St. Boniface Hospital's cardiac program among best in Canada: CIHI study

If you need heart surgery, St. Boniface Hospital in Winnipeg is one of the best places in Canada to be, according to a new study.

The Canadian Institute for Health Information looked at patient outcomes and re-admission rates after the most common kinds of heart surgery in its survey of hospitals in nine Canadian provinces. It released the results of that survey on Tuesday.

St. Boniface Hospital's cardiac sciences program had some of the highest scores in all markers, including low rates of patient mortality, low rates of re-admission after surgery, and high patient volumes for angioplasty, or cardiac catheterization surgeries.

"The results reflect the work of hundreds of health-care professionals that are involved in the journey of any of these patients having these procedures," said Dr. Ross Feldman, medical director of the Winnipeg Regional Health Authority's cardiac sciences program.

"There are excellent surgeons across Canada and we're lucky to have very good surgeons here in Manitoba as well, but more than that are the processes and the culture," added Dr. Rakesh Arora, medical director of intensive care cardiac surgery at St. Boniface.

He gave credit to the hospital's "leadership that promote engaged staff to give us the best care for our patients."

'Patients with heart problems in Manitoba do well'

The report looked at angioplasty, bypass surgery and valve replacement surgery — as well as a combination of the two — and assessed patients' death and re-admission rates in the 30 days after surgery.

"For patients undergoing bypass surgery or aortic valve surgery, we have the best results in Canada for 30-day mortality and rehospitalization for the first 30 days," said Arora.

He credits the hospital's "excellent" results in the study to evaluations of patients before surgery, the work of operating room staff, and a detailed handover process between the OR and the cardiac intensive-care unit, as well as the work of nurses and nurse educators within the cardiac sciences program.

The hospital's interdisciplinary cardiac team — made up of specialists, physician and clinical assistants, physiotherapists, respiratory therapists, dietitians, pharmacists, social workers, nurses and occasionally occupational therapists— sees patients consistently after surgery to co-ordinate a care plan and ensure their discharge home is smooth, said Arora.

"It's a reaffirmation that patients with heart problems in Manitoba do well, and an affirmation of the decision making, the investments, the procedures that were developed to centralize heart care at St. Boniface Hospital," said Feldman.

'We'd like to see less business'

According to the CIHI study, about 2.4 million Canadians live with heart disease, which is the second-leading cause of death after cancer.

Some risk factors for heart disease can be controlled, such as smoking, diet and exercise, and obesity.

"On one end, we'd like to see less business. We'd like to expand the program and start tackling more effectively the risk factors that get people to our doors, that cause heart disease — high blood pressure, problems with cholesterol," said Feldman.

On the other hand, he said the hospital would also like to expand its program to eventually start doing heart transplants in Manitoba, and would like to get patients to the hospital more quickly during cardiac emergencies.

"The best care is really dependent on them getting to St. Boniface as soon as possible and the best kind of procedures can only be done in the first 100 minutes, which is restricting to those in the southern and Interlake regions," said Feldman.

"It's so restricted by the ground transportation. We'd like to see that area expanded. That would require helicopter transport."

The WRHA has plans to begin a feasibility study for a helicopter pad at St. Boniface Hospital in spring of 2018.