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2020 SVS VQI Annual Report

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2020 SVS VQI Annual Report 2020 Detailed Annual Report © Society for Vascular Surgery Patient Safety Organization, 2020. All rights reserved. TABLE OF CONTENTS 1. Executive Summary: The Value of Participation in the SVS VQI 1 2. Impact of COVID-19 3 3. SVS VQI Members Profile 4 4. Outcomes and Data Quality Dashboards 5 5. Regional Quality Groups 7 6. MyPAD Pilot 8 7. Quality Improvement Methods: Learning from the Data 9 8. SVS VQI National QI Projects 10 9. SVS VQI Data Analysis 12 10. SVS Guidelines and the SVS VQI 13 11. SVS PSO Surveillance of Paclitaxel Mortality 13 12. Using SVS VQI Data for Collaborative Projects 15 13. The SVS VQI and Compliance with EUMDR 17 14. Future Developments 17 13. The SVS VQI and Compliance with EUMDR 17 14. Future Developments 17 APPENDICES A. Participating Sites 19 B. SVS Patient Safety Organization Structure 23 C. Medstreaming/M2S Technology Partner 23 SVS VQI 2020 Annual Report 1. EXECUTIVE SUMMARY - THE VALUE OF PARTICIPATION IN THE SVS VASCULAR QUALITY INITIATIVE (SVS VQI) Our mission is to gather data to help hospitals and physicians provide better vascular care by learning about their own performance. Although the past year has been dramatically Association (AHA), Society of Interventional impacted by COVID-19, the Society for Vascular Radiology (SIR), Society for Vascular Medicine Surgery’s VQI (SVS VQI) has had another very (SVM), Vascular Access Society of the Americas productive year. SVS VQI’s 14 registries contain (VASA), Society for Vascular Ultrasound (SVU), demographic, clinical, procedural and outcomes governmental regulatory agencies, device data from more than 750,000 vascular procedures manufacturers, and payers. The Registry performed nationwide and in Canada, with Assessment of Peripheral Interventional Devices the addition of Puerto Rico and Singapore this (RAPID) is a public/private partnership which year. Each record includes information from the uses the strength of different societies (SVS VQI, patient’s initial treatment and one-year follow-up. NCDR, and SIR) and their registries to enhance The wealth of data in the registry allows centers device evaluation and to develop objective and providers to be aware of their performance performance criteria for the endovascular and comparison to regional and national treatment of lower-extremity arterial occlusive benchmarks. disease. SVS VQI also works with industry to provide clinically detailed data for device Each center receives biannual dashboards and performance, post-market surveillance, and regular performance reports to allow them to label expansion. SVS VQI has partnered with do meaningful quality assurance and focus vascular registries from Europe and Asia to form their quality improvement initiatives. Biannual the International Consortium of Vascular Registries regional meetings allow physicians, nurses, data (ICVR) to bring a global perspective to improving managers, quality officers, and others to meet, vascular care and device evaluation. share information and ideas, and learn from each other in a positive and supportive environment. Members have used SVS VQI data to significantly improve the delivery of vascular care at a 103 local and national level thereby reducing new centers complications and expenses. 715 total centers Investigators have used SVS VQI data for risk stratification, outcomes analysis, quality 750,153 improvement, defining best clinical practices, procedures comparative effectiveness research and reducing resource utilization. This work has resulted in more 190 than 345 scientific publications in peer-reviewed new data analysis projects journals since 2011. SVS VQI membership also facilitates participation in clinical trials and other medical device evaluation projects. new120 published journal articles This year we are pleased to announce that the American College of Cardiology (ACC) National Cardiovascular Data Registry (NCDR) 18 Peripheral Vascular Intervention (PVI) Registry new quality is being merged with our SVS VQI registries effective January 2021. The SVS VQI collaborates improvement with multiple other organizations, including the abstracts and American Venous Forum (AVF), American Heart posters 1 www.VQI.org Activities for 2019/2020: INTRODUCTION TO THE SVS VQI 1. Center and procedure growth. As of September 2020, SVS VQI had reached two new milestones, with over 700 The SVS VQI is a collaboration of the Society for member centers and more than 750,000 vascular proce- Vascular Surgery Patient Safety Organization dures in its registries. (SVS PSO), 18 regional quality improvement 2. Projects and journal articles. In the past year, Society groups organized under the SVS PSO, and for Vascular Surgery Patient Safety Organization’s (SVS