Abstract
BackgroundRevascularization decisions can profoundly impact patient survival, quality of life, and procedural risk. Although use of Heart Teams to make revascularization decisions is growing, data on their implementation in the real-world are limited. Our objective was to assess the prevalence of Heart Teams and their association with collaboration in routine practice.MethodsA survey of cardiologists and cardiac surgeons at 31 hospitals in Michigan was performed in May, 2011 – prior to the recommendation for using Heart Teams in national guidelines. This survey included all percutaneous coronary intervention-performing hospitals in Michigan participating in the Blue Cross/Blue Shield of Michigan Cardiovascular Consortium and Michigan Society of Thoracic and Cardiovascular Surgeons Quality Collaborative. It targeted both the use of Heart Teams and multidisciplinary Case Conferences.ResultsThere were 53 physician survey respondents from 27 hospitals with 4 hospitals not responding. Among respondents, 11 (40.7%) hospitals reported no Heart Teams or Case Conferences while 7 (25.9%) hospitals reported either a Heart Team or Case Conference. However, there was disagreement about the presence of a Heart Team at seven hospitals, and about Case Conferences at nine hospitals. Hospitals with definite Heart Teams reported significantly greater levels of collaboration between cardiologists and cardiac surgeons.ConclusionThe overall presence of Heart Teams prior to their recommendation in national guidelines was limited. Even among hospitals with a potential Heart Team, there was substantial disagreement between respondents about their presence. Further refinement of the definition of a Heart Team and measures of successful implementation are needed.
Highlights
The Heart Team is a new concept in decision-making between cardiologists and surgeons for patients with complex coronary disease
There were 53 survey respondents from 27 hospitals who responded to the survey, out of the 31 hospitals participating in BMC2 at the time of the survey (87.1% hospital response rate)
The survey results from the BMC2/Michigan Society of Thoracic and Cardiovascular Surgeons (MSTCVS) shed for the first time some light into the degree and character of collaboration between surgeons and cardiologists across a broad range of hospitals prior to the recommendation of Heart Teams by national guidelines
Summary
The Heart Team is a new concept in decision-making between cardiologists and surgeons for patients with complex coronary disease. Methods: A survey of cardiologists and cardiac surgeons at 31 hospitals in Michigan was performed in May, 2011 – prior to the recommendation for using Heart Teams in national guidelines This survey included all percutaneous coronary intervention-performing hospitals in Michigan participating in the Blue Cross/Blue Shield of Michigan Cardiovascular Consortium and Michigan Society of Thoracic and Cardiovascular Surgeons Quality Collaborative. It targeted both the use of Heart Teams and multidisciplinary Case Conferences. There was disagreement about the presence of a Heart Team at seven hospitals, and about Case Conferences at nine
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