achieving quality: an outcomes report

2201 Lexington Ave.Ashland, KY 41101

1.888.377.KDMC | kdmc.com

2 | OUTCOMES | KING’S DAUGHTERS HEART AND VASCULAR CENTER

Dear Friends,

We are pleased to present you with this first quality outcomes

report for King’s Daughters Heart and Vascular Center. This

report covers the 2008 calendar year.

Since the inception of our cardiovascular program in the early

1990s, we have focused on two things: quality and excellent

customer service. Achieving the best outcomes for our

patients and our communities – we call it world-class care – is

not only our Vision, but our calling.

Over the years, we have earned quite a few recognitions and honors for our quality

care. We are proud of these because they acknowledge the tremendous talent and

commitment of our physicians, surgeons, nurses and team members.

On behalf of the entire King’s Daughters team, thank you for your interest in our

story.

Fred Jackson

President/CEO

King’s Daughters Medical Center

HHHHHHealthGrades Awards

Cardiac Surgery Excellence

2007-2008-2009-2010

Top 5% in the nationfor Cardiac Surgery

2007-2008-2009-2010

Top 10 in Kentucky for Vascular Surgery

2003-2010

Top 5 in Kentucky for Cardiac Surgery

2007-2008-2009-2010

Five-star rated for Peripheral Vascular Bypass

2010

Five-star rated for Cardiac Surgery

2007-2008-2009-2010

Pulmonary Care Excellence Award

2009-2010

Top 10 in Kentucky for Pulmonary Care

2009-2010

Five-star rated for Coronary Artery Bypass Graft

2007-2008-2009-2010

Five-star rated for treatment of

Congestive Heart Failure 2008-2009-2010

Five-star rated for Valve Replacement Surgery

2009-2010

Fred JacksonPresident/CEO

2008 - 2009 - 2010

2004 - 2005 - 2006 - 2007 - 20082007 - 2008 - 2009

KING’S DAUGHTERS HEART AND VASCULAR CENTER | OUTCOMES | 3

Welcome

During the past 20 years, King’s

Daughters has carefully developed a

top-notch Heart and Vascular Center

– by recruiting expert physicians,

skilled nurses and support staff, and

investing in advanced technology and

state-of-the-art facilities. The KDMC

program was built to rival the best

heart centers in the nation.

Practice makes perfect is a truism in just about every human

endeavor, medicine included. The more heart procedures you

do, the better you become at doing them, which leads to

better outcomes.

At King’s Daughters, we do more cardiovascular procedures

than any other hospital in the region, with excellent results.

We perform some of the most advanced and complex

procedures being performed today… procedures that you

might expect to find only at university-affiliated medical

centers.

King’s Daughters Heart and Vascular Center is a high-volume

program that maintains the highest quality standards while

performing complex procedures.

In 2008, the physicians and staff at KDMC performed:

n 10,753 cardiac catheterizations including:

• 7,745 diagnostic heart caths

• 3,008 angioplasties

• 678 pacemaker and ICD implant procedures

• 548 electrophysiology studies and ablations

n 2,355 vascular catheterizations (peripheral, kidney and

other) including:

• 1,349 diagnostic peripheral artery procedures

• 1,006 peripheral artery interventions

n 905 open-heart surgeries, including:

• 648 coronary artery bypass grafts

• 184 valve surgeries

n 50 maze procedures

n 20 mini maze procedures

n 71,944 non-invasive tests, including echos, dopplers, EKGs

and Holter monitors.

Richard Paulus, M.D.

Medical Director

King’s Daughters Heart & Vascular Center

Richard Paulus, M.D.Cardiologist

Admission statistics

Total inpatients Total outpatients

0

5000

10000

15000

20000

25000

30000

35000

2006

15,0

23

27,7

94 31,6

85

32,5

94

16,2

32

14,8

06

2007 2008

Part I: Access to Care

The Kentucky Heart Institute is committed to delivering world-class cardiac care to the people of this region.”“ —Sri Velury, M.D., medical director

Cardiac Outreach Services

PART I: A

CCESS TO CA

REKING’S DAUGHTERS HEART AND VASCULAR CENTER | OUTCOMES | 5

Kentucky Heart Institute

The Kentucky Heart Institute (KHI) is the

medical practice group for the heart

specialists affiliated with King’s Daughters

Medical Center. KHI is comprised of general

cardiologists, interventional and invasive

cardiologists, electrophysiologists and

cardiothoracic surgeons. The physicians of KHI provide services

throughout eastern Kentucky and southern Ohio, in locations

and settings that are convenient and accessible to area residents.

In many cases, the KHI specialists partner with local providers –

primary care physicians, clinics and hospitals – to provide cardiac

specialty services in the local community.

KHI physicians maintain offices in 16 locations in Kentucky and

seven locations in Ohio. All KHI physicians are board certified

or board eligible and all are fellowship trained. Additionally,

many have completed multiple fellowships in cardiovascular

subspecialties, including nuclear cardiology, electrophysiology,

minimally invasive surgeries and more.

Kentucky Heart Institute Physicians

Cardiologists Arshad Ali, M.D.David Bush, M.D.Richard Ansinelli, M.D. Ghassan Dalati, M.D. Zane Darnell, M.D. Ahmad Elesber, M.D. Chris Epling, D.O.David Glassman, M.D. Roger Klein, M.D.Bipin Nagra, M.D.Richard Paulus, M.D.Vaughn Payne, M.D.Arley Peter, M.D.Lynn Preston, D.O.Terence Ross, M.D.Hullukunte Shivaprasad, M.D.Sriharsha Velury, M.D.

ElectrophysiologistsDavid Glassman, M.D. Bipin Nagra, M.D. Vaughn Payne, M.D. Terence Ross, M.D.

Cardiothoracic Surgeons Robert Fried, M.D. Juan MacHannaford, M.D. Marcos Nores, M.D.

“Many people are reluctant to seek the healthcare they need, so we’re getting out into our communities and taking the first line of care directly to them.”

—Roger Klein, M.D., cardiologist

n Complete KHI physician bios begin on page 31.


PART I: A

CCESS TO CA

RE

Kentucky:

Ashland, Ky. Cardiothoracic Surgeons of KentuckyMedical Plaza B, 613 23rd St., Suite 210 (606) 326-9847

Comprehensive Heart & Vascular Associates 2201 Lexington Ave., Suite G10 (606) 329-1997

Kentucky Heart & Vascular Physicians Medical Plaza B, 613 23rd St., Suite 230 (606) 324-4745 Flatwoods, Ky.Kentucky Heart & Vascular Physicians1109 Bellefonte Road (606) 324-4745

Grayson, Ky.Comprehensive Heart & Vascular Associates 609 Carol Malone Blvd., Suite 105 (606) 474-2235

Kentucky Heart & Vascular Physicians609 Carol Malone Blvd., Suite 105 (606) 474-2235 Inez, Ky.Kentucky Heart & Vascular Physicians Route 40 East (office of Dr. Lon Lafferty) (606) 638-9954

Louisa, Ky.Kentucky Heart & Vascular PhysiciansThree Rivers Medical Plaza2483 Highway 644, Suite 103 (606) 638-9954

Morehead, Ky. Comprehensive Heart & Vascular AssociatesHealth Plus255 Old Viking Drive (606) 329-1997

Paintsville, Ky. Comprehensive Heart & Vascular Associates824 FM Stafford Ave. (606) 329-1997

Pikeville, Ky. Kentucky Heart & Vascular Physicians5425 N. Mayo Trail, Suite 202 (606) 432-2269

