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TAVR success: A team-based approach

TAVR success: A team-based approach

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Hemal Gada, MD, MBA

Hemal Gada, MD, MBA

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A successful heart team approach can lead to a leaner and more efficient operation, improved patient selection, outcomes and satisfaction, and even ultimately benefit your bottom line. But it’s paramount to ensure you’ve laid the groundwork for success: which means embracing delegation, empowering key team members, and prioritizing transparency at every level.
 
 
This is really a heart team approach, and that's not going away. Make peace with the fact that you're going to be dealing with a team from this point forward—it's not going to be an individual show." 
  Hemal Gada, MD, MBA
Medical Director of Structural Heart Program
PinnacleHealth CardioVascular Institute
 
 

Controlling complications doesn’t have to be complicated.

It’s a common misconception that the TAVR procedure is incredibly invasive or entails excessive complications. With novel generation platforms and a fully empowered team you can control complication rates and provide predictable patient outcomes. However, these objections deserve to be addressed, and you should keep them in mind as you educate your team.
 
 

5 key team members and skill sets to utilize

There are many team members involved in the care of each patient, and each one plays a role in helping your program perform at the highest level. Be sure to leverage the whole team's unique skill sets, and continually challenge yourself to identify new contributors to help your program excel.
 
1

Interventionalists

Creating change in a culture that may have been primarily surgical requires interventionists and surgeons to be in perfect lockstep, letting one another’s skills complement each other, and building trust in the relationship.

 
2

Clinic Coordinator

Having an adept clinic coordinator available to touch base with nursing staff in every setting assures that day-to-day hassles are managed and addressed before they become a problem.

 
3

Schedulers

Ensure your schedulers are putting their unique skills to use applying algorithms and arranging tests and procedures that will make your program more efficient.

 
4

Billing and Coding

An open, transparent conversation with your billing and coding team with regards to your documentation that informs DRG assignments, and coding for use of technologies that may be eligible for NTAP (New Technology Add-on Payments), is perhaps the most important piece of all. They’ll need to know precisely what you’re documenting.

 
5

Ancillary Services

Early contact with physical therapy, occupational therapy, case management and social work to help those units understand that your patients will not need ancillary services will save everyone headaches down the line.

 
 

Seeing is believing.

Dr. Gada’s strategy for an efficient team starts with clinical observation. The very first step of a new program involves the invitation of everyone from industry partners to TAVR team members to see the process in action through:

  • A preparatory conversation about economics, efficiencies and the experience and outcomes that are important to patients.
  • A day of observation to reinforce those economics, efficiencies and patient metrics in real-time.
  • Broad-based overviews and presentations between cases to discuss technicalities, procedures, and the fundamentals of a minimalist approach.

It doesn't take long to create a lean and efficient TAVR program that benefits both your clinic and your patients. But it does require a commitment to forward-thinking and planning. Remember, a culture doesn’t change overnight.

 

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