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September 2022 Regional Meeting Event at The Historic Davenport, Boated More Than 90 Attendees

Peri-Procedural Code Status for Transcatheter Aortic Valve Replacement: Absence of Program Policies and Standard Practices

Article By: Gwen M. Bernacki, MD, MHSA; Helene Starks, PhD, MPH; Ashok Krishnaswami, MD; Jill M. Steiner, MD, MS; Matthew B. Allen MD; Wayne B. Batchelor, MD, Eugene Yang, MD, MS; Janet Wyman, NP; James N. Kirkpatrick, MD

Background: Little is known about policies and practices for patients under-going Transcatheter Aortic Valve Replacement (TAVR) who have a documen-ted preference for Do Not Resuscitate (DNR) status at time of referral. Weinvestigated how practices across TAVR programs align with goals of care forpatients presenting with DNR status.

Methods: Between June and September 2019, we conducted semi-structuredinterviews with TAVR coordinators from 52/73 invited programs (71%) inWashington and California (TAVR volume > 100/year:34%; 50–99:36%; 1–50:30%); 2 programs reported no TAVR in 2018. TAVR coordinators describedperi-procedural code status policies and practices and how they accommodatepatients’ goals of care. We used data from the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry, strati-fied by programs’ DNR practice, to examine differences in program size,patient characteristics and risk status, and outcomes.

Results: Nearly all TAVR programs (48/50: 96%) addressed peri-proceduralcode status, yet only 26% had established policies. Temporarily rescindingDNR status until after TAVR was the norm (78%), yet time frames for rein-statement varied (38% <48 h post-TAVR; 44% 48 h-to-discharge; 18% >30 dayspost-discharge). For patients with fluctuating code status, no routine practicesfor discharge documentation were well-described. No clinically substantial dif-ferences by code status practice were noted in Society of Thoracic SurgeonsPredicted Risk of Mortality risk score, peri-procedural or in-hospital cardiacarrest, or hospice disposition. Six programs maintaining DNR status recog-nized TAVR as a palliative procedure. Among programs categorically reversingpatients’ DNR status, the rationale for differing lengths of time to reinstate-ment reflect divergent views on accountability and reporting requirements.

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Summer 2022 Women in Cardiology Event

L-R: Kristy M Heppner, MBA, PhD; Samira Bahrainy, MD; Beteal Ashinne, MD; Ruchi Kapoor, MD, PhD; Tina Ghia, MD; Susie Woo, MD, FACC; Naseem Ghazanfari, MD; Nina Rashedi, MD, FACC; Lianna Collinge, CAE; Therese Dumas, ACNP

Occupational Work Letter Template

COVID-19 Work Letter Template

Webinar Recording: Cardiovascular Manifestation & Management Strategy of COVID-19 Patients:

Originally Recorded: April 2, 2020

Moderators

David Zhang, MD, PhD, FACC | CHI Franciscan | Tacoma, WA

Gautam Nayak, MD, FACC | President, WA ACC | Confluence Health | Wenatchee, WA

Free Wellness Resources for Your Teams

These are apps that are used for mindfulness and meditation, which may sound hokey to some, but is vitally important in times like this when we’re stressed.  they have very short options – 1-3 minute exercises – that are great to do midday or pre-sleep.

Ten Percent Happier  (free with code HEALTHCARE)

Webinar Recording: COVID-19 and the CV Service Line: Practical Approaches for an Unprecedented Pandemic- Part 1

ACC’s COVID-19 Hub

CCA – ACC Communication Conference of COVID-19

Mission of the Washington Chapter of the American College of Cardiology

The Goal of the Washington American College of Cardiology is to improve Cardiovascular health for residents of Washington State through education, care, and advocacy.

The purpose of the Chapter is to contribute to the prevention of cardiovascular diseases and to ensure optimal quality of care for individuals with such diseases in Seattle, Tacoma, Olympia, Spokane and other cities in Washington State. In carrying out these purposes, the Chapter functions, in consultation with the leadership of the College, as a source of advice to local and state governmental and professional organizations concerning issues related to cardiovascular disease. The Chapter, in the interest of patients, physicians, and the public in general, maintains a high level of social consciousness and involvement with socioeconomic factors and access to the highest possible quality of cardiovascular health care.

American College of Cardiology Mission:

To Transform Cardiovascular Care and Improve Heart Health

News

Leadership and the ACC: Developing Leaders to Transform Cardiovascular Care and Improve Heart Health

Thank You Louis Schwartzberg for Creating This Beautiful Film in Gratitude to Fellows of the American College of Cardiology (FACC’s)

Gratitude – Louis Schwartzberg (Watch on Facebook)

EHR State of Mind

October 22, 2015] EHR’s suck. Let’s make ’em better. Go to the Let Doctors Be Doctors website and tell the IT and government folks what’s up. And check out ZDOGG MD for lyrics, behind-the-scenes dopeness, and all our other videos. Please share. View on YouTube

William Shatner Thanks Cardiologists

[February 28, 2015] William Shatner owes his good health and being able to enjoy his active life to taking advice from good physicians, including his cardiologist. Please share any of the four versions with your friends. The :30, :60 and :90 min. videos are on the California Chapter YouTube channel. 

MOC Questions & Info

The American Board of Internal Medicine (ABIM) has implemented changes to its Maintenance of Certification (MOC) program for board-certified internists.
> Learn More
> View Report [pdf]

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