Improve the health and well-being of each person we serve
We work hard to improve the health and well-being of each person we serve—even as the demand for care increases.
At Swedish, we put patients first.
Since our founding 107 years ago, we have led the way in providing high-quality, safe care for everyone in our community, regardless of their ability to pay. We value the trust we have earned as the community’s health system.
Recent media coverage has raised questions about overlapping surgeries. Our unwavering commitment to high-quality, safe care remains stronger than ever, and it is important to share the facts about overlapping surgeries.
Overlapping surgery is standard practice at the vast majority of teaching hospitals in America, both nationally and locally. Such surgeries represent a small percentage of total surgeries at Swedish’s five hospital campuses. This practice allows increased efficiency of care, improved resource use, enhanced training for residents and fellows, and helps coordinate surgical teams. Overlapping surgeries also offer greater and timelier access to certain surgical specialties, many of them high-demand practices. It has helped Swedish meet the health care needs of our community.
The Mayo Clinic study includes all types of operations, comparison matching both surgeons and type of operation. The total sample size is 36,000 surgeries. The findings are that there is no significant difference between non-overlapping and overlapping surgeries in mortality (inpatient and 30 day), length of stay, surgical duration, anesthesia duration, major morbidity, and Hospital Consumer Assessment of Healthcare Providers and Systems scores. Annals of Surgery 2017;265:639-644
The University of California, San Francisco study involves neurosurgical procedures. The sample is 7,358 neurosurgical procedures, 2012-2015, for nine surgeons. The study finds no significant difference between non-overlapping and overlapping cases for any patient outcomes except a slightly longer duration of surgery for overlapping cases. The outcomes the researchers reviewed are: length of stay, procedure time, estimated blood loss, discharge location, unplanned return to operating room, 30-day mortality, 30-day readmission, and major complications (respiratory failure, sepsis). Neurosurgery 2017 Feb 1;80(2):257-268
At Swedish, data show we are providing high-quality and safe care. In examining a three-year time period at Cherry Hill, which takes care of some of the sickest patients in our system, two specific risk-adjusted outcome measures -- Mortality and Readmissions in 30 days -- demonstrate excellent outcomes.
From January 2016 through April 2017, overlapping surgeries constituted 6 percent of all surgical cases at Swedish’s five hospital campuses. At Swedish Cherry Hill specifically, overlapping surgeries encompassed only 17 percent of all surgical case volume in that same time period.
We also have developed overlapping surgical policies that meet the requirements of the American College of Surgeons and the U.S. Senate Finance Committee Report. In addition, we are continuously working to improve the informed consent process. We strive to make both portions – the documentation and the physician-patient conversation – as effective as possible so that patients understand and feel comfortable with their care. To that point, we are piloting a new informed consent process for neurosurgery that specifically addresses overlapping surgery, with the goal of increasing transparency and ensuring our patients understand and feel comfortable with their care.
I encourage you to read our fact sheet on overlapping surgery to review these important statistical results.
Trust is the most important defining characteristic of the patient-doctor relationship. Swedish remains committed to putting our patients first -- and we will continue to do so.
Dr. Guy Hudson Chief Executive Officer[fa icon="quote-right"]
Swedish Cherry Hill campus
Surgery volumes have increased at the Cherry Hill campus, which houses the Swedish Neuroscience Institute.
Below are important facts that explain volume increases, impact to patients in need, and how our finances were affected. For Swedish Cherry Hill, when comparing 2015 to 2016:
- With the Affordable Care Act, we experienced a 130% increase in patients with Medicaid; many of whom were newly insured and very sick, having foregone treatment for years.
- Emergency room visits increased 3%.
- Staffing increased 7%.
- We experienced an $11.3 million increase in the uncompensated cost of care for patients with Medicaid and an $18 million net operating loss.
Swedish Neuroscience Institute
SNI is a world-famous neuroscience institute with a proud history of excellent patient safety and high quality outcomes, and because of this has become a destination for some of the most complex patients. Patients from 44 states travelled to Seattle and entrusted SNI with their care. Despite the complexity of cases, both our mortality and readmission rates are well below national averages and expectations when compared to peer institutions.
The Swedish Quality and Patient Safety team partners with its neurosurgery colleagues to measure process and outcomes in a variety of areas. We do also know that we are a learning organization and are reviewing our processes, outcomes and other data to continually improve patient outcomes and our caregivers’ ability to deliver the best care possible.
- We have processes in place that ensure we evaluate the care needs of each individual patient, determining appropriateness and medical necessity for surgery or other alternative treatments. In fact, in 2016, only 37% of patient referrals for surgical consultation actually resulted in surgery.
- Based on 2016 data, a patient would be 31% less likely to die while undergoing a craniotomy at Cherry Hill than nationally expected results.
- At Swedish, we have a very robust quality program that measures meaningful outcomes using national benchmarks derived from an independent comparative database called Premier. Many of our outcomes exceed these benchmarks.
SNI is often recognized by other experts outside of our organization.
- Awarded Comprehensive Stroke Center Certification from DNV GL-Healthcare
- Named in the Healthgrades Top 100 Hospitals for stroke care for 2017
- Chosen by Becker’s Hospital Review as one of the top 100 hospitals and health systems with great neurosurgery and spine programs