery Disease (CAD) registry to ensure we are providing the best care to our patients. Our attention to quality has led to multiple performance recognitions from the AHA and the ACC:

Heart Failure

According to the American Heart Association, by the year 2030, more than 8 million people in the United States (1 in every 33) will have heart failure. Because of the aging of our current population, the increase in heart failure will be greatest for older Americans. Among those 80 years of age and older, the number of patients with heart failure is expected to grow by 66% during this timeframe. Large increases are also expected for all sex and racial/ethnic subgroups.

One of Lexington Medical Center’s goals is preparing our HF patients for a safe transition home with the desired outcome of preventing the need for readmission. Some strategies to meet this goal are: providing a dedicated Social Worker to work with HF patients and family members, increasing referrals to Home Health Services, providing digital scales to patients on admission for use while hospitalized and to take home for easy daily weight monitoring, scheduling early follow-up appointments, follow-up phone calls within 72 hours of discharge, and identifying and connecting patients with a primary care physician. Lexington Medical Center continues to receive a grant from the Lexington Medical Center Foundation to purchase digital scales for our HF patients who do not own a scale.

In the spring of 2019, a Patient Care Navigator position was created specifically to help patients with heart failure navigate their transition from hospital to home. The Patient Care Navigator calls high risk patients between 24-72 hours after discharge. During this phone call, the Patient Care Navigator reviews the patient’s plan of care and medication list, addresses any symptoms the patient may be having as well as ensures the patient received any equipment or other in-home assistance that was ordered at discharge. Additionally, the Patient Care Navigator is responsible for scheduling all follow up appointments that were ordered at discharge. National guidelines from the American Heart Association state that patients should see their Primary Care Physician or their Cardiologist within seven days of discharge and LMC’s Patient Care Navigator is helping to make sure that happens. Overall, the Patient Care Navigator serves as a central hub for patients with heart failure so when they leave the hospital, they know who to call if they need help.

Sepsis Management

The Centers for Medicare and Medicaid services defines sepsis as a medical complication that occurs when your body has an extreme response to an infection. Sepsis can result in tissue damage, organ failure, and can be life threatening if not recognized and treated early.

According the Centers for Disease Control and Prevention, at least 1.7 million adults in America develop sepsis and nearly 350,000 Americans die as a result of sepsis. The National Surviving Sepsis Campaign recommends early recognition and early treatment to improve patient outcomes. Experts recommend ‘bundles’ of care to simplify the complex treatment of these patients.

LMC has adopted a multidisciplinary team approach for recognition and timely treatment of these patients. Early appropriate treatment has been shown to decrease incidence of organ failure and death. The electronic health record is used to identify patients with potential sepsis quickly in the Emergency Department and to screen for triggers of deterioration that may indicate that a patient is developing sepsis after arrival. LMC is committed to improving outcomes in this patient population.

Severe Sepsis/Septic Shock
Management Bundle Compliance Comparison Data
(Higher Percentage = Better)

Catheter-Associated Urinary Tract Infections (CAUTI)

What is a urinary catheter?

A urinary catheter is a thin tube placed in the bladder to drain urine. Urine drains through the tube into a bag that collects the urine. A urinary catheter may be used if you are unable to urinate on your own; to measure the amount of urine you make, for example during intensive care; during and after some types of surgery and during some tests of the kidneys and bladder. People with urinary catheters have a much higher chance of getting a urinary tract infection than people who don’t have a catheter.

How do patients get a catheter-associated urinary tract infection (CAUTI)?

If germs enter the urinary tract, they may cause an infection. Many of the germs that cause a catheter-associated urinary tract infection are common germs that can enter the urinary tract when the catheter is being put in or while the catheter remains in the bladder.

What are some of the things that healthcare providers at Lexington Medical Center are doing to prevent CAUTI?

• Other methods to drain urine are sometimes used, such as external catheters in males and females and putting a temporary catheter in to drain the urine and removing it right away.
• Catheters are put in only when necessary and they are removed as soon as possible.
• Only properly trained persons insert catheters using sterile technique.
• The skin in the area where the catheter will be inserted is cleaned before inserting the catheter.
• Bladder scanners are used to assess the amount of urine in a patient’s bladder to avoid unnecessary urinary catheterization.
• Healthcare providers clean their hands by washing with soap and water or using alcohol-based hand rub before and after touching your catheter.
• Healthcare providers avoid disconnecting the catheter and drain tube. This helps to prevent germs from getting into the catheter tube.
• The catheter is secured to the leg to prevent pulling on the catheter.
• Specialized cleansing wipes are used to perform daily catheter care while catheters are in place.

