ROUGH EDITED COPY

AHA

CARDIOVASCULAR CENTER OF EXCELLENCE

PROJECT #

November 8, 2017

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>: Good afternoon and thank you for joining the webinar. I am an accreditation manager at the American Heart Association and pleased to welcome you today to today's webinar Cardiovascular Center of Excellence Showcasing Common Health at Regional Hospital. We are very excited to have wonderful speakers today and our first speaker is Dr. Robert McNamara. Dr. McNamara is an associate professor with cardiovascular medicine at Yale. He received his medical degree from Washington University. Dr. McNamara trained in internal medicine and clinical cardiology in the hospital at the University of Pennsylvania. He completed his fellowship and echocardiographic at John Hopkins.

He has a Masters degree in clinical epidemiology at the Johns Hopkins School of Hygiene and Public Health.

He was on the faculty of the John Hopkins and both schools in public medicine and health for two years. He then worked with United States Indian Health Services for three years on the Navajo Reservation in Arizona. He has been on the faculty at the yellow school of medicine since 2002. He is a clinical cardiologist with an expertise in accurate echocardiographic. at your, he was the director in 2003 to 2012 and director of cardiovascular fellowship training since 2008 to 2010.

His research is assessing and promoting evidencebased medicine, first in atrial fibrillation and in acute coronary syndrome. He has been actively involved in a national cardiovascular data registry including serving on the steering committee of the registry of guidelines and international strategy workgroup among other committees and initiatives. He is on the international consortium for healthcare outcomes, coronary artery disease working group. He is a consultant for the American Heart Association initiative and inspire alliance to create new research collaboration of hospital and clinic partners under a single platform.

Finally, in 2013 he worked in Rwanda for three months as part of the human resources for health project to include postgraduate medical education.

Next, we would like to welcome our speakers from Commonwealth Health Regional and the first hospital to earn Cardiovascular Center of Excellence accreditation.

Our next speaker for Regional Hospital will be Elaine Walker. Elaine has over 35 years’ experience in cardiac nursing. She received her RN from the school of nursing and went on to get her BSN at Marywood University where she received her Masters degree in nursing administration.

Since 2015 Elaine has been the program director for the Commonwealth Heart and Vascular Institute as a regional hospital grant. She is held nursing and supervisory positions with telemetry, cardiopulmonary rehab, diagnostic services and diabetic exams. She is a board member for the great members and affiliates of the American Heart Association and a member of the American Association of Cardiovascular Pulmonary Rehabilitation as the hospital liaison.

Following Elaine will be Dr. David Fitzpatrick and he is the doctor of the Commonwealth Heart and Vascular Institute at the Regional Hospital and he received his medical degree from a medical college and he trained in internal medicine at the University of Maryland medical systems and also completed his residency there. He completed a cardiology fellowship at Dartmouth Medical Center 1998. Dr. Fitzpatrick is certified in internal medicine, cardiovascular disease, transthoracic and choreography.

He's been the medical director at the Coronary Disease Risk Prevention Clinic since 2002 and is the past president of the medical staff and Chairman at Department of Medicine at the Regional Hospital. Dr. Fitzpatrick has also held clinical instructor position at the Commonwealth Medical College.

He has been a fellow at the American College of Cardiology since 2000.

Final speaker is the manager and has over 30 years and experience in cardiac nursing working at various hospital settings including ICU, Cath Lab and others. There is a teaching for organization. She has worked at the Kentucky and Indiana organizations helping hospitals and states to improve their internal cardiovascular process. Joyce has been at the American Heart Association three years as a manager for hospital accreditation and is incremental at the Cardiovascular Center of Excellence Program.

There will be a question and answer session at the end of the webinar and questions can be submitted through today's presenters by typing your questions in the pain of the control panel. You may send in your questions at any time during and after the presentation and we will collect and address them at the Q&A session at the end of today's presentation. At this time, I would like to move on to the objectives for today to the presentation.

The objectives today are to have lessons learned on being a learning health system, Health Cardiovascular Center of a glance accreditation helps prioritized needs of the community and population health. Prepare for accreditation review, learn about best practices and benefits of accreditation and provide information on how to apply. Lastly, there will be questions and answers.

At this time, I would like to turn this over to Dr. McNamara.

>: Thank you Joyce. Just to specify the objectives of my 10 minutes, we will demonstrate how the Cardiovascular Center of Excellence Accreditation can assist you in becoming a premier learning health care system to improve your populations cardiovascular health. I will introduce, for just a few minutes, the concept of a cardiac or cardiovascular center of health for those of you who are not familiar with it before handing it over to those at the Regional Healthcare Center.

I know I am preaching to the choir as it can be seen on the lefthand side of the screen, I list the facts of how important cardiovascular diseases. If you have seen the statistics or similar.

People and communities often do not understand the risk they personally have. You can see some of the statistics in the righthand side as people do not always think about cardiovascular disease in themselves.