Prestonsburg, Ky. Comprehensive Heart & Vascular Associates 1709 KY Route 321 (606) 886-0892

Prestonsburg, Ky.Kentucky Heart & Vascular Physicians5000 KY Route 321, Suite 4102(606) 886-7595

Salyersville, Ky. Comprehensive Heart & Vascular Associates Hope Family Medical Center835 Parkway Drive (606) 886-0892

Vanceburg, Ky. Kentucky Heart & Vascular PhysiciansPrimary PlusAA Highway and Route 59 (606) 796-3029

West Liberty, Ky. Kentucky Heart & Vascular PhysiciansARH Morgan County Clinic476 Liberty Road (606) 743-3198

Ohio:

Burlington, Ohio Kentucky Heart & Vascular Physicians 384 County Road 120 South (740) 894-5126

Ironton, Ohio Comprehensive Heart & Vascular Associates419 Vernon St. (606) 329-1997

Jackson, Ohio Comprehensive Heart & Vascular Associates 14365 State Route 93 (740) 288-7681

Portsmouth, Ohio Comprehensive Heart & Vascular AssociatesKing’s Daughters Medical Specialties2001 Scioto Trail, 2nd Floor(740) 354-8878 Kentucky Heart & Vascular PhysiciansKing’s Daughters Medical Specialties2001 Scioto Trail, 2nd Floor (740) 353-8100

Waverly, Ohio Comprehensive Heart & Vascular Associates 227 Valleyview Drive(740) 354-8878

Wheelersburg, Ohio Comprehensive Heart & Vascular Associates 8750 Ohio River Road (740) 354-8878

Kentucky Heart Institute Practice Locations

Heart & Vascular outreach locations

Comprehensive Heart & Vascular Associates(606) 474-2235 Kentucky Heart & Vascular Physicians(606) 474-2235

Grayson

Comprehensive Heart & Vascular Associates(606) 329-1997

MoreheadCardiothoracic Surgeons of Kentucky(606) 326-9847 Comprehensive Heart & Vascular Associates(606) 329-1997Kentucky Heart & Vascular Physicians(606) 324-4745

Ashland


Ironton


Jackson

Comprehensive Heart & Vascular Associates(606) 886-0892 Kentucky Heart & Vascular Physicians(606) 886-7595

Prestonsburg


Waverly


Salyersville

PortsmouthComprehensive Heart & Vascular Associates(740) 354-8878Kentucky Heart & Vascular Physicians(740) 353-8100

Kentucky Heart & Vascular Physicians(740) 894-5126

Burlington


Inez


Louisa


West Liberty


Pikeville


Flatwoods

Comprehensive Heart & Vascular Associates (740) 354-8878

Wheelersburg


Vanceburg


Paintsville

Toll-free numbers: Comprehensive Heart & Vascular Associates

1-800-624-8240

Kentucky Heart & Vascular Physicians1-866-973-6655


PART I: A

CCESS TO CA

RE

Diagnostic Testing Services

During the past three years,

King’s Daughters has seen

significant growth in the number

of diagnostic cardiac tests

performed.

Part of this growth is attributable to an aging

population. But King’s Daughters has made a

strong commitment to providing cardiac care in

our communities, especially in those areas that are

underserved or unserved.

Today, King’s Daughters cardiologists provide services

in 23 locations throughout the region – making it

possible for people to receive the cardiac care they

need.

Change: +12.5%

0

2000

4000

6000

8000

10000

Echocardiograms

Doppler studies

Holter monitor tests

Electrocardiograms (EKG)

2006

5,9417,064

8,333

2007 2008

2006 2007 2008

2006 2007 2008

Change: +40.3%

Change: +12.5%

Change: -0.1%

Change: +31.6%

0

200

400

600

800

1000

794

575

893

0

500

1000

1500

2000

1,5801,437

1,579

0

10000

20000

30000

40000

50000

60000

70000

46,44854,833

61,139

2006 2007 2008

Zane Darnell, M.D. medical director

Outreach Cardiac Imaging

Reaching Out to the Community

Located in Ashland, Ky., King’s

Daughters Medical Center serves

a broad community in the foothills

of the Appalachian Mountains,

including counties in Kentucky,

Ohio and West Virginia. More

than 900,000 people live in the region served by King’s

Daughters. The area is very rural, with high poverty

levels and substantial health challenges.

Since 1994, King’s Daughters has focused hospital

resources on meeting specific community needs

through its Community Services Department. The staff

of 10 – assisted by more than 2,400 team member

volunteers from throughout the medical center – plans

and coordinates a wide variety of services for adults and

children.

Identifying those at risk for heart and vascular disease,

educating the public about heart attack and stroke signs

and symptoms, and reducing tobacco use throughout

the region are three important areas of focus.

In 2008, Community Services reached 1,332 adults

and 705 children through our Early Heart Attack

Care program and performed 33,083 general health

screenings.

PART I: A

CCESS TO CA

REKING’S DAUGHTERS HEART AND VASCULAR CENTER | OUTCOMES | 9

Screenings 2008

BloodPressure

Ank

le-B

rach

ial

Inde

x

Lipi

d Pr

ofile

Abd

omin

alU

ltra

soun

d

Caro

tid

Ult

raso

und

Total Cholesterol

BloodSugar

0

2000

4000

6000

8000

10000 9,190

335

7,448 7,826

34%

abn

orm

al

30%

abn

orm

al

19%

abn

orm

al

0

100

200

300

400

500 451

200 19930

% a

bnor

mal

67%

abn

orm

al

3%ab

norm

al

4%ab

norm

al

Outreach/Mobile Cardiology

Distance should never stand in the way of great cardiac care, so King’s Daughters provides

cardiac testing services throughout the region. When possible, we work with community

providers, such as clinics and physician offices, to conduct testing in their facilities.

When such arrangements aren’t feasible, we bring services with our Mobile Health Unit. In this

way, we are able to perform stress testing, echocardiography, Doppler studies, ankle-brachial

index studies and Holter monitoring in rural areas.

Part II: Cardiac Catheterization

King’s Daughters cardiac catheterization program performs more procedures each year than any other program in the region.”“ —Chris Epling, D.O., medical director

Chest Pain Center

PART II: CA

RDIA

C CATH

ETERIZATIO

NKING’S DAUGHTERS HEART AND VASCULAR CENTER | OUTCOMES | 11

0

2000

4000

6000

8000

Diagnostic catheterizations

2006

6,771 6,8737,745

2007 2008

Change: +14.0%

Interventional catheterizations

Change: +18.0%

0

1000

2000

3000

4000

2,560

2006 2007 2008

2,6953,008

0

2000

4000

6000

8000

Diagnostic catheterizations

2006

6,771 6,8737,745

2007 2008

Change: +14.0%

Interventional catheterizations

Change: +18.0%

0

1000

2000

3000

4000

2,560

2006 2007 2008

2,6953,008

Cardiac Catheterization

Technology has advanced a

great degree in the past decade,

allowing cardiologists to treat

a wider range of cardiovascular

problems using a catheter-based

approach. Stenting is an important

example of how we’re providing better care to heart

patients today.

In 2008, King’s Daughters performed more than

7,700 diagnostic cardiac catheterizations – more than

any other hospital in our region. Our interventional

cardiologists performed another 3,000 interventional

procedures – opening blocked arteries and placing

drug-eluting stents.

Not only do we strive for clinical excellence, but

patient efficiency as well. Length of stay (LOS) is a term

commonly used to measure the duration of a single

episode of hospitalization. KDMC’s length of stay

numbers for the past three years have been below the

American College of Cardiology (ACC) average.

