The Heart Center of Vero Beach at Indian River Medical Center
An affiliate of Duke University Health System
(expanded from the article published in the recent version of Advocate)

Regardless of where you live or whom you know, the fact that heart disease is the number one cause of death in the United States does not change. And the reality is that a majority of heart care is delivered on an urgent or an emergent basis during which patients do not have the choice of facilities...the nearest medical center will be the choice made for them. IRMC will be prepared to serve our community when it needs us, providing our residents with peace of mind knowing that the same world-class quality care available in the world's finest medical centers is available right here at home.

With that in mind, the board of directors of Indian River Medical Center approved the application for a certificate of need for open-heart surgery in Spring 1999 with the expectation that the open-heart program would be developed in affiliation with an established and nationally recognized center of excellence in heart care. Two years ago, the IRMC leadership began speaking with several nationally recognized centers of excellence and found an especially strong sense of compatibility with Duke University Health System.

Consistently rated as one of the top 3 heart programs in the country and one of the top 10 hospitals in the nation overall by US News and World Report, Duke's reputation and approach to affiliate programs matched the IRMC interest in excellence. The IRMC mission of quality patient care fit well with Duke's mission of research, education, and patient care. Though the initial focus of the relationship between IRMC and Duke University Health System will be on patient care, both organizations see opportunities to collaborate on research projects in the future--something which excites many members of IRMC's medical staff.

The formal agreement with Duke was signed in February 2005, launching Duke's formal involvement in the establishment of the Heart Center of Vero Beach. Duke will work closely with members of the IRMC team in the planning, implementation, performance, and peer review process to help establish a program worthy of the Duke stamp of approval. Duke currently maintains four similar affiliate programs with hospitals in North and South Carolina. The IRMC program has the distinction of being the first cardiac surgery program affiliate in Florida-and the only one being developed at the present time.

The Duke team is working with Dr. Seth Baker, IRMC chief of Cardiology, Dr. Clark Beckett, IRMC chief of Surgery, and Dr. Charles Celano, IRMC liaison with Duke, in the search process for medical directors of cardiovascular surgery, interventional cardiology, cardiac anesthesia and for the unit's top management positions. The quality of the physicians who have expressed interest in relocating to Vero for the IRMC program is exceptional and the search committee is confident that a world-class team will be in place for the Heart Center of Vero Beach when it opens in 2006.

When selected, the medical directors will have privileges at both IRMC and at Duke University and will serve as faculty at Duke. While, under other circumstances it may seem natural for someone to be reluctant to be the "first" patient in a new cardiac surgery program, our community can be assured that the surgery performed on our "first" patient will be done by a carefully selected, highly qualified and experienced surgeon supported by a surgical team that has performed the same procedure on hundreds of patients before. This is an important distinction to make to our community and is a critical part of establishing the peace of mind that comes with our affiliation with Duke.

As the search for the team continues, a concurrent operational assessment is being done to measure the hospital's readiness, identifying all that needs to be done in order to completely prepare for the unit's opening. The Heart Center of Vero Beach will not accept patients until every area meets and/or exceeds the Duke requirements for readiness. For example, Dr. George Mitchell, the full-time director of critical care medicine at IRMC, will bring on a partner in intensive care so that the Critical Care Unit will be fully prepared to play its important support role for the heart program. Additionally, he has instituted a program of multidisciplinary rounds in CCU, something that is very rare for a community hospital and that was particularly impressive to Duke. Similar enhancements to the IRMC infrastructure will be made in the months to come in preparation for the opening of the Heart Center of Vero Beach, currently scheduled for 2006.

IRMC will expand its current physical plant to include new surgical services and operating rooms to support the new program. This phase of construction is scheduled for completion in mid 2006. Both the Duke team and a group of Duke-affiliated cardiovascular surgeons have reviewed and approved the IRMC master facility plan. But preparedness goes beyond the institution. It includes preparedness on the part of the ambulance companies, blood banks, and other service providers relied upon by IRMC to support our programs. The complete medical delivery system needs to be fully prepared to accept the IRMC expansion into cardiac surgery and interventional cardiology.

This is a busy and exciting time at Indian River Medical Center. The impact that the Heart Center of Vero Beach will have on our community is tremendous. Not only will IRMC be able to provide world-class cardiovascular healthcare to our residents, but the Duke affiliation will allow us to maintain the highest level of care throughout the medical center by the quality controls that it will provide. Duke's reputation for excellence extends well beyond heart care as they are highly rated in all clinical services. Our expectation is to extend the Duke affiliation from heart care to other important clinical programs of interest to IRMC patients and physicians. IRMC is proud to bring such a stellar affiliation to Vero Beach and is grateful for the philanthropic support that Indian River Medical Center Foundation is able to provide to make such developments possible.