SCAI-supported ACE organization to begin accrediting centers for carotid stenting in July

Washington, DC - Accreditation for Cardiovascular Excellence (ACE), launched by the Society for Cardiovascular Angiography and Interventions (SCAI) at its recent conference in San Diego, plans to begin accrediting facilities that perform carotid stenting in July."We've actually started to test the system, and our expectation is to go live, hopefully sometime in July, with a fully functional accreditation process for carotid stenting," ACE president Dr Bonnie Weiner (Saint Vincent Hospital, Worcester, MA) told heartwire.SCAI originally began considering the creation of an accreditation process for facilities performing carotid stenting when the Center for Medicare and Medicaid Services (CMS) began covering carotid stenting for some patients early this decade. The agency covers the procedure only in centers it considers qualified to safely do the procedure and respond to any problems that might arise with the patients. "When CMS first started opening the coverage decision for carotid stenting, we pushed, as did other organizations, for a formal accreditation system. There wasn't one that CMS was comfortable handing the process over to, and as things have evolved and we've continued the discussion with CMS, it became clear that what they have been utilizing really doesn't meet the needs of the facilities in terms of setting quality standards and monitoring adherence to those quality standards," Weiner explained.SCAI's first step in the creation of accreditation standards for carotid stenting was the development of a training and competence document by a multidisciplinary writing committee. This document formed the framework for CMS facility accreditation criteria and includes requirements for the physical plant of the hospital and for outcomes data and processes for monitoring quality.SCAI decided to spin off ACE as a separate organization for liability reasons and because the organization's mission is separate from SCAI as a whole. ACE is based in Washington, DC, because it is funded by start-up money from SCAI and is using some of SCAI's resources, Weiner said. In addition to Weiner, ACE staff includes executive director Mary E Heisler, who previously worked for Johnson & Johnson and the Cleveland Clinic's cath lab. Dr Ken Rosenfield (Massachusetts General Hospital, Boston) and Dr Christopher White (Ochsner Clinic, New Orleans, LA) are codirectors.

Carotid stents today, percutaneous valves tomorrow

"Carotid stenting is the tip of the iceberg," Weiner said. "At the moment in the cardiovascular space, that's the only area where there is any kind of regulatory mandate for accreditation, but we have been looking at the much broader landscape of invasive procedures, and really we should be doing this for all of these things; we should be, as a professional organization, setting the standards and essentially providing the resources for facilities to do the best possible job for the patients they take care of."

As the group is launching its carotid stent accreditation program, it is also working with other professional organizations to develop more accreditation programs over the next year or two, including one for PCI.

"Now that we have the basic infrastructure built. We are developing a couple of other things in parallel." ACE is also developing an accreditation program for percutaneous valve implantation, but none of those devices are FDA approved yet. "We don't want to be so far ahead that we have to wait two years before anyone is actually doing procedures."