SCAI Institutes National Quality Program

May 5, 2011—At the Society for Cardiovascular Angiography and Interventions (SCAI) 2011 scientific sessions in Baltimore, Maryland, SCAI announced its national quality improvement program to measure and improve quality in the cardiac catheterization lab (CCL) for better patient care.

SCAI stated that, using evidence to guide new ways to advance care and improve outcomes, it is launching the program with its quality improvement toolkit to ensure facilities and providers have the tools necessary to deliver consistent quality care in CCLs as well as the elements requisite for an accredited cardiac catheterization lab.

According to SCAI, the national quality program addresses issues related to appropriateness of care and underscores the society's commitment to continuous quality improvement and performance measurement. SCAI supports five principles in its quality initiative:

• Accreditation of CCLs. Accreditation of Cardiovascular Excellence (ACE) program to accredit CCLs, requiring peer-review of a variety of procedures, including cardiac catheterization, carotid stenting, angiography, and coronary artery stenting.
• Third-party peer review. To further drive quality improvements in the CCL, SCAI has released a white paper calling for uniform use of “cath lab conferences” in which random cases are discussed in open forums by physician peers. The paper, “The Quality Imperative: Lessons from the Cath Lab,” is available on the clinical guidelines and resources section of the SCAI Web site.
• Measurement and public reporting. SCAI supports the use of risk-adjusted clinical data (rather than administrative claims data) reported to a national database of validated cases to track performance against which patient outcomes can be measured and used to improve quality on a continuous basis.
• Physician and patient education: SCAI supports ongoing physician and patient education on quality cardiovascular care through educational initiatives provided for health care providers as well as patients. SCAI's community-based educational series, Know What Counts, brings health care consumers together with providers to advance awareness of cardiovascular disease, prevention, and treatment options.

The SCAI-QIT toolkit addresses the following elements critical to CCL quality:

• Guidelines development
• Peer review conferences
• Random case selection
• National database participation
• Preprocedure checklists
• Data collection
• Inventory management

At the SCAI annual meeting, the society offered an interactive workshop to teach a group of “Quality Champions” how to use and customize the toolkit for use in their hospitals' CCLs. The Quality Improvement Committee provided participants with guidance for overcoming potential obstacles, offered tips for getting started with the toolkit, and demonstrated how to roll out specific tools in individual hospital and CCL settings.

“The Quality Improvement Toolkit is a critical component of a robust and well-rounded continuous quality improvement program for all physicians and cath lab staff to put in place the correct tools, programs, and knowledge infrastructure to improve quality, reduce variability in care, and help identify and remediate less-than-optimal performers,” commented SCAI President Christopher J. White, MD. “We see this as an essential part of our commitment to our patients to continuously evaluate our own performance to deliver the best possible care.”

In related news at the SCAI annual meeting, the ACE program awarded its first accreditation to the CCL and angioplasty/stenting program at Bon Secours St. Francis Health System in South Carolina. ACE accreditation recognizes the commitment of clinicians and staff to quality assurance, peer review, and use of evidence-based guidelines.

“ACE's goals are to help facilities achieve better patient care in their community and to increase the consistency of superior patient care in cardiovascular procedures throughout the United States,” commented Bonnie Weiner, MD, Chief Medical Officer and Chair of ACE's Board of Directors. “Bon Secours St. Francis Health System has achieved ACE's highest standards for quality and is a model for other cardiovascular programs. We look forward to awarding accreditation to many other deserving programs moving forward.”

According to ACE, the organization provides professional review of facilities where invasive cardiac and endovascular procedures are performed and accredits those that achieve predetermined benchmarks for quality care. ACE's accreditation programs currently include programs for cardiac catheterization, percutaneous coronary interventions, and carotid artery stenting. ACE has plans to expand to accreditation programs for other cardiovascular procedures. ACE is currently reviewing other percutaneous coronary intervention and carotid artery stenting program applications, with additional accreditation awards expected in the coming months.

Programs that achieve full accreditation are recognized by ACE for 2 years, at which time their facility must be reviewed again for continued recognition. ACE also provides tools and guidance for quality improvement and is committed to helping facilities achieve the highest standards of care.

Dr. Weiner added, “Because we employ a standardized, unbiased assessment, patients who are treated at an ACE-accredited cardiovascular center should feel confident the facility has taken the appropriate, evidence-based steps to help ensure the best care for each individual patient.”