Oversight, in practice

Situation. A nine-hospital system had grown through acquisition, with perfusion delivered by three different vendors plus employed teams. Each ran its own protocols. Practice for the same operation varied meaningfully by site, and leadership had no way to see — let alone govern — the differences.

Approach. We established a system-wide perfusion governance committee with clear clinical authority above the vendors, then built a single versioned protocol library harmonized to evidence-based standards. Adoption was tracked by site, with variation surfaced on an executive dashboard.

Result. A 58% reduction in unwarranted site-to-site practice variation within the first year, and — for the first time — a single clinical standard every vendor was contractually held to.

Situation. A large academic center had outsourced perfusion for years, but the contract contained no meaningful clinical or service SLAs. The vendor reported on its own performance. When quality questions arose, leadership had no independent, data-backed way to answer them.

Approach. We rewrote oversight around measurable SLAs tied to clinical and service metrics, then ran an independent monthly vendor scorecard. Gaps triggered structured remediation plans with owners and deadlines — managed by us, reported to the health system.

Result. Independently verified SLA compliance reached 96%, and the annual contract review moved from a relationship conversation to a data-driven one — with the leverage on the institution's side.

Situation. A regional system was scaling its ECMO program while carrying documentation and competency gaps in perfusion that surfaced only in the scramble before each Joint Commission survey. Growth was outpacing governance, and the risk was compounding.

Approach. We stood up a continuous-readiness program — perfusion documentation, credentialing, and protocols kept audit-ready year-round with mock surveys — and wrapped the ECMO expansion in ELSO-aligned quality oversight and a defined competency and coverage model.

Result. The subsequent Joint Commission survey closed with zero perfusion-related findings, and the ECMO program scaled on a governed footing rather than an improvised one.