As previously highlighted in The Value of an LAAC Coordinator article, investing in LAAC capability presents a rich opportunity for many cardiovascular service lines. As an LAAC coordinator at CHI Health Nebraska Heart, Amy Schwartz believes that most Left Atrial Appendage Closure (LAAC) programs have the potential to service many more patients. In fact, her team has led a highly successful effort to expand their patient population. This has had a beneficial impact on both her organization and the community it serves.
Here are the steps that allowed Amy Schwartz and her team to expand their LAAC patient population.
Step 1: Establish strong internal advocates
LAAC outreach efforts will only be as strong as the internal advocates who represent the LAAC program. Whether it be cardiologists, echocardiographers, or gastroenterologists, internal champions are a key component to outreach and expansion. These key players will perform an essential role toward developing a trusting relationship with the community physicians, who are so important to expanding the LAAC patient population.
It takes a constant and persistent effort to gain the trust of physicians in the community. A steady stream of education and awareness is needed. Colleague-to-colleague communication is paramount—and will require strong internal advocates willing to participate in the outreach.
So the first and potentially most important step for success: make sure internal champions are committed to expansion.
Step 2: Expand beyond the obvious LAAC patients
Be aware that patients with prior bleeds are just the beginning. There are numerous patients beyond those with a history of bleeding that could benefit from LAAC. Which patients are at risk of a future bleed? Which patients are having difficulties with anticoagulants? Which patients are at risk of falls?
By expanding awareness beyond the obvious patient type, Amy and her team were able to identify a huge pool of potential patients in their community.
WATCHMAN is for which patients?
Step 3: Vibrant and constant outreach
Here are some successful ways that Amy and her team reached out to identify appropriate patients:
|They identified PCPs in their community and invited them to dinner meetings, where one of the cardiologists from CHI Health Nebraska Heart gave a presentation about LAAC and what patients are appropriate.|
|They reached out to sister hospitals in their network and presented at their quarterly clinician education meeting.|
|The nurses from Amy’s program approached INR nurses about LAAC. INR nurses began sending lists of patients who had experienced falls or might benefit from getting off of blood thinners.|
Step 4: Educate patients on the benefits of LAAC
When potential patient candidates come into an LAAC program, this is not the finish line. Amy and her team have found that education is essential.
“These patients generally feel fine,” says Amy. “They’re asymptomatic, their rate is controlled, so they have no idea why you’re asking them to have a procedure done.”
Educating patients about the safety and importance of the procedure has proven valuable to increasing LAAC in appropriate patients.
By Boston Scientific
Dr. Shephal Doshi, EP and Dr. Robert Gillespie, Cardiologist review the clinical data and provide guidance on identifying patients who may be appropriate for LAAC.
By Marie-France Poulin, MD; Hussam Suradi, MD; and Clifford J. Kavinsky, MD, PhD
Cardiovascular service line leaders can compare their leadership styles to the renowned Peter Drucker.