San Antonio hospital makes changes to heart program after low Society of Thoracic Surgeons score

After being ranked as one of the lowest performing hospitals in the country for adult heart surgeries in August 2018, University Hospital in San Antonio is retooling its heart care program, according to San Antonio Express-News.

In August, the Society of Thoracic Surgeons gave the hospital one star, its lowest ranking, for overall performance in aortic valve replacement surgery as well as for combined aortic valve and coronary artery bypass surgery. The hospital's scores improved slightly in January after data from the first half of 2018 was included — it was bumped up to two stars for aortic valve replacement surgery. However, University Hospital remains among the lowest ranking hospitals for heart surgery.

The hospital's heart surgeons did note there are certain factors, such as socioeconomic and insurance status, that are not included in STS ratings. University Hospital is a safety net hospital and thus may accommodate more uninsured patients or patients with more comorbidities. But the surgeons have acknowledged they are unsatisfied with the scores.

The hospital has undertaken several initiatives to improve its cardiac program, including a nursing protocol that aims to help patients get off ventilators more quickly when possible. This protocol helped reduce the hospital's bypass surgery morbidity rate from 18 percent to 13.2 percent.

Another initiative involves ensuring the hospital is accurately reporting information to STS through data collection reviews, internal audit and classification processes. Additionally, the hospital is more closely examining comorbidities that can increase patient risk for surgery.

"We're guilty. We had a one-star rating. I don't think it's reflective of the entire program," said John Calhoon, MD, director of the University Health System/UT Health Heart and Vascular Institute, told San Antonio Express-News. "It nonetheless is reflective of the data we turned in. We found some data we didn't turn in. We're working to make sure our reports are as accurate as possible. We're very humbly proud that we report."


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