Length of stay (LOS)

2006 2007 2008 ACCavg.

0.0

0.5

1.0

1.5

2.0

2.5

3.0

2.8 2.77 2.63.0


PART II: CA

RDIA

C CATH

ETERIZATIO

N

Acting Quickly to Save Heart Muscle

The time that elapses between a

heart attack patient’s arrival in the

emergency room and the opening

of the blocked coronary artery is

referred to as door-to-balloon (D2B)

time. The more quickly a blocked

artery can be opened, the less damage a patient is

likely to sustain to the heart muscle. D2B has emerged

as an important measure of quality.

At King’s Daughters, we’ve implemented several

programs that help ensure patients receive the quickest,

most appropriate care. Our Code: Heart program has

allowed us to significantly reduce the amount of time

that elapses between diagnosis and angioplasty.

The national D2B goal is 90 minutes. In 2008, our D2B

average time was just 51 minutes.

We also have worked with emergency departments

throughout our region to develop protocols to

streamline the transfer process so patients who need

the advanced level of care available at King’s Daughters

can receive it quickly.

Our air ambulance services makes it possible for

patients in remote and underserved areas to be

transferred to King’s Daughters quickly.

Average door-to-balloon time

Risk-adjusted mortality

2006 2007 2008 Target

2006 2007 2008 ACCavg.

0

18

36

54

72

90

Less

tha

n 90

min

utes

70minutes

59minutes 51

minutes

0

20

40

60

80

100

1.4% 1.2% 1.3%1.0%

PART II: CA

RDIA

C CATH

ETERIZATIO


Heart attack care

0

20

40

60

80

100

The Centers for Medicare Services (CMS) reports quality data on its Web site, www.hospitalcompare.hhs.gov. These data are useful in comparing hospital performance on specific care measures. King’s Daughters physicians and nurses work hard to ensure patients receive the highest standard of care.

KD

MC

97%

KY

91%

US

94%

KD

MC

99%

KY

92%

US

93%

KD

MC

93%

KY

82% US

90%

KD

MC

99%

KY

94%

US

95%

KD

MC

99%

KY

90%

US

93%

KD

MC

98%

KY

72%

US

77%

heart attackpatients givenaspirin at arrival

heart attackpatients givenaspirin at discharge

heart attackpatients givenACE inhibitoror ARB for LVSD

heart attackpatients givensmokingcessation advice

heart attackpatients givenbeta blockerat discharge

heart attackpatients givenPCI within90 minutes ofarrival

SOURCE: www.hospitalcompare.hhs.gov

“We take quality heart care very seriously at King’s Daughters. Ultimately, it’s people’s lives we are dealing with. There is no greater responsibility than that.”

—Ahmad Elesber, M.D., associate medical directorHeart Failure Services

I am especially excited about advances in minimally invasive heart surgery ... and our patients are, too.”“ —Marcos Nores, M.D., medical director

Cardiothoracic Surgery

Part III: Experienced, Innovative Surgical Care

PART III: SU

RGERY


0

25

50

75

100

Coronary artery bypass graft(CABG)

Change: -14.9%

0

200

400

600

800

665

2006 2007 2008

663566

CABG off-pump & redo

52

2006 2007 2008

37

56

24 18 22

CABG off-pump CABG redo

Surgery on the Cutting Edge

Through a collaboration between cardiology

and cardiac surgery, our physicians are able

to provide innovative care, better outcomes

and improved quality of life for patients with

cardiovascular disease. Our cardiac surgery

program has received five-star ratings from

HealthGrades continuously since 2007 and was named one of

the 100 Top Cardiovascular Programs in the nation by Thomson

Reuters for three consecutive years.

Some of our services include:

• Minimally invasive mitral and aortic valve surgery

• Off-pump coronary artery bypass surgery

• Pump-supported high-risk angioplasty

• Percutaneous perivalvular leak closure

• Percutaneous valve procedures

• Mitral and aortic balloon valvuloplasty

• Acute aortic dissection

• Pulmonary embolism

• Valve-sparing aortic root reconstruction

• Aortic root replacement with tissue or mechanical valves

• Maze and mini maze for atrial fibrillation

• Heart remodeling for heart failure

Coronary artery bypass grafting (CABG) remains the most

frequently performed cardiac surgical procedure at King’s

Daughters. Advances in cardiac catheterization have presented

new options for treatment of blocked coronary arteries, which

have in turn impacted CABG volumes. At the same time,

advances in the operating rooms have allowed cardiothoracic

surgeons to offer new treatment options for valvular disease,

atrial fibrillation and structural heart defects.

Risk-adjusted mortality/stroke

0.0

0.5

1.0

1.5

2.0

1.5%

2006

2007

1.6%

0.8%

STS:

1.7

%

STS:

1.2

%

KDMC STS Database

Risk-adjustedmortality

Risk-adjustedpermanent stroke

0.7%

0.6%

2008

0.2%

2006

2007

2008

SOURCE: Society of Thoracic Surgeons National Cardiac Database, Duke Clinical Research Institute


PART III: SU

RGERY

Surgical Intervention for Heart Defects

Coronary Artery Bypass

Grafting (CABG) will always

be an important part of the

cardiac surgery program. But

new and innovative procedures

that treat heart defects and

abnormalities are emerging that provide new

promise for patients.

Advances in valve surgery are an example of this.

Using minimally invasive approaches, cardiothoracic

surgeons can restore function to stenotic valves,

repair defects and even replace valves through

keyhole-size incisions in the chest. The number

of valve surgeries performed at King’s Daughters

has grown steadily since 2006. In 2009, KDMC

added a cardiothoracic surgeon with subspeciality

fellowship training at the Cleveland Clinic in

endovascular aortic surgery.

Cardiothoracic surgeons, from left, Marcos Nores, M.D.; Juan MacHannaford, M.D.; and Robert Fried, M.D.

0

20

40

60

80

100

2006 2007 2008

Aortic valve replacement

Mitral valverepair

Mitral valvereplacement

Tricuspid valverepair

Valve surgeries

81

63

72

30 31

10

36

47 49 52

15 13

Mortality: CABG, valve andvalve plus CABG procedures

2006 2007 2008 2009 STSdatabase

0

1

2

3

4

5

2.1%

1.2%

2.0%1.9%

SOURCE: Society of Thoracic Surgeons National Cardiac Database, Duke Clinical Research Institute

PART III: SU

RGERY


0

25

50

75

100

0

25

50

75

100

Maze procedures

32

2006 2007 2008

48 50

Maze, minimally invasive

3

2006 2007 2008

11 20

Thoracotomy/lobectomy

2006 2007 20080

25

50

75

100

65

38

107

Surgical Intervention for Heart Arrhythmias

Heart arrhythmias can be

frightening – and frustrating.

Although these problems often

can be treated with medication,

many patients seek a cure.

The electrophysiologists and

cardiothoracic surgeons at King’s Daughters offer

alternatives.

Electrophysiologists map the electrical pathways of

the heart that cause the arrhythmia and can perform

an ablation – destroying the irregular pathways using

electrical freezing or burning techniques.

Cardiothoracic surgeons take a surgical approach,

creating a maze on the surface of the heart that

disrupts the irregular pathways.

In 2008, our cardiothoracic surgeons performed 70

maze procedures – 20 of these using a minimally

invasive approach through ports in the chest.