Lexington Medical Center closely monitors patients with urinary catheters. Interdisciplinary health care teams carefully evaluate clinical practice issues and infection outcome data. Lexington Medical Center reports CAUTI data to the National Healthcare Safety Network (NHSN), a Clinical Registry of the Centers for Disease Control. This data is shared with health consumers through the Center for Medicare and Medicaid Services Quality website.

Catheter-Associated Urinary Tract Infections
(Lower = Better)

Central Line-Associated Bloodstream Infections (CLABSIs)

Central line-associated bloodstream infections (CLABSIs) result in thousands of deaths each year and billions of dollars in added costs to the U.S. healthcare system. LMC is committed to reducing our central line infections through a variety of mechanisms.

What is a central line?

A central line (also known as a central venous catheter) is a catheter (tube) that doctors often place in a large vein in the neck, chest, or groin to give medication or fluids or to collect blood for medical tests. Intravenous catheters (also known as IVs) are used frequently to give medicine or fluids into a vein near the skin’s surface (usually on the arm or hand), for short periods of time.

What is a central line-associated bloodstream infection?

A central line-associated bloodstream infection (CLABSI) is a serious infection that occurs when germs (usually bacteria or virus) enter the bloodstream through the central line. Patients who get a CLABSI have a fever, and might also have red skin and soreness around the central line. If this happens, healthcare providers can do tests to learn if there is an infection present.

What are some of the things that healthcare providers at Lexington Medical Center are doing to prevent CLABSI?

• Lexington Medical Center follows CDC (Centers for Disease Control) recommended central line insertion and maintenance practices to prevent infection when the central line is placed, including: perform hand hygiene, apply appropriate skin antiseptic, ensure that the skin prep agent has completely dried before inserting the central line.
• We have several types of central line catheters coated with antimicrobial infection protection available.
• We use maximal sterile barrier precautions during insertion (sterile gloves, sterile gown, cap, mask and large sterile drape).
• Once the central line is in place our staff follows recommended CDC central line maintenance practices.
• We bathe all central line patients with antiseptic impregnated cloths to further reduce risk of infection.
• We remove a central line as soon as it is no longer needed.

Lexington Medical Center closely monitors patients with central lines. Interdisciplinary health care teams carefully evaluate clinical practice issues and infection outcome data. We report CLABSI data to the National Healthcare Safety Network (NHSN), a secure Centers for Disease Control managed data reporting system. This data is shared with health consumers through the SD DHEC Hospital Acquired Infection Website as well as the Center for Medicare and Medicaid Services Quality website.

Central Line-Associated Bloodstream Infections
(Lower = Better)

Total Joint Program

After thousands of successful hip and knee replacements, Lexington Medical Center is the first and only facility in the Midlands recognized as a DNV Center of Excellence for Hip and Knee Replacements.

Our Total Joint Program provides a patient-centered experience that focuses on patient and family preparation and education to ensure patient safety and prompt recovery. Our highly skilled staff is dedicated to always providing the best care experience, which includes a comprehensive program that covers the patient's care from start to finish. This program combines innovative surgical techniques and after-surgery rehabilitation with skilled, compassionate care. Lexington Medical Center values a team approach whereby all disciplines work together to provide the best possible experience for all patients.

Our patients receive the most comprehensive and patient-centered care and education before, during, and after their replacement surgery. This allows patients and family to be prepared physically and mentally for earlier discharge home.

Average Length of Stay for Total Hip Replacement
(Days)

Average Length of Stay for Total Knee Replacement
(Days)

Stroke Care Quality Initiatives

Stroke is the No. 5 cause of death and a leading cause of adult disability in the U.S. On average, someone in the U.S. suffers a stroke every 40 seconds, and nearly 795,000 people suffer a new or recurrent stroke each year. Early stroke detection and treatment are key to improving survival, minimizing disability, and speeding recovery times. Every minute of brain ischemia can kill 2 million nerve cells and 14 billion synapses. The less time elapsed before treatment, the better the odds of a good outcome. Always remember, time is tissue.

For patients eligible for IV alteplase (tPA), the benefit depends on time. Clinicians should initiate treatment as quickly as possible. The American Heart Association’s national stroke guidelines recommend starting tPA while patients are still in CT immediately after they have the non- contrast CT. Delaying tPA for additional advanced imaging, such as CT angiography, CT perfusion or MRI, is not recommended.

Lexington Medical Center has received the American Heart Association’s GOLD PLUS Get With The Guidelines® Stroke award along with Target Stroke Honor Roll ELITE for our commitment to ensuring stroke patients receive the most appropriate treatment according to nationally recognized, research-based guidelines. We join only a handful of other hospitals in the state in achieving this recognition level.

