Endorsements

None

Objectives

Describe a multidisciplinary team and it’s utilization in the

inpatient cardiovascular surgical patient

Understand clinical and clinician benefits of a multidisciplinary

team

A general understanding of aortic stenosis and treatment

options

Identify the Heart Team of Southcoast Health, and their

respective role and patient benefits

Why I love my job

Introduction

Southcoast Health‘s Cardiovascular Care Center is built upon a

multidisciplinary team of providers who work collaboratively to

treat our patients, eliminating the need for patients to travel out

of our region for care. The strength of our cardiac program lies

in our comprehensive approach as we put our patients at the

forefront of our mission.

Dr. Margaret Ferrell, Physician-in-Chief of Southcoast Health

Cardiovascular Services.

Multidisciplinary Team

“Multidisciplinary care occurs when professionals from a range of

disciplines with different but complementary skills, knowledge and

experience work together to deliver comprehensive healthcare aimed

at providing the best possible outcome for the physical and

psychosocial needs of a patient and their careers. As patient needs

may change with time, the composition of the team may also change

to meet these needs.” - Mitchell GK, Tieman JJ, Shelby-James TM.

Multidisciplinary care planning and teamwork in primary care. Med J

Aust 2008;188(8 Suppl):S61–4.

Grade I-C recommendation - UpToDate

Grade I: strong recommendation

C: evidence comes from observational studies,

unsystematic clinical experience, or from randomized,

controlled trials

Multidisciplinary Team

cont. As many as nine different specialties can be in contact with

one single patient, identifying and caring for their individual

needs

Such as:

Physical Therapy

Occupational Therapy

Nursing

Registered Dietician

Respiratory Therapy

Case Management

Clinical and Clinician

Outcomes

Improved communication between different levels of healthcare

workers

Reduced length of stay

Reduced cost of stay

Increase quality of outcomes

Optimizing healthcare workers' performance

Increasing job satisfaction

Surg Neurol Int. 2014 Aug 28;5(Suppl 7):S295-303. doi: 10.4103/2152-7806.139612. eCollection

2014.

Multidisciplinary in-hospital teams improve patient outcomes: A review.

Aortic Stenosis and

Surgical Options

Aortic Stenosis

Aortic stenosis disease (AS) is a common native valve

disease found in up to 7-10% of the elderly population.

AS occurs when the heart valve essentially becomes like “a

stiff door,” not allowing the valve to completely open,

increasing not only the work of the heart which can lead to

heart damage, but also lead to decreased blood flow to vital

organs.

Surgical Aortic Valve

Replacement

Surgical aortic valve replacement (AVR) is the

standard treatment for patients with symptomatic

severe AS.

However, despite the excellent results of

conventional surgery, surgical risk is markedly

increased in elderly patients with comorbidities.

Additionally, several registries have demonstrated

that about one-third of patients are considered too

high-risk for conventional open heart surgery and

remain untreated.

AVR requires cardiopulmonary bypass machine

(“heart-lung machine”)

Transcatheter Aortic Valve

Implantation

Transcatheter aortic valve implantation (TAVI)

otherwise known as TAVR (Transcatheter Aortic

Valve Repair) was developed as an alternative

to surgical AVR initially in this high-risk patient

population.

TAVR does not require cardiopulmonary bypass

or sternotomy.

The Heart Team

Heart Team

The Heart Team, as defined by the Centers for

Medicare and Medicaid Services within the National

Coverage Determination for transcatheter aortic valve

replacement, embodies “collaboration and dedication

across medical specialties to offer optimal patient-

centered care”, with a requirement that the

cardiovascular surgeon and interventional cardiologist

jointly participate during the procedure.

Outcomes of Heart Team

Optimization of patient selection

Improved skill sets of clinicians due to collaboration

Increased procedural success, and reduced hospital

readmissions

An additional goal is to deliver more patient-centered

care, taking into account patient preferences and values

through processes such as shared decision making.

Clinical Excellence

Southcoast Health heart program has been ranked by

Healthgrades as one of the Top 10% in the Nation for Overall

Cardiac Service.

Southcoast Heart Center has additionally received the following

Healthgrades awards:

America’s 100 Best Cardiac Care (2016)

Cardiac Care Excellence Award (2016)

Coronary Bypass Surgery Five-Star Recipient (2016)

More Than Medicine

Questions