Part IV: The Medicine of Rhythm Management

Cardiac rhythm problems are very common. Unfortunately, not everyone knows there are effective treatments and interventions available to them.”“ —Terence Ross, M.D., cardiologist/electrophysiologist

Electrophysiology

The field of cardiac rhythm

management is dynamic and

evolving. Emerging technologies

and medical practices include

treatment of atrial and ventricular

arrhythmias, treatment of heart

failure, remote follow-up of devices and prophylactic

use of implantable cardiac defibrillators (ICDs). Each

year, more and more people in the U.S. are implanted

with some type of device to improve heart function and

protect them from sudden cardiac death.

At KDMC, electrophysiology has emerged as

a high-volume subspecialty of cardiology. The

electrophysiologists are supported by an outstanding

team of physicians, nurses, radiologic technologists and

support staff, with experience in cardiovascular care as

well as device management.

Cardiac arrhythmias are very common, with atrial

fibrillation the most commonly diagnosed disorder.

While much can be done with medications to improve

heart rhythm problems, there are times when further

evaluation, testing, device implantation or surgical

procedures may be appropriate.

Components of our program include:

• three board certified/board eligible fellowship-trained

electrophysiologists

• electrophysiology laboratories with advanced

mapping technology, including CARTO 3-D mapping

system integrated with the EP MED

• View Mate intracardiac echocardiogram system

• anticoagulant therapy clinics throughout the region

0

75

150

225

300

0

75

150

225

300

EP studies

EP studies with ablation

2006

173

248

296

141

232252

2007 2008

2006 2007 2008

Change: +71%

Change: +79%

PART IV: ELECTRO

PHYSIO

LOG

YKING’S DAUGHTERS HEART AND VASCULAR CENTER | OUTCOMES | 19

EP studiesOur electrophysiologists performed 548

electrophysiology studies in 2008; of these

252 patients also underwent ablation. During

an ablation, the cardiologist freezes or burns

the abnormal electrical pathways in the heart

to reduce or eliminate arrhythmias. Overall,

volumes grew by 70 percent from 2006 to

2008.

Implantable Devices

More and more people are

surviving heart attacks and other

cardiac incidents. Those who seek

treatment quickly have the best

opportunity to return to full, normal

lives. Unfortunately, those who

delay seeking care often suffer permanent damage and

require assistive devices – such as pacemakers or ICDs

— to maintain normal heart function.

Over the years, we’ve seen a steady growth in the

number of patients requiring assistive devices.

The bi-ventricular pacemaker, a relatively new

technology, offers hope to patients with advanced heart

failure. As this technology has become accepted, we

have seen significant growth in the number of patients

receiving this support.


PART IV: ELECTRO

PHYSIO

LOG

Y 0

75

150

225

300

0

75

150

225

300

Permanent pacemakerinsertion

ICD insertion

2006

230255 259

149169

233

2007 2008

2006 2007 2008

Change: +13%

Change: +56%

0

75

150

225

300Bi-ventricular pacemaker/ICD

78

157186

2006 2007 2008

Change: +138%

Electrophysiologists, from left, David Glassman, M.D., Terence Ross, M.D., and Bipin Nagra, M.D.

Part V: Vascular Care

Vascular disease is more prevalent than most people realize... and it doesn’t have to be accepted as part of the normal aging process.”“ —Omran Abul-Khoudoud, M.D., medical director

Vascular Surgery

Vascular Disease

An estimated 15 million Ameri-

cans have vascular disease and

another 20 to 30 million are at risk

for developing it. While we all are

familiar with the effects of heart

disease, most Americans are un-

aware that their vascular systems are subject to many

of the same problems as the heart. And in fact, vascu-

lar disease causes almost as much death and disability

as heart disease and more than any type of cancer.

At King’s Daughters, we’re dedicated to helping

people understand vascular disease, its risks and

prevention. We sponsor educational programs and

screenings throughout our region to spread the word

– poor circulation isn’t to be ignored. Our vascular

specialists – vascular/endovascular surgeons, interven-

tional cardiologists and interventional radiologists – are

leading the fight against the devastating impact of

peripheral vascular disease, abdominal aortic aneurysm

and carotid artery disease.

Abdominal Aortic AneurysmThis “silent killer” is a particular threat to men over the

age of 50, smokers and people with a family history of

AAA. In 2009, KDMC launched a new program of free

core vascular screenings to aid in early detection of this

killer. Our goal is to identify at-risk individuals and refer

them to appropriate care before a health crisis.

Carotid SurgeryDuring a carotid endarterectomy, the surgeon removes

plaque and calcium deposits to improve blood flow

to the brain. The goal is to reduce the risk of stroke.

Screening for blockages of the carotid arteries is part

of our new core vascular screening program.


PART V: VA

SCULA

R CARE

Vascular/endovascular surgeons, clockwise from front, Omran Abul-Khoudoud, M.D., Al Addasi, M.D., and Alexander Hou, M.D.

Screening to save lives

Screening is an important

component of our vascular

program. In 2009, we conducted

more than 1,300 free vascular

screenings throughout the region,

including our annual Legs for Life

program in October, in which 124

people were screened in one day.

On average, 32 percent of those

screened have abnormal readings

and are referred for care.

Peripheral Vascular Disease

Peripheral vascular disease affects

the circulation of blood in the arms

and legs. Also known as PAD, this

disease is one of the leading causes

of amputation in the United States.

PAD is not something to be accepted with age — there

are effective medications, catheter-based treatments

and surgical procedures that can make a difference.

0

500

1000

1500

2000

0

300

600

900

1200

Peripheral artery catheterizations (diagnostic)

1,849

2006 2007 2008

1,311 1,349

Peripheral arterycatheterizations (interventional)

839

2006 2007 2008

967 1,006

Change: -27.0%

Change: +20.0%

Interventional radiologists Wes Lewis, M.D., and Pho Nguyen, M.D.

PART V: VA

SCULA

R CARE


Part VI: Quality Care at the hospital and beyond

Above all else, it’s people we are caring for, and about. They deserve our best... and we’re committed to delivering it every day.”“ —David Bush, M.D., cardiologist

PART V

I: FOLLO

W-U

P CARE


HCAHPS patient satisfaction scores

0

20

40

60

80

100

Another measure of patient satisfaction is the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey conducted by the Centers for Medicare Services. The HCAHPS study focuses only on those enrolled in Medicare.

KD

MC

200

7: 8

5%

KD

MC

200

7: 8

2%

KD

MC

200

7: 8

8%

KD

MC

200

8: 8

3%

KD

MC

200

8: 8

5%

KD

MC

200

8: 8

4%

KY

200

8: 6

5%

KY

200

8: 8

0%

KY

200

8: 6

7%

NA

TIO

NA

L 20

08: 6

5%

NA

TIO

NA

L 20

08: 7

9%

NA

TIO

NA

L 20

08: 6

9%

Patients are asked to ratethe hospital on a scale of 1 to 10,with 10 being the best score.Patients giving a 9 or 10.

Patients saying “yes,” they would definitely recommend the hospital where they receivedcare.

Patients who said their doctoralways listened carefully.

Patient Satisfaction

Patient satisfaction is an

important component of

quality, so we conduct ongoing

surveys to help us continually

improve our services. Patients are

randomly selected to participate

in the Press Ganey Study of Patient Satisfaction.

Patients are asked about nurse and physician

communication, cleanliness, comfort, food and other

factors regarding their stay.