To be recognized with this prestigious award, hospitals must meet quality measures developed to reduce the time between the patient’s arrival at the hospital and treatment with tPA, the only drug approved by the U.S. Food and Drug Administration to treat ischemic stroke. The criteria to achieve this level of designation include: door to needle times within 60 minutes for at least 85% of applicable patients. By meeting the aggressive target criteria for door to tPA administration, our Stroke team has demonstrated its highest commitment to the stroke population through rapid diagnosis and initiating treatment to those presenting to the Emergency department.

This truly demonstrates our commitment to providing the absolute highest quality of patient care in one of our largest time sensitive populations. Furthermore, this was accomplished during a very complex, challenging year as we navigated the COVID-19 pandemic.

AHA / GWTG Stroke
Target Stroke Metrics

Door to tPA to Administration

Metabolic and Bariatric Surgery

Combating one of the nation’s leading health concerns, bariatric surgical procedures reduce comorbidities such as hypertension, diabetes, sleep apnea and gastroesophageal reflux disease through weight loss. Lexington Medical Center has performed more than nearly 8,500 bariatric surgeries since 1998. These surgeons work with their patients to choose the most appropriate procedure to address their own personal health needs, which includes gastric bypass, sleeve gastrectomy, adjustable gastric band and gastric balloon.

As a fully accredited center through the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program, Lexington Medical Center hosts a comprehensive program and is proud of the high level of bariatric care offered to patients. Hallmarks of this well-established program include three bariatric surgeons performing each procedure, a multi-layered patient support system that includes patient education and support groups, and the availability of bariatric care 24 hours a day, seven days a week, 365 days a year. Lexington Medical Center is committed to continual improvement through long-term monitoring of each surgical case.

Our bariatric program was selected as one of the "Top 101 Best Hospitals for Bariatric Surgery" by The Leapfrog Group and Money.com

 

History of Bariatric Surgery at Lexington Medical Center

Total 8,553
(1998 - December 2022)

Lexington Medical Center has a rich history of bariatric surgery. These board-certified surgeons perform a variety of bariatric procedures, including revisions of previous surgeries. Recently, the sleeve gastrectomy surpassed the gastric bypass as the most-performed procedure.

Length of Stay (Days)
(Lower Numbers = Better)

The goal after bariatric surgery is to enable patients to return home as quickly as possible. Lexington Medical Center works hard to achieve this measure and are proud of its low length of stay rates.

Readmissions Within 30 Days After Laparoscopic Sleeve Gastrectomy
(January 2022 – December 2022)

These providers and their team use a multidisciplinary approach to avoid readmissions after bariatric surgery.

An expected rate is the estimated rate of readmissions that Lexington Medical Center was expected to have during the timeframe, taking into account the complexity of surgical cases performed and comorbidities of patients. An observed rate is the actual rate of readmissions observed at the facility during the timeframe.

Perinatal

Our goal at Lexington Medical Center is to provide the best possible care & outcomes for our newest additions to our community and their parents. We strive to remain up to date with the most advanced protocols and treatments. Our team, comprised of our Labor & Delivery staff, Mother/Baby staff and Special Care Nursery staff, is dedicated to providing exceptional care.

With 4,000+ deliveries last year, LMC has become one of the top providers of Perinatal Care in the area. Good prenatal care helps to identify and reduce risk factors for problems during pregnancy, throughout delivery and in the postpartum period. The Lexington Medical network offers convenient locations across the Midlands and spans from Chapin to the Northeast and into Lexington. We have 9 OBGYN practices that provide prenatal care and are comprised of numerous physicians as well as many advanced practice providers. LMC also has a Maternal Fetal Medicine office on our main campus with 2 physicians and a nurse practitioner. In March of 2019, our North Tower opened encompassing state-of-the-art labor and delivery suites, new spacious postpartum rooms and individual rooms for babies in our Special Care Nursery. We offer doulas through the labor process, lactation consultants to assist with breastfeeding, and neonatologists to care for premature and/or ill babies.

Our postpartum care aims to help you with a safe transition home. We offer rooming-in to give both mother and baby ample time for bonding. If you are in need of rest and recovery, our newborn nursery staff provide compassionate care for your little one. LMC provides a patient-centered experience that focuses on preparation and education to ensure patient safety and prompt recovery. We are here to guide you as your family grows.

Why should you choose LMC for your perinatal care?
You and your new baby are our top priorities! Our dedication to quality care ensures the best possible outcome for your growing family. Our proven way to ensure best outcomes is through early recognition of potential complications and timely interventions.