Frm the Drawing Bard t Reality Paul Armstrng, DO Assistant Prfessr f Surgery Divisin f Vascular and Endvascular Surgery University f Suth Flrida Schl f Medicine Tampa Flrida
Disclsure
8.5 millin persns PAD (up t 20% >60 yr) AAA 15 leading cause f death ESRD increases 5% / yr (14% f U.S ppulatin) Annual risk f strke is 2-5 % fr severe ASX cartid Baby Bmers Fast-grwing ppulatin demgraphic Histry f pr risk factr mdificatin at yunger age African Americans and age > 50 are vulnerable t PAD Tech Savvy, interested in access t gd health care practices
What is Excellence in Healthcare? What are the rules? Wh s keeping scre? Des everyne get a trphy?
Vascular Service Line Mdels Traditinal Vascular Patient-Hspital Interactin Dctr evaluates patient Prgram Develpment Public Awareness Patient arrives at hspital Team f Service Line Healthcare Specialists Cntemprary Diagnstic Technlgy Cmprehensive Therapies Inpatient and Outpatient Treatment Dctr calls specialist Service Line QA, QI, Research Specialist Treats Patient Reginal Access Cmmunity Outreach
Hspital Value Public awareness Structured care evidence based practice Reimbursement multidisciplinary practice Recruiting tl Supprt research and educatin Prvides pprtunity fr QA / QI emphasis n utcmes review patterns f care identify areas fr future imprvement Imprves patient safety
Value t Payers Shws the Facility is prviding highest level pssible care. Prvides infrmatin fr internal review f health services Imprves cmpliance with reginal/natinal guidelines Demnstrates cmmitment t quality Establish cmpetence f the Vascular Service Line Optimize vascular clinical utcmes Imprve patient safety
Value t Patients Access t quality vascular prviders Access t recmmended vascular treatments Access t clinical research Encurages care decisins by patients and families Offers pprtunity fr cmmunity educatin Demnstrates hspital s cmmitment t highest standard f care
Drawbacks t Success Lack f Executive Champin Hspital Turf Wars Market Cmpetitin Insufficient Infrastructure
Keys t Prgram Develpment Acquire executive leadership Identify reginal physician champins Evaluate facility infrastructure Calculate capital needs Cnsider barriers t participatin Develp a brand
Prgram Preparatin (steps t success) Pst Prcedure Care Team Mnitring Tracking cmplicatins Discharge planning Service Line Clinical Quality Set and Measure Metrics Develp QA/QI Prgrams Gvernance Service Line Administratr Senir Vascular Officer Adpt Prven Practices Implement Guidelines Facility Infrastructure Develp Vascular Units / Staffing Cntinuus Self Imprvement Initiatin Safety Prtcls Crdinatin f Services Surgical & Endvascular Services Anesthesia Services Radilgy & Imaging Services Infectin Cntrl
Building the Vascular Service Line Vascular Clinical Pathways Risk Factrs Preventin Diagnsis Therapies Surveillance Technlgy and Infrastructure
Expense f Excellence JACO $33,000 / 3 yrs (60% first year, 20% /yr after) Mck Surveys Emplyee educatin Healthcare Facilities Accreditatin Prgram $25,000 / 3 yrs AHA $60,000 / 3 yrs des nt include applicatin cst in the 5 crnerstne prgrams Get with the Guidelines (GWTG) (AMI registry) $6500/yr 4 Mdules $9300/yr; Prgram Sftware Additins $9747 VQI Initiatin fee, Mdules fees, salary line fr data entry Annual SVS patient safety rganizatin (PSO) fee Annual database subscriptin fee $100,000
Vascular Accreditatin Center f Excellence Missin Statement Prvide cmprehensive vascular care in Gergia well-rganized vascular facilities and service lines highly trained facility staffing with expertise in vascular care lead by experienced vascular physician prviders Emphasis n quality and utcmes Supprt research and educatin Imprve patient safety If I were t start a Center f Excellence
If I were t start a Pursue Service Line Quality Demnstrate higher quality Better utcmes Transparency in care Less incidents / near misses Enhanced access t highly specialized vascular care Imprve the patient experience Seamless integratin Less waiting Better understanding abut vascular disease Attract cmpetent emplyees Becme the emplyer f chice Develp emplyee buy in Cntain Cst Capacity t cure mre with the same business plan /rganizatin
If I were t start a Preach Cllective Cmpensatin Increases vlume increased revenue Medicare payments t a Accredited Hspital can be maintained due t apprpriate patient status placement Imprved perfrmance f CMS Cre Measures Timely diagnsis and dispsitin Prvides relative infrmatin fr internal review f health services Creates team apprach Integrates crss-departmental prcesses Breaks dwn wrk-place sils Identifies facility service gaps Allws fr evaluatin and revisin utdated business prcesses
If I were t start a Petitin fr Service Line Grwth and Develpment Build new vascular infrastructure (e.g.. Hybrid perating rms) Develp reginal training centers fr healthcare prfessinals Prvide CME fr healthcare prfessinals Develp multi-disciplinary utpatient vascular clinic / imaging services ne stp vascular shpping Netwrk vascular healthcare with city, cunty and state leadership
If I were t start a Lk fr Crprate-Technlgy Partnerships Vendr Benefits Create healthcare value beynd medical devices Add new value elements t their business mdel Available t participatin in high quality clinical research Lng-term cntract cmmitment t vendr technlgies Access t medical prviders and with specialty expertise Access fr crprate training in an advanced health system
If I were t start a Certificatin Peripheral Artery Disease Accreditatin Artic Disease Accreditatin Visceral Artery Disease Accreditatin Cerebrvascular Disease Accreditatin Vascular Access Accreditatin Venus Disease Accreditatin Develp integrated vascular care pathways fr the majr vascular disciplines Enhance access t highly specialized vascular care
If I were t start a Enrllment Interested Hspital r Hspital Prvider Identified GVS sends prgram infrmatin / applicatin Hspital cmpletes applicatin GFVS crdinates site visit within 6 mnths f preapprval and reevaluates site every 3 years thereafter. Hspital begins submitting Data t FVS Web based database r VQI Database N GVS Reviews Applicatin Yes Hspital granted prvisinal apprval until cmpletin f site visit Hspital des nt meet VCE prgram criteria and is encuraged t reapply at a future date. GVS and Hspital develp Business Agreement Hspital Submits Prgram Fee
Wh Will Take the Lead? Detailed understanding lcal, reginal and state medical cmmunity familiar with individual institutinal plicy built successful practice mdels lcally aware f state healthcare plicy serve the state ppulatin Sme infrastructure already in place Sets natinal guidelines Fcus f natinal healthcare plicy Academic and Educatinal Fcus Glbal Vascular Expertise (?) 1st ut f the gate Lackluster Trauma and Bariatric Certificatin
Frm the Drawing Bard t Reality Paul Armstrng, DO Assistant Prfessr f Surgery Divisin f Vascular and Endvascular Surgery University f Suth Flrida Schl f Medicine Tampa Flrida