Press Ganey conducts patient satisfaction surveys for

more than 3,000 hospitals across the country, making

it the most widely used, and most competitive

database available. 0

20

40

60

80

100

Inpatient satisfaction

2006meanscore

89.0 90.1 89.5

2007meanscore

2008meanscore

Percentile ranking: 99th*

Heart and Vascular Center inpatients were asked to rate their hospital stay on a scale of 1 to 5, with 1 meaning very poor and 5 meaning very good. These numbers are then converted to a 100 point scale and a mean score is calculated.

*A ranking in the 99th percentile means our program is among the top one percent in the nation when it comes to patient satisfaction.


PART V

I: FOLLO

W-U

P CARE

Returning Patients to Strength

Phase I cardiac rehabilitation

occurs in the inpatient setting,

immediately following cardiac

incident or treatment. Phase

II and Phase III occur in the

outpatient setting. Typically,

patients have three cardiac rehab visits a week for

12 weeks. It is a medically monitored exercise

program. Upon completion of Phase II, patients may

enter Phase III, which is a maintenance program.

Fewer people participated in Phase III rehab from

2006 to 2008, a decline most likely attributable to

high gasoline prices and the economic downturn.

0

1000

2000

3000

4000

5000

6000

2006

2,23

3 2,75

2

2,77

8

4,06

3

5,26

2

5,18

9

4,22

1

2,40

4

930

2007 2008

Phase I Phase II Phase III

Cardiac rehabilitation visits

PART V

I: FOLLO

W-U

P CARE


The King’s Daughters Cardiology

Clinic provides individualized

services to patients taking blood

thinners, those diagnosed with

heart failure and people with

difficult to manage lipid profiles.

Anticoagulant therapy

The coumadin service works in conjunction with the

referring physician to help ensure anticoagulant therapy

is as safe and effective as possible. Services include:

• Education

• Laboratory testing (INR levels)

• One-on-one consultation and support

King’s Daughters provides coumadin services in

Ashland, Grayson and Prestonsburg, Kentucky and

in Portsmouth, Ohio.

Heart failure clinic

Patients diagnosed with heart failure are at increased

risk for multiple hospitalizations. Our heart failure

services are designed to help patients and families

manage symptoms, reduce hospitalizations and lead

the most independent life possible. Services include:

• Medication optimization

• Point of Care testing

• Hemodynamic monitoring using BioZ

• IV diuretic therapy

• Assistance with implanted device optimization

• Accurate scales

• 24/7 telephone support and advice

• Monthly support group

• Formalized family education

• Referrals for needed services including oxygen,

home health and sleep studies

• Nutrition counseling

• Social work services

Lipid clinic

Patients with lipid problems sometimes require

personalized/detailed care. The KDMC lipid clinic

provides diagnostic testing, monitoring and nutritional

advice. Patients are supported in making lifestyle and

behavioral changes that affect lipid levels. Health

professionals give special attention to patients with:

• Difficult to treat cholesterol problems

• Inherited lipid disorders

• Liver or kidney problems that limit medication choice

Cardiology Clinic: Care for chronic heart problems

“ Patients with chronic heart conditions

face special challenges. Our Cardiology Clinic helps them manage symptoms and medications to reduce hospitalizations and improve quality of life.”

—Richard Ansinelli, M.D., associate medical director

Heart Failure Services

Part VII: Kentucky Heart Foundation

By participating in cardiovascular research we are pushing the boundaries of medicine further, which ultimately results in better outcomes for our patients.”“ —Arshad Ali, M.D., cardiologist and

associate medical director, Kentucky Heart Foundation

PART V

II: KEN

TUCK

Y HEA

RT FOU

ND

ATIO


Kentucky Heart Foundation

The Kentucky Heart Foundation is

a cardiovascular research institute

dedicated to improving the

quality of life, reducing the impact

of cardiovascular disease and

advancing the frontiers of medical

science. The Foundation was initiated in 2007 through

a generous donation by KDMC cardiologist Richard

Paulus, M.D.

VISION

To improve the quality of life by reducing the

devastating impact of cardiovascular disease.

MISSION

To reduce the impact of heart and vascular disease

through research, prevention and education.

The Kentucky Heart Foundation is a 501(c)3 non-

profit organization that relies solely on government

and foundation grants, research contracts, corporate

donations and contributions from individuals who

support the Foundation’s vision and mission.

During Fiscal Year 2008, the Kentucky Heart

Foundation was the conduit for a number of active

trials, including:

CHAMPION PCI: a clinical trial comparing Cangrelor

to Clopidogrel in subjects who require percutaneous

coronary intervention.

IMPROVE-IT: a multicenter, double-blind, randomized

study to establish the clinical benefit and safety of

Vytorin vs. Simvastatin in monotherapy in high-risk

subjects presenting with acute coronary syndrome.

PROTECT II: a prospective, multi-center, randomized

trial of the IMPELLA RECOVER LP205 system vs.

intraaortic balloon pump in patients undergoing non-

emergent, high-risk PCI.

DETERMINE: defibrillators to reduce risk by magnetic

resonance imaging evaluation.

SAPPHIRE: a stenting and angioplasty with protection

in patients at high risk for endarterectomy.

PLATO: a randomized, double-blind, parallel group,

phase 3, efficacy and safety study of ZAD6140

compared with Clopidogrel for prevention of vascular

events in patients with non-ST or ST elevation acute

coronary syndromes.

COGENT: a clinical trial to determine whether CGT-

2168 (Clopidogrel and Omeprazole) compared to

Clopidogrel is safe and effective in reducing the

incidence of gastrointestinal bleeding and symptomatic

ulcer disease in the setting of concomitant aspirin

therapy.

HIT-HITTs: a Bivalirudin PCI registry designed to compare

outcomes of patients who receive Bivalirudin instead

of Heparin to reduce the incidence of Heprin-induced

thrombocytopenia.

SATURN: A 104-week, randomized, double-blind,

parallel group, multi-center Phase IIIb study comparing

the effects of treatment with Rosuvastatin 40 mg or

Atorvastatin 80 mg on atherosclerotic disease burden

as measured by intravascular ultrasound in patients

with coronary artery disease.

PIVOTAL: positive impact of endovascular options

for treating aneurysms early.


PART V

III: PHYSICIA

NS/O

ffice Locations

Part VIII: Our Heart & Vascular Physicians

We have assembled an outstanding group of physicians and surgeons here. I have the highest level of confidence in my colleagues and know each one is committed to outstanding patient care.“ —Richard Paulus, M.D., medical director

King’s Daughters Heart & Vascular Center

Kentucky Heart Institute PhysiciansCardiologists

Arshad Ali, M.D.also: Peripheral Vascular Specialisttelephone: (606) 329-1997 • fax: (606) 329-1227Comprehensive Heart & Vascular AssociatesHeart and Vascular Center • 2201 Lexington Ave., Suite G10 Ashland, KY 41101

Medical School: Rawalpindi Medical College, Rawalpindi, Pakistan, 1983Residency: State University of New York - Buffalo, Buffalo, N.Y., 1994Cardiovascular Fellowship: Ochsner Foundation Hospital and Clinic, New Orleans, La., 1997 Coronary and Peripheral Interventional Fellowship: St. John Hospital, Detroit, Mich., 1998

Board Certification: American Board of Internal Medicine, subspecialty certifications in Cardiovascular Disease and Interventional Cardiology

Richard Ansinelli, M.D.also: Peripheral Vascular Specialisttelephone: (606) 324-4745 • fax: (606) 324-4941Kentucky Heart & Vascular PhysiciansMedical Plaza B • 613 23rd St., Suite 230, Ashland, KY 41101

