January 22, 2016
This BOG Update is brought to you by Janet F. Wyman, DNP, AACC, Co-Chair, CVT Section Leadership Council; George Rodgers, MD, FACC, CVTSLC Co-Chair; Nancy Lundy, NP, AACC, Chair, CVT State Liaisons.
The needs of our patients are more diverse and complex than any one professional has the knowledge, skills, time or energy to address alone. Although this team may vary based on practice setting, patient population, and regulatory variations, advanced practice registered nurses (APRNs), physician assistants (PAs), and pharmacists (PharmDs) a group known as the Advanced Practice Providers (APPs) are essential members of a high performing CV care team.
In order to clarify the ACC's position on the role of the APPs in CV team-based care, the College's Clinical Quality Committee proposed creating a health policy statement (HPS). After the convening of a multidisciplinary think tank for development, the much-anticipated 2015 Health Policy Statement on Cardiovascular (CV) Team-Based Care and the Role of Advanced Practice Providers was released last year and is the result of longstanding recognition by the College and the CV community as a whole that a multidisciplinary team is necessary to achieve quality care. The statement has received positive reviews from external stakeholders for being forward-thinking.
The health policy statement recognizes that implementing a team-based approach to CV care is not without its challenges. There are differences in state regulations regarding the licensure of practitioners and variations in payment policies by private and public payers. New payment models focusing on value over volume "represent both an opportunity and a challenge for CV team-based care." As CV professionals, the challenge is before us to engage and influence these discussions. If we do not actively participate, someone else will step up and lead, inconsistencies in the ability of teams to deliver care will continue and patients will not receive the same quality of care from one state to another.
That is why collaboration is critical. The opportunities for collaboration between the BOG and the CV Team Section Leadership Council include:
- Ensure your Chapter, like the ACC national organization, is working to make the College the "home for all CV professionals" by including them as full voting members of Chapter Councils and in all Chapter activities.
- Help promote the discussion about effective quality team-based care in your Chapter, at your Chapter Council and annual meetings. The CVT Section Leadership has developed a slide deck that provides an overview of the health policy statement to help facilitate the discussion.
- Be a strong advocate for a team professional community by engaging the Advanced Practice Nurses, Physician Assistants, PharmDs and Nurses at the local level. If the CV team members in your practice are not members of the College, strongly encourage them to join us! Hand them your completed letter of support your recommendation can make a difference.
- Think about ways in which your Chapter can positively impact the three barriers/opportunities to more effective team-based care, highlighted in the policy statement. They include:
- Expanding inter-professional education to encourage creative interaction by all members of the team; incorporate interprofessional education and activities into your existing Chapter meeting. Use the CVT Section Leadership Council as a resource for this we're happy to help!
- Pursuing advocacy around sensible payment reforms. Now that the SGR is off the list, let's consider this the next challenge that impacts patient care. Our BOG is a highly effective grassroots group we know we can tackle this issue!
- Exploring emerging technologies to extend the capabilities of the CV team including telemedicine and virtual teams to help bring care to underserved regions. The CVT Section Leadership Council believes that this could be a great project for the BOG/Chapters since there are already telemedicine and virtual teams out there that are improving access to care, especially in underserved regions. Let's learn what is currently being done in this emerging area, identify what is working, and create best practices that can have a big impact on cardiovascular health and disease.
It is our hope that each of you will begin integrating the goals from the health policy statement in your Chapter's vision and plans. Please call on the CV Team Section Leadership Council for input in this area we would be more than glad to work with Chapters that are interested in pursuing any of the aforementioned goals. We look forward to this on-going discussion and plan to keep the BOG apprised of advances within the College to improve patient care through our CV care teams.