“To me, it’s not about the operation, it’s about the patient,” says Reese Williams, DNP. “So, I pride myself on knowing more, going in ahead of time, reviewing their cardiac cath films and their preoperative labs, knowing their past medical history and meeting the patient. This allows me to better support the cardiothoracic surgeons, administration and nursing staff and ultimately provide higher quality care.”
That perspective serves Reese well in her role as Director of Cardiothoracic Surgery and Inpatient Care at AP Health. She leads a team of advanced practitioners that staff the cardiothoracic surgery service line at Bethesda Hospital, part of Baptist Health South Florida.
“We provide full-time, 24/7 coverage for cardiothoracic care,” Reese explains. “We’re not just in the OR – we provide full pre-op, intraoperative and postoperative care. While the service line has been in existence for more than a decade, our role is to support the program as advanced practice providers while it continues to grow.”
Building a Cardiothoracic Service Line
Reese is no stranger to building a cardiothoracic service line. Prior to AP Health, she followed a mentor to Commonwealth Health, to help rebuild its cardiothoracic program, boost quality, and improve patient outcomes. While there she worked with all areas of the hospital and its corporate parent to put systems and protocols in place to improve care.
“I worked with all of administration, nurse education, corporate, and consultants; I was even asked to serve on the bylaws committee,” Reese says. “I built policies, procedures, education and order sets into a model that provided more oversight and continuity of care from initial consultation through discharge. Our corporate parent saw the improvements we made and wanted to implement our model across all their hospitals.
“One of the things I’m most proud of from that experience is that our program became a three-star program for medications as designated by the Society of Thoracic Surgeons (STS),” Reese says. “It was the first time the program had achieved that status and it was in an area where I was directly responsible.”
Forging her own Path in Cardiothoracic Surgery
Reese did not follow a traditional path to the OR. While getting her Nurse Practitioner degree at Vanderbilt, Reese decided that she wanted to forego the more common career choice of becoming a nurse anesthetist to assist in cardiothoracic surgery.
“I had started out in EMS while in nursing school and moved into critical care,” Reese says. “When I went to graduate school at Vanderbilt, I was fortunate to have two cardiac surgeons as mentors. After shadowing them, I knew I wanted to be on their side of the drape in surgeries. I didn’t realize at the time that there were not a lot of NPs in cardiothoracic surgery, it was a role that was typically filled by PAs. I then found a great program at University of California, Davis. I was the first NP in that role, so I spent the first two weeks writing every SOP for my job so I could get credentialed. It was my first experience with the administrative side of medicine and while it was grueling, I know it was beneficial for me over the long term.”
“What I love about cardiothoracic surgery is that it is consistently inconsistent,” Reese says. “We can go through our algorithms and protocols, but it still comes down to knowing the patient and everything about them, head to toe. You could go in for what is planned as a 3-4 hour case and it ends up being a 10-hour operation. It’s gratifying to be in the operating room and know that everyone is there until the patient gets out of the room, until the patient is doing well. And that’s what it’s all about.”
Reese says the idea of making a bigger impact through having oversight and coverage of a service line was what attracted her to AP Health.
“What AP Health offers hospital systems and programs is staffing; but as a whole, it is quality and outcomes,” she explains. “It is because the providers within AP Health are experts in their fields that we are able to provide training and mentorship for NPs and PAs entering into challenging specialties such as cardiothoracic surgery. Knowing the working parts and the requirements of the Society of Thoracic Surgeons and seeing the patients pre-op, inter-op and post-op provides continuity of care, and that improves quality.”