Medical School: The Ohio State University, Columbus, Ohio, 1976Residency: Walter Reed Army Medical Center, Washington, D.C., 1979Cardiology Fellowship: Walter Reed Army Medical Center, Washington, D.C., 1981Board Certification: American Board of Internal Medicine, subspecialty certifications in Cardiovascular Disease and Interventional Cardiology

David Bush, M.D.telephone: (606) 324-4745 • fax: (606) 324-4941Kentucky Heart & Vascular PhysiciansMedical Plaza B • 613 23rd St., Suite 230, Ashland, KY 41101

Medical School: University of Louisville, Louisville, Ky., 1988Residency: University of Louisville hospitals, Louisville, Ky., 1991Cardiology Fellowship: University of Louisville hospitals, Louisville, Ky., 1993Chief Cardiovascular Fellow: University of Louisville hospitals, Louisville, Ky., 1994Board Certification: American Board of Internal Medicine, subspecialty certification in Cardiovascular Disease

PART V

III: PHYSICIA

NS/C

ardiologistsKING’S DAUGHTERS HEART AND VASCULAR CENTER | OUTCOMES | 31


PART V

III: PHYSICIA

NS/C

ardiologists

Ghassan Dalati, M.D.telephone: (606) 886-0892 • fax: (606) 886-9746Comprehensive Heart & Vascular Associates400 University Drive, Suite 205, Prestonsburg, KY 41653

Medical School: University of Damascus, Syria, 1997Residency: University of Missouri-Columbia, Columbia, Mo., 2002Fellowship: Louisiana State University, Baton Rouge, La., 2005Board Certification: American Board of Internal Medicine, subspecialty certification in Cardiovascular Disease

Zane Darnell, M.D.also: Peripheral Vascular Specialisttelephone: (606) 324-4745 • fax: (606) 324-4941Kentucky Heart & Vascular PhysiciansMedical Plaza B613 23rd St., Suite 230, Ashland, KY 41101

Medical School: Northeastern Ohio Universities College of Medicine, Rootstown, Ohio, 1995Residency: Marshall University School of Medicine, Huntington, W.Va., 1998 Cardiovascular Fellowship: Marshall University, Huntington, W.Va., 2001Board Certification: American Board of Internal Medicine, subspecialty certification in Cardiovascular Disease

Ahmad Elesber, M.D.also: Peripheral Vascular Specialisttelephone: (606) 329-1997 • fax: (606) 329-1227Comprehensive Heart & Vascular AssociatesHeart and Vascular Center, 2201 Lexington Ave., Suite G10 Ashland, KY 41101

Medical School: American University of Beirut, Beirut, Lebanon, 1999Internship: American University of Beirut, Beirut, Lebanon, 2000Residency: Mayo Clinic College of Medicine, Rochester, Minn., 2003Cardiology Fellowship: Mayo Clinic College of Medicine, Rochester, Minn., 2006Cardiology/Interventional Cardiology Fellowship: Mayo Clinic College of Medicine, Rochester, Minn., 2007Board Certification: American Board of Internal Medicine, subspecialty certifications in Cardiovascular Disease and Interventional Cardiology

PART V

III: PHYSICIA

NS/C


Chris Epling, D.O.also: Peripheral Vascular Specialisttelephone: (606) 324-4745 • fax: (606) 324-4941Kentucky Heart & Vascular PhysiciansMedical Plaza B613 23rd St., Suite 230, Ashland, KY 41101

Medical School: West Virginia School of Osteopathic Medicine, Lewisburg, W.Va., 1997 Residency: Frankford Hospital, Philadelphia, Pa., 2000 Invasive Cardiology Fellowship: Marshall University, Huntington, W.Va., 2003Interventional Cardiology/Peripheral Vascular Disease Fellowship: The Ohio State University Medical Center, Columbus, Ohio, 2004Board Certification: American Osteopathic Board of Internal Medicine, subspecialty certification in Cardiology

David Glassman, M.D.also: Electrophysiologisttelephone: (606) 324-4745 • fax: (606) 324-4941Kentucky Heart & Vascular PhysiciansMedical Plaza B613 23rd St., Suite 230, Ashland, KY 41101

Medical School: Indiana University School of Medicine, Indianapolis, Ind., 2002Residency: University of Iowa, Iowa City, Iowa, 2005Cardiology/Cardiac Electrophysiology Fellowship: Brown University, Providence, R.I., 2009Board Certification: American Board of Internal Medicine

Roger Klein, M.D.telephone: (606) 329-1997 • fax: (606) 329-1227Comprehensive Heart & Vascular AssociatesHeart and Vascular Center2201 Lexington Ave., Suite G10, Ashland, KY 41101

Medical School: University of Cincinnati, Cincinnati, Ohio, 1979Residency: Jewish Hospital, Cincinnati, Ohio, 1982Fellowship: Jewish Hospital, Cincinnati, Ohio, 1983Cardiology Fellowship: Marshall University, Huntington, W.Va., 1987Board Certification: American Board of Internal Medicine, subspecialty certification in Cardiovascular Disease

Bipinpreet Nagra, M.D.also: Electrophysiologisttelephone: (606) 329-1997 • fax: (606) 329-1227Comprehensive Heart & Vascular AssociatesHeart and Vascular Center2201 Lexington Ave., Suite G10, Ashland, KY 41101

Medical School: University of Delhi Maulana Azad Medical College, New Delhi, India, 1999Internship: University of Connecticut, Farmington, Conn., 2001Residency: Albert Einstein Medical Center, Philadelphia, Pa., 2003Cardiology Fellowship: Albert Einstein Medical Center, Philadelphia, Pa., 2006 Electrophysiology Fellowship: The Ohio State University, Columbus, Ohio, 2007Board Certification: American Board of Internal Medicine, subspecialty certifications in Cardiovascular Disease and Clinical Cardiac Electrophysiology


PART V

III: PHYSICIA

NS/C

ardiologists

Richard Paulus, M.D.also: Peripheral Vascular Specialisttelephone: (606) 324-4745 • fax: (606) 324-4941Kentucky Heart & Vascular PhysiciansMedical Plaza B613 23rd St., Suite 230, Ashland, KY 41101

Medical School: University of Vermont, Burlington, Vt., 1973Internship: Harkness Hospital, San Francisco, Calif., 1974Residency: University of Vermont Medical Center Hospital, Burlington, Vt., 1976Residency: Alaska Regional Hospital, Anchorage, Alaska, 1977Cardiology Fellowship: Texas Heart Institute/St. Luke’s Episcopal Hospital, Houston, Texas, 1987Board Certification: American Board of Internal Medicine, subspecialty certification in Cardiovascular Disease

Vaughn Payne, M.D.also: Electrophysiologist; Peripheral Vascular Specialisttelephone: (606) 886-7595 • fax: (606) 886-7529Kentucky Heart & Vascular Physicians5000 Ky. Route 321, Prestonsburg, KY 41653

Medical School: University of Missouri at Kansas City, Kansas City, Mo., 1986Residency: University of Louisville School of Medicine, Louisville, Ky., 1989Cardiology Fellowship: University of Louisville School of Medicine, Louisville, Ky., 1991Electrophysiology Fellowship: University of Louisville School of Medicine, Louisville, Ky., 1992Board Certification: American Board of Internal Medicine, subspecialty certification in Cardiovascular Disease

Arley Peter, M.D.telephone: (606) 324-4745 • fax: (606) 324-4941Kentucky Heart & Vascular PhysiciansMedical Plaza B613 23rd St., Suite 230, Ashland, KY 41101

