By Dr. Ross Feldman,
Medical Lead,
Cardiac Sciences Manitoba

February 01, 2019

CSP News

The TAVI Program was highlighted in today’s Free Press.
Winnipeg Free Press link appended (need FP subscription to access full story—sorry)

CSP Updates

How are new practices/equipment/technology incorporated into the Cardiac Sciences Program?

As in all large medical communities there is constant change in practice. This is especially evident in the $125M+/yr. operation of the CSP, where those changes need to be managed to assure those practices and accompanying new equipment technology and supplies can be accommodated within existing static budgets along with existing HR and unit complements. Further, each new practice change involves education and training of not only operators but of all receiving outpatient and inpatient units (as well as potentially receiving units). Based on these considerations processes have been long-established in the CSP and in the WRHA to manage these changes. This entails a 3 step process in which the CSP subcommittee of the Surgical PRES (Product Review Evaluation Standardization) committee is integral. The Cardiac Sciences Program PRES subcommittee is responsible for vetting practice changes, clinical supply formulary changes and service expansion requests.
Step 1: Practice Change forms, clinical supply formulary forms, service expansion requests to be submitted to the Surgical PRES CSP Subcommittee
Step 2: The CSP subcommittee will review the forms submitted at their next monthly meeting.
Step 3: If approved at the subcommittee, the recommendation for approval and forms will be forwarded to the surgical PRES committee for final sign off. Their meetings are also held on a monthly basis.

The Cardiac PRES subcommittee which has been quiescent recently will be resuming asap and will be meeting monthly. FYI, we are currently recruiting for new members. If this sounds like a committee that you would be interested in participating in, please email wither Kiran or me.

Measurement and Monitoring of Safety in Canada: CPSI Safety Improvement Project – An 18 month learning collaborative.

We are pleased to announce that the Cardiac Sciences Program has been selected by the Canadian Patient Safety Institute to participate in launching a new safety improvement project. This is a learning collaborative approach with expert faculty and mentoring over 18 months based upon the Measurement and Monitoring of Safety Framework (MMSF). This follows on the success of a 12-month demonstration project that was led by Dr. Ross Baker at the University of Toronto. During this new Safety Improvement Project, participating teams will be supported in rewiring their thinking on patient safety and work within their organization to foster and promote a new approach to safety.

Two CSP teams, one from the Cardiac Cath Lab, and the other one from ACCU, will participate in this initiative with the aim of promoting and sharing their learnings across the program and eventually across the wider region at the end of the initiative. Efforts will revolve around the five dimensions of the MMSF which prompt participants with a series of key questions to conceptually address any problem in safety.

We thank the staff in these two areas for their continued efforts in ensuring safe care for our patients, and wish them the best of luck in this exciting cross-Canada initiative.

Publications by our Faculty this week

Saw J, Starovoytov A, Humphries K, Sheth T, So D, Minhas K, Brass N, Lavoie A, Bishop H, Lavi S, Pearce C, Renner S, Madan M, Welsh RC, Lutchmedial S, Vijayaraghavan R, Aymong E, Har B, Ibrahim R, Gornik HL, Ganesh S, Buller C, Matteau A, Martucci G, Ko D, Mancini GBJ. Canadian spontaneous coronary artery dissection cohort study: in-hospital and 30-day outcomes. Eur Heart J. 2019 Jan 30. doi: 10.1093/eurheartj/ehz007. [Epub ahead of print]

Boreskie KF, Kehler DS, Costa EC, Hiebert BM, Hamm NC, Moffatt TL, Hay JL, Stammers AN, Kimber DE, Kent DE, Cornish DE, Arora RC, Strachan SM, Semenchuk BN, Duhamel TA. Standardization of the Fried frailty phenotype improves cardiovascular disease risk discrimination. Exp Gerontol. 2019 Jan 23;119:40-44. doi: 10.1016/j.exger.2019.01.021. [Epub ahead of print]

Grocott HP. Lumbar Cerebrospinal Fluid Drains for Thoracic Endovascular Aneurysm Repair: Common Practice or Standard of Care? Anesthesiology. 2019 Feb;130(2):352. doi: 10.1097/ALN.0000000000002520. No abstract available.

Grocott HP. Coming soon: an expansion of the Journal’s critical care offerings. Can J Anaesth. 2017 Oct;64(10):989-990. doi: 10.1007/s12630-017-0941-x. Epub 2017 Jul 21. No abstract available.