Lehigh Valley Health Network Earns Sixth Consecutive Certification for Left Ventricular Assist (LVAD) Program

When a patient needs a left ventricular assist device (LVAD) for a weakened heart or heart failure, the clinician they choose is all-important. A complex, open-heart procedure, implanting an LVAD – a mechanical pump that helps the lower left chamber pump blood – is undertaken only by highly skilled cardiac thoracic surgeons. Ensuring a good choice is certification from The Joint Commission, a leading accreditor and certifier of health care organizations. Recently Lehigh Valley Health Network (LVHN) and its Heart and Vascular Institute received its sixth consecutive disease specific care certification from The Joint Commission.

Timothy Misselbeck, MD, Section Chief Cardiac Surgeon, Director of Mechanical Circulatory Support with Lehigh Valley Heart and Vascular Institute, believes the multidisciplinary aspect was key in LVHN maintaining a six-year consecutive certification of the program.

“There are a lot of moving parts,” says Dr. Misselbeck, who is one of only two surgeons performing about 10 LVAD procedures per year at the Heart and Vascular Institute. “The physicians, operating room staff, nurses, cardiac rehabilitation colleagues, pharmacists and administration all need to work seamlessly together. It’s just not as simple as a surgeon in the OR.” 

The Joint Commission’s comprehensive, two-day credentialing process may include tours and evaluations of the emergency department, medical surgical or critical care, cardiac units and catheterization labs. They often interview staff and patients. The certifiers conduct an active review of patient records as well as interviews with staff actively working with the patient to learn about course of care, treatment and follow-up services. Items such as training, team member assessment, education and competence are all taken into consideration. 

“They cover a lot of ground, and we always learn areas to emphasize,” Dr. Misselbeck says. “This year we are concentrating on continuing multidisciplinary meetings, appropriate antibiotic therapy around the implants to reduce infection and solid pathways for patients’ cardiac rehabilitation.”

As part of the recertification process, The Joint Commission evaluated how the Heart and Vascular Institute staff utilizes clinical outcomes and performance measures to identify opportunities to improve care, as well as what they do to educate and prepare patients and their caregivers for discharge.

To meet these kinds of benchmarks, the Heart and Vascular Institute maintains a robust system of ensuring quality. Data on many parameters of the patient’s journey – such as survival, infection, device malfunction, implantation, readmission and quality of life – is put into an international database. The data is compared to other institutions of similar size. “We track our patients and see if they are improving,” Dr. Misselbeck says. “Our results are consistent with national averages for a good quality of life.”

Quality of life is an important measure because more patients are keeping LVADs for longer periods of time than they used to. If the patient can't have a heart transplant because of age or other factors, an LVAD may be used as a permanent treatment. “We see some patients the rest of their life,” Dr. Misselbeck says, “so our LVAD coordinators are a vitally important part of the program.”

During The Joint Commission’s review and recertification, evaluators shared, “The program is overwhelmingly good. It was clear through interaction with the staff that they are informed and ready to care for these patients.” From the surgeons to the staff, everyone in the Heart and Vascular Institute’s LVAD program is pleased with the results. “Our team is very engaged in providing the best outcomes,” Dr. Misselbeck says. “The Joint Commission process is a good validation of our system and what we’re trying to achieve for our patients.”