Medical School: Federal University of Ceara, Fortaleza, Brazil, 2000Residency: University of Miami, Miami, Fla., 2004Cardiology Fellowship: University of Miami, Miami, Fla., 2007Board Certification: American Board of Internal Medicine, subspecialty certification in Cardiovascular Disease

Lynn Preston, D.O.telephone: (606) 638-9954 • fax: (606) 638-3595Kentucky Heart & Vascular Physicians2483 Highway 644, Suite 103Louisa, KY 41230

Medical School: Chicago College of Osteopathic Medicine, Downers Grove, Ill., 1994Residency: Rush Presbyterian-St. Luke’s Medical Center, Chicago, Ill., 1997Cardiology Fellowship: Rush Presbyterian-St. Luke’s Medical Center, Chicago, Ill., 2000Board Certification: American Board of Internal Medicine

PART V

III: PHYSICIA

NS/C


Terence Ross, M.D.also: Electrophysiologisttelephone: (606) 324-4745 • fax: (606) 324-4941Kentucky Heart & Vascular PhysiciansMedical Plaza B613 23rd St., Suite 230, Ashland, KY 41101

Medical School: Thomas Jefferson Medical College, Philadelphia, Pa., 1981Residency: William Beaumont Army Medical Center, El Paso, Texas, 1984Cardiology Fellowship: Brooke Army Medical Center, San Antonio, Texas, 1986 Board Certification: American Board of Internal Medicine, subspecialty certifications in Clinical Cardiac Electrophysiology, Cardiovascular Disease and Interventional Cardiology

Hullukunte Shivaprasad, M.D.telephone: (740) 354-8878 • fax: (740) 354-1642Comprehensive Heart & Vascular AssociatesKing’s Daughters Medical Specialties - Portsmouth2001 Scioto Trail, 2nd Floor, Portsmouth, OH 45662

Medical School: Bangalore Medical College, Bangalore, India, 1973Residency: Mount Vernon Hospital, Mount Vernon, N.Y., 1979Fellowship: Wright State University/VA Medical Center, Dayton, Ohio, 1981Board Certification: American Board of Internal Medicine, subspecialty certification in Cardiovascular Disease

Sriharsha Velury, M.D.also: Peripheral Vascular Specialisttelephone: (606) 329-1997 • fax: (606) 329-1227Comprehensive Heart & Vascular AssociatesHeart and Vascular Center2201 Lexington Ave., Suite G10, Ashland, KY 41101

Medical School: Gandhi Medical College, Hyderabad, India, 1982Residency: St. Vincent Hospital, Worchester, Mass., 1991Cardiology Fellowship: St. Vincent Hospital, Worchester, Mass., 1994Interventional Cardiology Fellowship: St. Vincent Hospital, Worchester, Mass., 1995Board Certification: American Board of Internal Medicine, subspecialty certification in Cardiovascular Disease


PART V

III: PHYSICIA

NS/C

ardiothoracic Surgeons

Cardiothoracic Surgeons

Robert Fried, M.D.telephone: (606) 326-9847 • fax: (606) 324-3418Cardiothoracic Surgeons of KentuckyMedical Plaza B613 23rd St., Suite 210Ashland, KY 41101

Medical School: Georgetown University, Washington, D.C., 1983Internship: St. Vincent’s Hospital and Medical Center, New York, N.Y., 1984General Surgery Residency: St. Vincent’s Hospital and Medical Center, New York, N.Y., 1988Surgical Critical Care Fellowship: Mt. Sinai Hospital and Medical Center, New York, N.Y., 1989Cardiothoracic Surgery Fellowship: The New York Hospital/Cornell Medical Center, New York, N.Y., 1990Cardiothoracic Surgery Residency: Montefiore - Albert Einstein Hospital, New York, N.Y., 1992Board Certification: American Board of Surgery; American Board of Thoracic Surgery

Juan MacHannaford, M.D.telephone: (606) 326-9847 • fax: (606) 324-3418Cardiothoracic Surgeons of KentuckyMedical Plaza B613 23rd St., Suite 210Ashland, KY 41101

Medical School: University of Illinois College of Medicine, Chicago, Ill., 1999Residency: University of Illinois Metropolitan Group Hospitals, Chicago, Ill., 2004Cardiothoracic Surgery Fellowship: Rush University Medical Center, Chicago, Ill., 2007Endovascular Aortic Fellowship: Cleveland Clinic, Cleveland, Ohio, 2008Board Certification: American Board of Surgery; American Board of Thoracic Surgery

Marcos Nores, M.D.telephone: (606) 326-9847 • fax: (606) 324-3418Cardiothoracic Surgeons of KentuckyMedical Plaza B613 23rd St., Suite 210Ashland, KY 41101

Medical School: University of Buenos Aires, Buenos Aires, Argentina, 1989Internship: St. Elizabeth’s Hospital of Boston, Boston, Mass., 1993General Surgery Residency: Cedars Sinai Medical Center, Los Angeles, Calif., 1998Thoracic Surgery Residency: George Washington University, Washington, D.C., 2000Cardiothoracic Surgery Residency: Cleveland Clinic Foundation, Cleveland, Ohio, 2003; chief resident for Cardiothoracic Surgery, 2002Board Certification: American Board of Surgery; American Board of Thoracic Surgery

PART V

III: PHYSICIA

NS/Electrophysiologists


Electrophysiologists

David Glassman, M.D.See listing under Cardiologiststelephone: (606) 324-4745 • fax: (606) 324-4941Kentucky Heart & Vascular PhysiciansMedical Plaza B613 23rd St., Suite 230, Ashland, KY 41101

Bipinpreet Nagra, M.D.See listing under Cardiologiststelephone: (606) 329-1997 • fax: (606) 329-1227Comprehensive Heart & Vascular AssociatesHeart and Vascular Center2201 Lexington Ave., Suite G10, Ashland, KY 41101

Vaughn Payne, M.D.See listing under Cardiologiststelephone: (606) 886-7595 • fax: (606) 886-7529Kentucky Heart & Vascular Physicians5000 Ky. Route 321, Prestonsburg, KY 41653

Terence Ross, M.D.See listing under Cardiologiststelephone: (606) 324-4745 • fax: (606) 324-4941Kentucky Heart & Vascular PhysiciansMedical Plaza B613 23rd St., Suite 230, Ashland, KY 41101


PART V

III: PHYSICIA

NS/Pediatric C

ardiologists

Pediatric Cardiologists

n Through an agreement with Pediatric Cardiology Associates of Louisville, Ky., the Kentucky Heart Institute provides pediatric cardiology services at King’s Daughters Medical Center.