PSO) Medstreaming/M2S, its commercial technology Research Advisory Council approved 190 data-analysis proj- partner. The SVS PSO now has two new ects using SVS VQI data, and 120 articles based on SVS VQI partnerships – one with the ACC to merge data were published in peer reviewed journals. the NCDR PVI registry into the SVS VQI and 3. National Quality Improvement initiatives. The SVS PSO one to partner with the AHA and SVM for continues work on two major quality initiatives, working with the continued development of the Vascular regional quality groups and centers to develop strategies Medicine Consult Registry. Other partners to 1) increase the prescription of Antiplatelet agents and include the AVF, SVM, SIR, VASA and SVU, Statin medications at discharge for secondary prevention following a vascular operation and 2) increase the imaging along with an additional 16 endorsing societies of AAA sac diameter for long-term follow-up of patients who (see Appendix C for the full list). The mission have undergone Endovascular AAA repair. of SVS VQI is to improve the quality, safety, effectiveness and cost of vascular healthcare. 4. SVS VQI Best Practices Dashboards. Center-level dash- board reports are produced quarterly for each SVS VQI registry to report outcomes and provide benchmarks. The SVS PSO is a wholly-owned subsidiary of the Society for Vascular Surgery, with headquarters 5. While the VQI@VAM had to move to a new, online format in Chicago. The SVS PSO governs all functions on short notice, the VQI ONLINE remote event was clearly of SVS VQI, including the specification of a success - with attendance at record levels. We pre- data elements captured in each registry, the sented the latest quality activities, including in-depth case reviews, case study presentations, and outcomes analysis standard reports made available to regional as well as presentations from quality experts. In addition, groups, member hospitals and physicians, and the presentations were used to create an online reference SVS VQI national quality improvement projects. library that can be used as a resource in the future. This library can be accessed for onboarding new sites and in- The SVS PSO is supported by over 250 physician depth learning by current participants. volunteers who dedicate their time and effort 6. Industry projects. Several post-approval surveillance in support of SVS VQI mission. These physicians projects are currently underway in SVS VQI. In addition, the provide governance, clinical support to all Transcarotid Surveillance Project (TSP) facilitates reimburse- the registries and data analyses and ad-hoc ment for centers wishing to perform TransCarotid Arterial support in areas such as industry partnerships Revascularization (TCAR). SVS VQI allows data collection for CREST-2 participation and works with industry and regulatory and communications. In addition, each center agencies in the Registry Assessment of Peripheral Interven- and region have lead physicians and regional tional Devices (RAPID) and Superficial Popliteal EvidEnce medical directors to provide guidance, identify Development (SPEED) projects. best practices and develop regional initiatives. 7. Development. The launch of the Venous Stent Registry and Vascular Medicine Consult Registries were major mile- The SVS PSO is funded by annual registry stones. We completed a major revision to the Hemodialysis subscription fees from participating hospitals or Access Registry (HDA) and minor revisions for EVAR, PVI, physician groups, and additional contributions INFRA and SUPRA and Varicose Vein Registries. In response for SVS VQI projects are provided by corporate to the pandemic, COVID-19 variables have been added to supporters. SVS VQI which will allow us to measure outcomes and the impact of the virus on vascular care in the future. 8. EUMDR. The new European MDR adds a new total product life-cycle approach to medical device regulation. SVS VQI has supplied data for a number of industry partners to help meet EUMDR requirements. Vascular9. SVS Guidelines. Quality Professional societies publish Initiative® clinical practice guidelines to provide evidence-based recom- mendations and to reduce practice variation and to improve care. A report on SVS VQI Assessment of SVS Clinical Practice Guidelines on AAA was published in the September 2020 issue of JVS. (https://pubmed.ncbi.nlm.nih. gov/31973949/). 2 SVS VQI 2020 Annual Report 2. IMPACT OF COVID-19 THE SVS VQI REGISTRIES The abrupt shutdown nationally of routine elective As of end of September 2019, there were 14 SVS vascular surgery procedures on March 15, 2020 fol- VQI registries that contained 635,345 vascular lowing the plea from US Surgeon General to help procedures. During the past year (October ‘Flatten the Curve’. As a result, vascular procedures 2019 through September
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