Board of Governors Meeting

Science & Quality Division Update

William J. Oetgen, MD, MBA, FACC

September 9, 2012

ACCF Heart House Organization

Seven Divisions

Business Development & Entrepreneurship

Finance & Strategy

Technology & Business Services

Marketing & Communications

Advocacy

Lifelong Learning

Science & Quality

ACCF Heart House Organization

Seven Divisions

Business Development & Entrepreneurship

Finance & Strategy

Technology & Business Services

Marketing & Communications

Advocacy

Lifelong Learning

Science & Quality

International Affairs

ACCF Heart House Organization

Science & Quality

NCDR

National Quality Initiatives

Science & Clinical Policy – Document Development

ACCF Heart House Organization

Science & Quality

NCDR

Science & Clinical Policy – Document Development

National Quality Initiatives

FOCUS

SMARTCare

Door-to-Balloon

Hospital-to-Home

Million Hearts

Quality Improvement Products(Toolkits and Guidelines Implementation Tools)

Overall Development ProcessAtrial Fibrillation Toolkit

H2H “Mind Your Meds” ToolkitHeart Failure Toolkit

QI 101 Toolkit

The tools are not a list of things. They are solutions to a specific gap or need in care.

STEP 1. Overall Goal Statement

STEP 2. Success Metric/GoalStated actions or principles that achieve the goal statement. The statement should clearly identify the role responsible.

STEP 3.Barrier/NeedProvider, patient, or system barriers that impede achievement of the individual success metric.

STEP 4. Method of MeasurementNot limited to collection of clinical data and can include process information or qualitative assessments for a Plan-Do-Study-Act test cycle.

STEP 5. Strategy/ToolFeasible solutions or strategies which address the identified barriers. These should aim to support achievement of the stated success metrics.

ACC Toolkit Development

ACC ToolkitsAtrial Fibrillation (AFib) Toolkitcardiosource.org/afibtools

H2H Mind Your Meds Toolkith2hquality.org (login required)

Heart Failure Toolkitcardiosource.org/hftools

Quality Improvement (QI) 101 Toolkitcardiosource.org/Science-And-Quality/Clinical-Tools.aspx

ACCF Heart House Organization

Science & Quality

NCDR

National Quality Initiatives

Science & Clinical Policy – Document Development

2012 Published Documents – ACCF/AHA

PRACTICE GUIDELINES

PERFORMANCE MEASURES

DATA STANDARDS

APPROPRIATE USE CRITERIA

CLINICAL COMPETENCE STATEMENT

HEALTH POLICY STATEMENT

EXPERT CONSENSUS DOCUMENTS

CONFERENCE REPORT

2012 Published Documents – ACCF/AHA

PRACTICE GUIDELINES•Perioperative Cardiac Evaluation for Noncardiac Surgery – Addendum published (July)

•UA/NSTEMI Focused Update (July)

•Device-Based Therapy Focused Update (Sept 10)

•Stable Ischemic Heart Disease Revision (Nov 20)

•ST Elevation MI Revision (in press; pub date TBD)

•Guideline Methodology Summit Report (in press; pub date TBD)

2012 Published Documents – ACCF/AHA

PERFORMANCE MEASURES•Heart Failure (discussion of 2011 Measures) (April)

•Atrial Fibrillation Implementation Notes (August)

DATA STANDARDS•Acute Coronary Syndromes/Coronary Artery Disease (in press; pub date TBD)

2012 Published Documents - ACCF

APPROPRIATE USE CRITERIA•Diagnostic Catheterization (May)

•PVD – Arterial (June) (Note: PVD Venous in progress)

CLINICAL COMPETENCE STATEMENT•Institutional and Operator Requirements for Transcatheter Valve Replacement and Repair: Part I TAVR (SCAI/ACCF…; March)

HEALTH POLICY STATEMENT•Patient-Centered Care (May)

2012 Published Documents - ACCF

EXPERT CONSENSUS DOCUMENTS•Transcatheter Aortic Valve Replacement (January)

•Catheterization Laboratory Standards Update (May)

•CVD Evaluation and Management Among Kidney and Liver Transplant Patients (AHA/ACCF…; July)

•Pacemaker Device Selection (HRS/ACCF…; July)

•Third Universal Definition of MI (ESC/ACCF…; August)

•Advisory to Prevent Deaths from CVD (WHF/ACCF…; Sept 10)

•Interpretation of Troponin Elevations (in press; pub date TBD)

CONFERENCE REPORT•Patient Radiation Safety in Adult CV Medicine (March)

BOG Participation

BOG Authors:•Catheterization Lab Standards ECD – Cavendish (CA)•Patient-Centered Care HPS – Teichholz (NJ)

BOG Reviewers:•Acute Coronary Syndromes/Coronary Artery Disease DS – Cox (Halifax, Canada)•Catheterization Lab Standards ECD – Robb (NH)•Device-Based Therapy Focused GL Update – Lewandowski (WI)•Heart Failure PM – Hobbs (OH)•Pacemaker Device Selection ECD – Strobel (IN)•Patient-Centered Care HPS – Haffey (CO) and Vijayaraghavan (AZ)•ST Elevation Myocardial Infarction (STEMI) GL Revision – Kutscher (NJ)•Stable Ischemic Heart Disease GL Revision – Poirier (Sainte-Foy, Canada)•TAVR ECD and TVRR CCS – Ramee (LA)•Troponin Markers ECD – Sherman (CO)•Unstable Angina/Non-STEMI Focused GL Update – Zimmerman (Regina, Canada)

Documents in Progress

• Radiation Safety for Patients (lifetime cumulative dose) ECD• Radiation Safety for Providers ECD (Revision of 1998 doc)

• Use of Percutaneous Cardiac Assist Devices ECD (SCAI/ACCF…)

• Analysis of 12-Lead ECG as Screening Test for CVD in General Populations of Young People (AHA/ACCF…)

• Treatment of HTN in Prev (AHA/ACCF…)

Board of Governors Meeting

Science & Quality Division Update

Thank You!