Salt Lake City-based Intermountain Health's St. Mary's Regional Hospital in Grand Junction, Colo., recently became the first community hospital in the nation to receive vascular verification from the American College of Surgeons and the Society for Vascular Surgery.
That achievement was in part due to the leadership of the hospital's medical director of vascular surgery, Tej Singh, MD.
Dr. Singh spoke to Becker's about what the designation means for St. Mary's and the steps his program took to earn the achievement.
Editor's note: Responses have been lightly edited for clarity and length.
Question: How did the idea of pursuing vascular verification come about?
Dr. Tej Singh: When I was recruited to build the vascular program here at St. Mary's, it was a pivotal moment for us. At the time, the American College of Surgeons and the Society for Vascular Surgery's verification program had just been announced, and our leadership, administration and team all looked at each other and said, "We think we have everything to be verified."
Q: How long did the process take?
TS: The whole process took about 18 months. Could it be done in 12 months? Possibly, but we had to build our program from scratch. We decided to base everything on the national guidelines, ensuring our program aligned perfectly with them. Some hospitals may already have established programs, but if they don't align with the guidelines they'll still need to make changes. I'd recommend committing a core team of 20 to 25 people and expecting the process to take a year to 18 months.
We expressed our interest in April 2023. From there, we worked steadily to prepare for our site visit in July 2024. In December 2023, prior to our site visit, we received our first critique. They told us, "Your department knows everything, but the rest of the hospital doesn't seem to know what you're doing."
So we spent four to five months socializing the program and getting buy-in from across the hospital. After the site visit, we received a document outlining corrective actions in August 2024. Nobody ever passes on the first go. It's expected that there will be things to fix. Fortunately, we didn't have anything critical flagged as a red, meaning we were on track. From August to the end of October, we worked on those corrective actions, improving and refining everything. We were officially notified of our verification in November.
Q: What did that process look like at the hospital?
TS: We did a deep dive, a complete reshuffle and reorganization of our vascular services. We eliminated all the waste in the operating room, in the endovascular suite and across our endovascular practices. That deep dive and reorganization were absolutely instrumental to our success.
We implemented new nursing education modules, developed a new QA process, collaborated with other specialties and uncovered gaps in patient care. We also standardized every process in our clinic to eliminate variation. No more one doctor doing it one way and another doing it differently. This not only created cost savings but also resulted in efficient, effective care.
Q: What were some of the key factors to your program's success?
TS: I'm a vascular surgeon, but I also have my MBA and have completed work through the Stanford (Calif.) LEAD program. Currently, I'm enrolled in a surgical leadership program at Boston-based Harvard University. While my primary role is as a vascular surgeon, I'm deeply involved in standardizing processes. If you can standardize business processes for your practice or organization, you not only save money but also improve efficiency and effectiveness.
The approach we took was to cut out waste and streamline processes. The ultimate result was becoming more efficient and more effective, and that became a real highlight of our verification process. By incorporating a bit of a business perspective into our verification process, I think we were able to really propel things forward.
Additionally, one of the highlights from our site review was the acknowledgment of how supportive our administration was of high-quality vascular care and the importance of having a medical director passionate about leading a team like this.
We got nurses, administration, leadership and staff together to define what our program would look like. Every program is unique, but in a community hospital like ours, where everyone is so passionate, it was surprisingly easy to get everyone on board. It was like putting a train on its tracks.
Q: Why is it meaningful that St. Mary’s was the first community hospital to achieve this distinction?
TS: In April of 2023, there were four test hospitals that achieved verification for comprehensive inpatient care and all of them were academic centers. So, when you consider a place like Intermountain, with its extensive network of hospitals across many states and its own insurance plan through SelectHealth, it became clear to me that St. Mary's, though a community hospital, was uniquely positioned. St. Mary's is a substantial 346-bed hospital that draws vascular patients from a 250-mile radius. I saw this not as a challenge, but as an opportunity to optimize our program.
Q: What advice would you give to other hospitals considering vascular verification?
TS: Making a commitment to better vascular care and achieving verification is transformative. It's very exciting when you can bring together the Society for Vascular Surgery and the American College of Surgeons, two organizations that have always prioritized quality, doing things right, and improving patient care, in the vascular space.
Hospitals entering this process must be fully prepared because it's a significant commitment. But the payoff is incredible: you'll align your team, improve your systems and identify gaps. Whether those gaps are organizational, quality-related or structural. Ultimately, the patients are the ones who benefit the most. It's like lifting the hood of your hospital, examining the engine, and figuring out what you're doing well, what you're not and where there's room to enhance services, equipment, spending, facilities and care.
That ability to think bigger and strategically is a crucial skill, and it was specifically called out in our review. They recognized that we had a supportive administration paired with a medical director who was not only committed to carrying the program forward but also had the resources to make it happen. That's essential.