A Message from our CMO

By Bonnie Weiner, MD

So much has happened at ACE since our inaugural issue of the ACE Advisor. The entire ACE Accreditation Video Series is now available on the ACE website, including first-hand accounts from physicians whose programs have benefitted from ACE Cath Lab Accreditation. We are also pleased to announce that ACE awarded its first re-Accreditation to Bon Secours St. Francis Health System in Greenville, South Carolina. Please join us in congratulating Bon Secours for their ongoing commitment to quality care for their patients.

The new year also brought some important recognition to ACE from the Commonwealth of Pennsylvania. The Commonwealth has singled out ACE standards as the benchmark for cardiac catheterization lab facilities seeking a waiver from state regulation to provide elective PCI services without onsite open heart surgery.

Finally, the next time you visit our website, you'll find a new section describing ACE's Quality Review -- a collaborative success-focused approach that engages everyone on the team in achieving lasting positive changes in the cath lab. A win-win for all parties involved is now a realistic goal in the Quality arena.

I would also like to share a few thoughts here about how ACE contributes to the "Real Value" described in a recent editorial by Peter L. Duffy, MD, MMM, FSCAI. The concept has generated much discussion. ACE's Accreditation and Quality Review processes satisfy key components of Dr. Duffy's Real Value formula by going beyond appropriate use criteria to recognize the importance of clinically defined outcomes and patient-expected outcomes relative to cost in determining the value of cardiovascular care. Here are a few examples:

• Dr. Duffy stresses the importance of demonstrating value by "delineating, tracking, and improving our clinically defined outcomes": ACE works with programs during the accreditation process to improve their documentation process[1],[2] in these ways.
• Resource utilization is a "major driver" in Dr. Duffy's Real Value concept. It includes "total resource utilization, encompassing definable dollar outlays, staff and equipment use, and the time involved to providing the care" as well as "opportunity cost." ACE works closely with programs throughout the Quality Review and Accreditation processes to address these issues and reduce costs by helping to identify and reduce unnecessary variation.
• Dr. Duffy also raises the questions "How much will we reduce long- and short-term morbidity (future complications) if we perform the procedure?" and "How much will we extend this person's life expectancy with the quality of life he or she expects?" ACE assists programs in answering these questions with a Quality Review process that supports clinicians as they evaluate the potential benefits and risks of PCI based on outcomes data.

It is truly a challenging time for physicians and quality professionals who are under close scrutiny as we strive to both improve patient care and reduce costs. But tools such as Dr. Duffy's Real Value formula can help us focus our efforts on the key areas that can help us meet this challenge. Thank you for your continued support of ACE as we work with our clients to achieve and demonstrate the appropriateness and value of what they do each day.

A video of Dr. Duffy discussing the key points of his paper "Real Value: A Strategy for Interventional Cardiologists to Lead Healthcare Reform," recently e-published in Catheterization and Cardiovascular Interventions and a PDF of his paper are available on SCAI's™ website.

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