John Muir Health

Cardiovascular is the second largest hospital-based service of john muir health. Cardiovascular achievements in 2024 includes: - the concord medical center received a clinical excellence award for cardiac surgery, coronary intervention, joint replacement and outpatient joint replacement from healthgrades. Excellence awards place our medical centers among the top 5-10% of hospitals nationwide in those specialty care areas.- the concord medical center ranks #1 in california and #8 in us for coronary artery bypass graft surgery for 30-day patient survival rate after coronary artery bypass graft (cabg) surgery. The rankings are based on data from cms from their fiscal year 2025 hospital value-based purchasing (vbp)program.- concord medical center is one of only four hospitals in california performing significantly "better" than the state average in cabg mortality outcomes. During this reporting period, concord had an observed mortality rate of 0.41% while the state average observed mortality rate was 2.46%. - on june 3, vascular surgeon, dr. Niren angle, performed the first transcarotid artery revascularization (tcar) procedure at john muir health. Tcar is a hybrid procedure designed to treat patients with carotid artery disease who are at risk for open surgery. What's unique about tcar is it temporarily reverses the blood flow during the procedure, so that any plaque that may break off during the procedure is diverted away from the brain to prevent stroke. The carotid artery is then stented. Tcar is performed through a smaller incision in the neck and in less than half the time of a carotid endarterectomy. A second tcar procedure was performed by dr. Rajiv nagesetty on june 25.- the american heart association and american stroke association recently recognized john muir health's two acute care medical centers for treatment of heart disease patients. The recognitions include: a) get with the guidelines - heart failure gold plus (concord and walnut creek), commitment to improving outcomes for patients with heart failure, meaning reduced readmissions and more healthy days at home. B) get with the guidelines - coronary artery disease stemi receiving gold plus (concord) and gold (walnut creek), commitment to offering rapid, research-based care to people experiencing an st elevation myocardial infarction (stemi), known to be more severe and dangerous than other types of heart attacks. - concord medical center was one of just four hospitals in california to earn a performance rating of "better than expected" for superior clinical outcomes in coronary artery bypass graft (cabg) surgery. This recognition comes from the california department of health care access and information (hcai) in their newest public released 2022 cabg outcomes reporting program (ccorp) report. John muir health's 244 cabg cases performed were the third most of any hospital in the san francisco bay area. In their 2024 rankings, u.s. News and world report rated concord medical center as high performing in heart attack, heart bypass surgery, heart failure and transcatheter aortic valve replacement (tavr). Walnut creek medical center was rated as high performing in heart attack and heart failure.- healthgrades, recently recognized hospitals for clinical excellence in cardiovascular care. This year's awards recognize hospitals with outstanding performance and outstanding achievements in clinical care. John muir health's medical centers received the following cardiovascular recognitions:a) cardiac surgery excellence award (concord)superior clinical outcomes in heart bypass surgery and heart valve surgery.b) surgical care excellence award (concord and walnut creek)superior clinical outcomes in surgical care across 15 of the most common in-hospital surgical procedures including cardiac & vascular surgeries.c) excellence awards place our medical centers among the top 10% of hospitals nationwide in those specialty care areas. Congratulations on these exceptional recognitions that further validate the skills and expertise of our teams, and the excellence of john muir health!- interventional cardiologists at concord medical center performed our first minimally invasive tricuspid valve repair. We utilized the abbott triclip transcatheter edge-to-edge (teer) repair system and significantly improved the patient's tricuspid regurgitation. Tri-cuspid valve disease is under diagnosed and undertreated nationally, and we are thrilled to be able to offer this therapy to our community.

Womens and children's services is the third largest program within john muir health. The pediatric intensive care unit at the walnut creek medical center is certified by the california children's services. Accomplishments in 2024 include:the pediatric hospitalist team has done the following quality improvement projects to improve the quality of care we provide to hospitalized patients: a) national qi collaborative run by vip network/aap light (learning and implementing guidelines for hyperbilirubinemia treatment). There were four primary measures: 1. Decrease sub threshold initiation of inpatient phototherapy. 2. Increase appropriate obtainment of direct antiglobulin (dat) testing. 3. Decrease unnecessary testing of rebound total serum bilirubin testing in low-risk patients who undergo inpatient phototherapy. 4. Decrease unnecessary ivf use. Based on this collaboration the following interventions were implemented: - staff education (rn and physician) about new guidelines (pre-implementation) and continued education of hospitalists, neonatologists, rounding pediatric providers about new national guidelines- roll out of new hyperbilirubinemia rn workflow and agile md hyperbilirubinemia pathways (birth hospitalization and readmission)- revised newborn order set- revised note templates to reflect changes b) path: asthma qi project: pathway-guided treatment of hospitalized pediatric asthma patients). Collaboration with er providers and goals include: - decrease los for asthma patients - increase utilization of the pediatric asthma pathways, increase team-based albuterol weaning, increase md discharges before noon, increase rn turnaround time (dc order to discharge)c) national qi collaborative run by vip network/aap: barck (better assessment and responses to croup in kids) - decrease utilization in the evaluation and management of croup - reduce hospitalizations, reduce testing/imaging, increase administration of dexamethasone - jmh is one of 144 sites - 14-month data collection june 2024-july 2025, 1st orientation meeting was nov 2024d) food insecurity screening: md admission patient food insecurity screening. Goals include: - goal 75% pediatric admissions screened for food insecurity during admission/provide relevant resources, - participated in development of hospital wide standard "community resources" handout (available in spanish and english)

Other services offered at john muir health (jmh) are: rehabilitation services rehabilitation services, outpatient, underwent program downsizing in 2024 mid-year with the closure of tice valley and brentwood therapy clinics. The remaining outpatient therapy clinics are located in pleasant hill and concord. Access however, is maintained through jmh's vast network of subcontracted outpatient clinics throughout the communities. Despite this, jmh's outpatient therapy division saw over 80,000 visits in serving the ambulatory community in east county. Orthopedics, women's health, pediatrics, neuro, lymphedema care, and hand therapy are some of jmh's many specialty rehabilitation services offered at the remaining outpatient therapy practices. Inpatient rehabilitation continued to partner with our acute care services to work on patient hospital throughput and capacity management at both campuses. Jmh's inpatient rehabilitation unit (irf) admitted 528 patients in 2024 (a near 2% increase from 2023), with stroke representing the highest admitting diagnosis at 44.3%, followed by spinal cord injury at 18%, brain injury at 16%. The average length of stay in 2024 was 13.2 days. 2024 discharge disposition to community was at 87.5%. Jmh continue to exceed regional and national outcomes for medicare quality indicator measures as published on the medicare care compare website for period 4/1/2023 - 6/30/2024 in areas of skin integrity-pressure ulcer/injury, and for falls. Neuropsychology services for in and outpatients remain busy and robust.