Gates Vascular Institute's 3 Secrets for a Successful Multidisciplinary Center

Gates Vascular Institute in Buffalo, N.Y., part of Buffalo-based Kaleida Health, was founded in April 2012. The center features specialists ranging from interventional radiologists to cardiologists to neurosurgeons to vascular surgeons working together to provide comprehensive cardiac, stroke and vascular disease treatment.

Physicians at GVI share both patients and space in a building with "many opportunities for collisions and collaborations" between specialties, says L. Nelson Hopkins, MD, president of GVI. From the open lobby and physicians' areas to the patient and operating rooms that can accommodate a range of different patients and procedures, GVI is designed to "provide physicians with opportunities to interact" and work together to deliver the best care to patients, he says.  

The center's innovative approach has been well-received by both physicians and patients. "Physicians appreciate the transparency and the opportunity to call upon a fellow specialist," says Dr. Hopkins.

Lorene Mariano, senior director of vascular procedure services, says that even physicians most reluctant to embrace the multidisciplinary approach "quickly started to see the value of sharing their expertise" in making both their days easier and the patients' stays safer.

And patients? "They couldn't be happier," says Ms. Mariano. Patients save time by seeing all their physicians simultaneously, and can consult all at once on treatment plans. Ms. Mariano says GVI has seen many great outcomes, and patients are very pleased with the care they receive. "They feel like there's a real team working on their behalf," Ms. Mariano says.

Below, Dr. Hopkins and Ms. Mariano share three key components to a successful multidisciplinary institute.

1. Specialized technology.
Ms. Mariano emphasizes the role that the technology and equipment plays in Gates' successes. When GVI was under construction, hospital leadership took the opportunity to install state-of-the-art equipment that allows each room and lab to be adaptable to the needs of different physicians and patients.

This is seen in the catheterization labs, where a partnership with Toshiba provided dual plane X-ray systems that allow movement between specialties and procedures to make the right equipment available for the right practitioner. All of the patient rooms are similarly outfitted with equipment that can adapt to fit a patient's, and a physician's, needs, says Ms. Mariano.

The physician's areas also employ technology to encourage collaboration. "GVI has a few mediascapes, which allow physicians to sit at tables with their laptops and toggle between computers to display their screens on a flat screen monitor.  It enables physicians to share case images and discuss cases. We also use telemedicine to communicate with physicians in outlying areas, to determine if patients need to be brought to GVI immediately for treatment," says Dr. Hopkins.     

2. Conducive layout. GVI's focus on collaboration can be seen clearly in design of the building itself. Physicians from different specialties occupy the same labs, operating rooms and common areas, and the layout "provides physicians with opportunities to interact in a variety of ways—from scheduled meetings to impromptu teamwork in particularly emergent cases," says Dr. Hopkins.

Such a layout also allows physicians from other specialties to assist each other in the event of an emergency: "A neurosurgeon was prepared to coil an aneurysm when the patient suddenly went into cardiac arrest. He called on the cardiac interventionalist next door, as opposed to in a distant part of the hospital, to help fix the heart. The neurosurgeon could continue coiling the aneurysm," says Dr. Hopkins.  

"The results could have been drastically different in a standard hospital setting where specialists are isolated" and a cardiac interventionalist would have been much farther away, he says.

3. Focused leadership and frequent communication. "Before we opened our doors, we were at seminars where people weren't thinking this was possible," says Ms. Mariano. She cites Dr. Hopkins' clear, detailed ideas as the catalyst for GVI's creation. "He had a vision," she says, which was the starting point for GVI during the hospital merger.

Ms. Mariano also stresses the importance of communicating plans and articulating goals to physicians, board members and other involved parties early on to ease the transition into this new model of care delivery. Additionally, she recommends site visits for inspiration and best practices, and offers GVI for site visits to organizations looking to create a similar center.

"Come visit us," she says. "Come see where healthcare needs to go."

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