Bradley Keller, M.D.telephone: 1-800-334-8635Kentucky Heart InstituteKing’s Daughters Medical Center2201 Lexington Ave. • Ashland, KY 41101

Medical School: Pennsylvania State University, Philadelphia, Pa., 1985Residency: Johns Hopkins Hospital, Baltimore, Md., 1988Pediatric Cardiology Fellowship: University of Rochester School of Medicine, Roch-ester, N.Y., 1991Board Certification: American Board of Pediatrics, subspecialty certification in Pediatric Cardiology

Robert Solinger, M.D.telephone: 1-800-334-8635Kentucky Heart InstituteKing’s Daughters Medical Center2201 Lexington Ave. • Ashland, KY 41101

Medical School: University of Louisville School of Medicine, Louisville, Ky., 1967Residency: University of Louisville School of Medicine, Louisville, Ky., 1969Pediatric Cardiology Fellowship: University of Louisville Hospitals, Louisville, Ky., 1972Board Certification: American Board of Pediatrics, subspecialty certification in Pediatric Cardiology

Additional Heart & Vascular SpecialistsCardiologists

Michele Friday, M.D.telephone: (606) 833-0144 • fax: (606) 833-01131180 St. Christopher Dr., Suite 2, Ashland, KY 41101

Medical School: St. George’s University of Medicine, Grenada, West Indies, 1988Internship: Grenada General Hospital, Grenada, West Indies, 1991Residency: St. Michael’s Medical Center, Newark, N.J., 1997Cardiology Fellowship: St. Michael’s Medical Center, Newark, N.J., 2000Interventional Cardiology Fellowship: Beth-Israel Medical Center, New York, N.Y., 2002Board Certification: American Board of Internal Medicine, subspecialty certification in Cardiovascular Disease

Malcolm A. King, M.D.telephone: (606) 325-9633 • fax: (606) 325-96342301 Lexington Ave., Suite 205Ashland, KY 41101

Medical School: University of Kentucky, Lexington, Ky., 1982Residency: Indiana University Medical Center, Indianapolis, Ind., 1985Cardiology Fellowship: University of Kentucky, Lexington, Ky., 1987Post-Fellowship: University of Kentucky, Lexington, Ky., 1988Board Certification: American Board of Internal Medicine, subspecialty certification in Cardiovascular Disease

Yogendra Prasad, M.D.telephone: (606) 833-0144 • fax: (606) 833-01131180 St. Christopher Dr., Suite 2 Ashland, KY 41101

Medical School: University of Agra, India, 1994Residency: Bronx-Lebanon Hospital Center, New York, N.Y., 2001Cardiovascular Disease Fellowship: Montefiore Medical Center, New York, N.Y., 2004Board Certification: American Board of Internal Medicine, subspecialty certification in Cardiovascular Disease

PART V

III: PHYSICIA

NS/C



PART V

III: PHYSICIA

NS/Interventional Radiologists

Charles Rhodes, M.D.telephone: (606) 836-9613 • fax: (606) 836-0026Ashland-Bellefonte Cardiology800 St. Christopher Dr., Suite 1Ashland, KY 41101

Medical School: Cornell University, New York, N.Y., 1974Residency: Duke University Medical Center, Durham, N.C., 1977Cardiology Fellowship: Duke University Medical Center, Durham, N.C., 1979Board Certification: American Board of Internal Medicine, subspecialty certification in Cardiovascular Disease

Interventional Radiologists

Paul Wesley Lewis, M.D.telephone: (606) 408-4311 • fax: (606) 408-7096Tri-State Radiology • KDMC Radiology Department2201 Lexington Ave. • Ashland, KY 41101

Medical School: University of Kentucky, Lexington, Ky., 1994Residency: University of Cincinnati, Cincinnati, Ohio, 1998Interventional Radiology Fellowship: University of Cincinnati, Cincinnati, Ohio, 1999 Board Certification: American Board of Radiology, subspecialty certfication in Vascular and Interventional Radiology

Pho Nguyen, M.D.telephone: (606) 408-4311 • fax: (606) 408-7096Tri-State Radiology • KDMC Radiology Department2201 Lexington Ave. • Ashland, KY 41101

Medical School: University of Cincinnati College of Medicine, Cincinnati, Ohio, 2000Internship: Jewish Hospital, Cincinnati, Ohio, 2001Residency: University of Tennessee, Knoxville, Tenn., 2005Vascular and Interventional Radiology Fellowship: Duke University Medical Center, Durham, N.C., 2006Board Certification: American Board of Radiology, subspecialty certification in Vascular and Interventional Radiology

PART V

III: PHYSICIA

NS/Vascular Surgeons


Vascular/Endovascular Surgeons

Omran Abul-Khoudoud, M.D. telephone: (606) 326-1675 • fax: (606) 326-1436Tri-State Vascular Group2301 Lexington Ave., Suite 230, Ashland, KY 41101Also: 2001 Scioto Trail, Portsmouth, OH 45662

Medical School: American University of Beirut, Beirut, Lebanon, 1995 General Surgery Residency: Union Memorial Hospital, Baltimore, Md., 2000 Vascular Surgery Fellowship: University of Medicine and Dentistry of New Jersey-Robert Wood Johnson, New Brunswick, N.J., 2001Board Certification: American Board of Surgery, subspecialty certification in Vascular Surgery

Al Addasi, M.D. telephone: (606) 326-1675 • fax: (606) 326-1436Tri-State Vascular Group2301 Lexington Ave., Suite 230, Ashland, KY 41101Also: 2001 Scioto Trail, Portsmouth, OH 45662

Medical School: University of Jordan, Amman, Jordan, 1996 General Surgery Residency: Union Memorial Hospital, Baltimore, Md., 2006 Vascular Surgery Fellowship: Henry Ford Hospital, Detroit, Mich., 2008Board Certification: American Board of Surgery, subspecialty certification in Vascular Surgery

Alexander Hou, M.D.telephone: (606) 324-1070 • fax: (606) 324-1071Vascular Institute of KentuckyMedical Plaza A617 23rd St., Suite 445, Ashland, KY 41101

Medical School: University of Medicine and Dentistry of New Jersey - Robert Wood Johnson Medical School, Camden, N.J., 1996Internship: Abington Memorial Hospital, Abington, Pa., 1997 General Surgery Residency: Graduate Hospital, Philadelphia, Pa., 2002Vascular and Endovascular Fellowship: Maimonides Medical Center, Brooklyn, N.Y., 2004

01/10 • 2500

Named by FORTUNE Magazine as One America’s Top Employers, 2008-2009-2010

Named by FORTUNE Magazine as one of America’s Top Employers, 2008-2009-2010

PLACESBEST

WORKRanked as one of

America’s Best Places to Work in Healthcare,

2008-2009

One of the Nation’s100 Top Hospitals

2004-2005-2006-2007-2008

One of the Nation’s100 Top Hospitals forCardiovascular Care,

2006-2007-2008

★★★★★Cardiac Surgery

2007-2008-2009-2010Vascular Care, 2010

Top 5% of Cardiac Surgery Programs in the Nation

Best in the Region for Critical Care, 2009-2010

World-Class Care From One of America’s Best Hospitals

One of the Best Places to Work in Kentucky, 2007-2008-2009-2010

King’s Daughters Medical Center is accredited by the Society of Chest Pain Centers, 2004-2010

Accredited by the Joint Commission on Accreditation of Healthcare Organizations. Earned the Joint Commission’s Gold Seal of Approval,™ 2007-2010

KDMC’s Surgical Weight Loss program is a Center of Excellence as designated by the American Society for Bariatric Surgery,2008-2011

KDMC’s cancer program earned “Three-Year Approval with Commendation” from the

American College of Surgeons Commission on Cancer.

The Cancer Resource Center also is recognized as a “Comprehensive

Community Cancer Program”2010-2013

King’s Daughters earned accreditation from the

American College of Radiology for MRI, CT scans, and ultrasound, 2009-2012

KDMC’s Spine and Pain Center earned accreditation from the

American Academy of Pain Management, 2007-2010

KDMC’s Rehabilitation Center has earned continuous accreditation since 1985 by the Commission on Accreditation of Rehabilitation

Facilities, 2008-2011

Our Vision

World-Class CareIn Our

Communities

Our Mission

To Care.To Serve.To Heal.

achieving quality: an outcomes report

Documents

heart procedures

vascular center outcomes

peripheral vascular

topnotch heart

cardiovascular procedures

complex procedures

entire kings daughters

vascular surgery2003