“It is not the strongest of the species that survives, nor the most intelligent that survives. It is the one that is the most adaptable to change.” -- Charles Darwin 

This week I joined 500 cardiologists, care team members, cardiovascular administrators and others at the Cardiovascular Summit, tackling the plethora of challenges inherent in the shifting practice landscape we now face. For the last three years, I have watched this program grow in size, in purpose and in focus. This year’s conference was jam packed with timely, in-depth plenary sessions, interactive small group workshops and networking opportunities, the topics ranging from strategic national issues to those impacting small private practice groups.Faced with the shifting sands of hospital integration, regulatory changes, threatened financial penalties, unimaginable payment system complexities, evolving MOC requirements, and GME funding reductions – the list goes on and on and on – it was clear our patience has run out. Those attending underwent a metamorphosis from addled bystander to engaged and determined combatant, recognizing it’s impossible for any of us to understand and navigate all of these issues individually while continuing to fulfill our other full-time mission: delivering high quality patient care. That’s why we turn to this course, joining with the College and other experts to help us all navigate and thrive in an environment of significant change.The surge toward hospital integration and physician employment has mandated the College to amplify its offerings, meeting the very different needs of our members in an integrated environment. In this new paradigm, quality programs and tools aimed at helping members demonstrate their value, more effectively engage in best practices at the point of care, and close identified gaps in care delivery are becoming increasingly critical.In response to these needs, the ACC recently launched an innovative program, combining under one umbrella the full breadth of its proven hospital quality improvement offerings.  ACC’s Quality Improvement for Institutions is comprised of the NCDR and established quality initiatives including Hospital to Home (H2H), the Door to Balloon (D2B) Alliance, as well as new initiatives such as Surviving MI.  This program provides institutions with a comprehensive suite of cardiovascular registries and service solutions that support quality clinical care, deliver improved patient outcomes, and offer national recognition for participating in ACC quality initiatives. The NCDR will continue to deliver quality data for benchmarking, and Quality Improvement for Institutions takes it to the next level by providing the assessment, monitoring and evaluation tools institutions need to transform data into practical, lasting solutions. By bundling quality offerings together under one website, each member of a hospital’s cardiac care team has on-demand access to proven quality improvement programs and tools that address public reporting, reimbursements, regulations and more.The College’s aggressive advocacy efforts clearly remain vital, ensuring we have a seat at the table as health care reform staggers forward. ACC Advocacy is advancing the College’s mission of improving the cardiovascular wellbeing of the nation through interactions with Congress, federal government agencies, state legislative and regulatory bodies, private insurers, and other policy-making groups.Unlike the popular notion, my hope is that what happened in Vegas this week won’t stay in Vegas, but expands nationwide. I hope the crucial information gleaned from these experts will be shared with others, enhancing the skills of practices across the country, helping them to evolve and adapt, so they can move from simply surviving to thriving.[youtuber youtube='http://www.youtube.com/watch?v=w73wr5kWtE0&feature=youtu.be'] [youtuber youtube='http://www.youtube.com/watch?v=6I24d-m5nE0&feature=youtu.be'] 
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