I want to talk about a few concepts here at the beginning. First, population health. You get many definitions of population health. First and always, we want everyone to have be at the next level. You have quality improvement audio cutting out. Hospitals whether heart failure, a fib, they are generally getting good quality care and they certainly encourage you to continue at this level.

The next level that we talk about is it is starting to get more traction and you can go back one is a system of care which the hospital operates. These are in terms of the CMS and river in hospitals on the front end and nursing homes and nursing care and discharge transitions on the backend. With programs like Mission Lifeline and others, we will get good results in this level as well.

Finally, we will push the envelope with this and talk about the communities in which the whole system resides.

Joyce, you can move forward.

Improving the health care before the patient's get into the medical system. Many may think why is this up to the hospital to address population health? Many of you are likely in cities where they are the largest employer with the most modern buildings and hospitals offer great opportunities positively impacting population health.

The second concept I want to emphasize today concerns learning health care systems. Again, this is a phrase that many of you have heard that have gotten a lot of recent buzz and you talk about it and many different ways and this is a schematic I will go through here.

We all want to base our efforts on data. Data is just letters, numbers and symbols that need to be structured and organized to give meaning as information.

Information in itself needs to interpret that. This is where many of you come in. Synthesizing the information based on your experience to create knowledge. Finally, as you put this knowledge into decisionmaking it requires wisdom. This is schematic, not rocket science, but is an important concept to keep in mind. Another thing to keep in mind during this process requiring communications at every level.

If you want to learn more about learning healthcare systems, HHA is a scientific statement in circulation for the journal. This is some really nice figures to reinforce that concept.

The final concept I want to emphasize is partnership and how the AHA and ACC can help you with the cycle of clinical decisionmaking. These great organizations turn to science and to guidelines they can influence the process of quality improvement and provide the data to start the cycle.

Those were the concepts that I wanted to talk about and now I can get more specific.

We can talk about the capstone and here is an overall figure with this component.

This next slide will show individuals. Many of these things that we start thinking about is the foundation and those requirements include having three of the four cornerstones that have been put out by the ACC and one must be Chesapeake Center.

To provide a smooth transition from the current efforts that may or may not include an offering of the introductory time. You can get this without these cornerstones as long as you can prove or demonstrate equivalency using the readiness assessment that we will look at in a few moments. The official cornerstone and then a more deliberate and thoughtful manner.

This critical idea I want to emphasize; this happens more than just accumulating with individual cornerstone. It involves the cornerstone and coordinating within the service line including a favorite, and including the labs and all of the imaging labs as well as other services like surgery. Finally, the hospital as a whole where the service line fits into this. All of that is part of the CVCOE. As I mentioned before, the systems outside of the hospital and population health.

So, this may seem daunting, but to develop a readiness assessment to help start the process. This will be helpful during this introductory period at the readiness assessment is divided into three sections, demographics, program readiness, description and the impact on the population health.

The idea for the review team is to help you evaluate your hospital accreditation success now, we will go over these three areas.

You have your hospital scope of practice in the demographics section, this is a snapshot of the hospital capabilities and services provided. This section includes a large and broad array of objective elements. We have volumes, participation in registry, availability and the like. This is the criteria.

The next section involves the program readiness description and this section is designed to evaluate critical components in every program that would create success and addresses your program's ability to meet the intent of this CVCOE. This section is divided into three specific categories, chest pain, heart failure and atrial fibrillation. You need to know if they have one of the applicable accreditations with chest pain, but heart failure and atrial fibrillation and they bypass that disease into that category. You would not need to necessarily fill out each of these two have the relevant cornerstones.

Each answer should reflect the organization structure process and outcome to give the relative disease process.

To give an idea of what this means, each of these areas there will be questions relating the program government with the systems of care and the clinical qualities going with each one of the sections.

The final area of the readiness assessment is your program's impact on population health and this is that most of you will be familiar and we know this area that we can help you with. This is going on during the whole process.

I want to reemphasize on a view reports concluding these comments at the start of the process is collaboration. We reflect the facilities current structure process and outcomes and will have further engagement between you and the representative to maximize communication along each step of the journey.

Finally, just to reemphasize the three concepts that I introduced before. Versus population health in your hospital is the hub of health within your community. Second is it is a learning healthcare system. Finally, the AHA and ACC are your partners in this process.

Just remember the hardest part of the journey is taking that first step.

Now, I will turn it over to Elaine Walker at the regional Hospital and get her thoughts into the journey to the Cardiovascular Center.

>: Thank you Dr. McNamara. I want to say many components that you put out are the lessons that we learned and I will be emphasizing that through our journey. Dr. Fitzpatrick is here with me and we will be sharing sites back and forth so I will refer to Dr. Fitzpatrick. By the way, today's his birthday and he doesn't know I know that. He thinks this webinar is for him.

Thank you so much for having us participate in this webinar today and we are very excited to share our journey with the Cardiovascular Center of Excellence. I want to give a shout out to Joyce, our main speaker today, who started this journey as we have already had her and she is very helpful. Also to a few others to our reviewers who came to support us.