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The Cath Lab Connection
When it comes to collaboration between JHH and Bayview, cardiology sets the pace

Cardiology administrators Michael Cole, of Hopkins Hospital, and Martha McDowell, of Bayview.
In 2002, the physician practice at the Johns Hopkins Bayview Medical Center merged with its counterpart at The Johns Hopkins Hospital, uniting under the Clinical Practice Association. Now, departments, divisions and clinical staff are making marriages of their own. At the heart of this increasingly seamless integration is, appropriately enough, cardiology, where collaboration between the two hospitals’ cardiac catheterization labs has led to significant savings and more efficient patient care coverage.

Michael Cole, administrative director of invasive cardiology at Hopkins Hospital, and Martha McDowell, cardiovascular manager at Bayview, began meeting weekly in mid-2000. They quickly recognized that they could save both hospitals money by purchasing together inventory materials they both use, particularly small-in-size but high-in-price items such as implantable defibrillators, drug-eluting stents and pacemakers.

“Vendors needed to understand that they had to negotiate with Mike and me as one unit, not two units separately just because we’re on two different campuses,” McDowell explains. “If Hopkins Hospital were getting, say, a 20 percent discount on 1,000 stents, we now both would get a 25 percent discount because, between the two of us, we bought 1,500.”

In other words, both hospitals stand to gain even though they have strikingly different volumes when it comes to cardiology procedures. JHH implants approximately 340 defibrillators each year to control the irregular heartbeats of patients; Bayview, which just began performing such procedures recently, does only about 50. Purchasing defibrillators in bulk, with all their accompanying accessories, such as the leads and wires that deliver electrical charges to the cardiac tissue, saved the hospitals $625,000 this past year.

Hopkins Hospital also performs about 1,300 angioplasties per year, using approximately 1,100 stents, wire-mesh devices expanded with a tiny balloon to open up coronary artery blockages. Some are “drug-eluting,” or coated with medication, time-released to prevent future blockages. Bayview does 50 angioplasties annually, using about 2.5 stents per procedure. Last year, what Cole calls “aggressive contract negotiations” for the best price on stents will save both facilities combined $430,000.

Bayview implants about 100 pacemakers annually. Hopkins, on the other hand, implanted 215 of these silver-dollar-size devices. Cole says aggressive price negotiations now are under way.

For Bayview’s primary angioplasty program, McDowell, working with Michael Thomas, manager of the JHH cath lab, integrated staff to ensure round-the-clock coverage. McDowell’s Bayview facility has only two nurses and one radiology technician. “The demand that 24/7 lab coverage puts on a small staff is significant,” explains Cole.

“By integrating our labs, we have increased the number of staff capable of covering the on-call shifts. This has provided flexibility in staff scheduling and allowed for an uninterrupted continuum of patient care,” Cole says, adding that he hopes other divisions use this model.

“There’s just no reason for us to be operating separately,” says McDowell.

—Neil A. Grauer



Johns Hopkins Medicine

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