2018 Detailed Annual Report © Society for Vascular Surgery Patient Safety Organization, 2018. All rights reserved. TABLE OF CONTENTS 1. Executive Summary: The Value of Participation in the VQI 3 2. VQI Members Profile 5 3. Outcomes and Data Quality Dashboards 6 4. Regional Quality Groups 7 5. Quality Improvement Projects: Learning from the Data 8 6. VQI National QI Projects 9 7. VQI Data Analysis 12 8. Using VQI Data for Collaborative Projects 12 9. Future Developments 15 APPENDICES A. Participating Sites 17 B. SVS Patient Safety Organization 19 C. Medstreaming/M2S Technology Partner 19 D. VQI Registry Dashboards 20 E. Sample COPI Report (Endovascular AAA Length of Stay) and Best Practice Dashboard (Center-level) 32 F. VQI Regional Quality Groups and Leadership 37 G. VQI Quality Improvement Projects 2017/18 38 H. National Approved Project List, October 2017 – September 2018 39 I. National Publications, October 2017 – September 2018 44 J. SVS PSO Councils and Registry Committees 49 2 SVS VQI 2018 Annual Report 1. EXECUTIVE SUMMARY—THE VALUE OF PARTICIPATION IN THE VASCULAR QUALITY INITIATIVE (VQI) “If you can’t measure it, you can’t improve it.” This management catchphrase has been attributed to Edwards Deming, Peter Drucker, Lord Kelvin and others, but it could serve as the founding principle of the Vascular Quality Initiative. Our mission is to gath- er data to help hospitals and providers assess their performance and provide better vascular care. VQI’s 12 registries contain demographic, clinical, use the strength of different societies (VQI, NCDR, procedural and outcomes data from more and SIR) to enhance device evaluation and than 500,000 vascular procedures performed to develop objective performance criteria for nationwide and in Canada. Each record the endovascular treatment of lower-extremity includes information from the patient’s initial arterial occlusive disease. VQI also works with hospitalization and at one-year follow-up. The industry to provide clinically detailed data for wealth of data allows centers and providers to device performance, post-market surveillance, compare their performance to regional and and label expansion. VQI has partnered with national benchmarks. All centers and providers vascular registries from Europe and Asia to receive biannual dashboards and regular form the International Consortium of Vascular performance reports, so they can use their Registries (ICVR) to bring a global perspective to data to support quality improvement initiatives. improving vascular care and device evaluation. Biannual regional meetings allow physicians of different specialties, nurses, data managers, quality officers, and others to meet, share information and ideas, and learn from each other in a positive and supportive environment. Members have used VQI data to significantly new56 centers improve the delivery of vascular care at local and national levels, reducing complications and 502 expenses. total centers Investigators have used VQI data for risk 519,178 stratification, outcomes analysis, quality procedures improvement, defining best clinical practices, comparative effectiveness research and new99 data reducing resource utilization. This work has analysis projects resulted in more than 140 scientific publications in peer-reviewed journals since 2011. VQI 63 membership also facilitates participation new published journal articles in clinical trials and other medical device evaluation efforts. The VQI collaborates with multiple organizations, 18 including the American College of Cardiology, new quality Society of Interventional Radiology, governmental improvement regulatory agencies, device manufacturers, and abstracts and payers. The Registry Assessment of Peripheral posters Interventional Devices (RAPID) is a collaboration of VQI with these other groups. RAPID plans to 3 www.VQI.org Activities for 2017/2018 INTRODUCTION TO THE VQI 1. Center and procedure growth: As of September The Vascular Quality Initiative® (VQI®) is a 2018, VQI had reached two new milestones, with more collaboration of the Society for Vascular Surgery than 500 member centers and more than 500,000 Patient Safety Organization (SVS PSO), 18 vascular procedures in its registries. regional quality improvement groups organized under the SVS PSO, and Medstreaming/M2S, its 2. Projects and journal articles: In the past year, commercial technology partner. Other partners VQI’s Research Advisory Council approved 99 data include the American Venous Forum (AVF), the analysis projects using VQI data, and 63 articles were Society for Vascular Medicine (SVM), Vascular published in peer reviewed journals. Access Society of America (VASA) and the Society of Vascular Ultrasound (SVU), along 3. National quality improvement initiatives: The SVS with an additional 15 endorsing societies (see PSO launched two major quality initiatives, working Appendix B for the full list). with regional quality groups and centers to develop strategies to 1) increase the prescription of appropri- The mission of VQI is to improve the quality, ate discharge medications for secondary prevention safety, effectiveness and cost of vascular and 2) increase the use of imaging for long-term healthcare. follow-up of endovascular AAA patients. The SVS PSO is a wholly-owned LLC of the 4. Quality project program: There are 55 VQI centers Society for Vascular Surgery, with headquarters working on specific quality improvement projects. Re- in Chicago. The SVS PSO governs all functions sults will be presented as posters and abstracts at the of VQI, including the specification of data VQI@VAM meeting to take place in June 2019. elements captured in each registry, the types of standard reports made available to regional 5. Dashboards and Center Opportunity Profile groups, member hospitals and physicians, for Improvement (COPI) reports: The center-level and national quality improvement projects and physician-level dashboard reports are produced sponsored by VQI. quarterly for each VQI registry to report outcomes and provide benchmarks. COPI reports use VQI data to The SVS PSO is supported by 170 physician highlight process of care for improvement. volunteers who dedicate their time and effort in support of VQI’s mission. These physicians 6. VQI@VAM: The SVS PSO hosts this annual meeting in provide governance, clinical support to all conjunction with the SVS Vascular Annual Meeting to the registries and data analyses and ad-hoc present the latest quality activities, including in-depth support in areas such as industry partnerships case reviews, case study presentations, and outcomes and communications. In addition, all centers analysis as well as presentations from quality experts. and regions have lead physicians and regional VQI@VAM19 will be held at National Harbour, MD. medical directors to provide guidance, identify best practices and develop regional initiatives. 7. Industry projects: Five post-approval surveillance projects are currently underway in VQI. In addition, the The SVS PSO is funded by annual registry Transcarotid Surveillance Project (TSP) allows centers subscription fees from participating hospitals or to participate in the study and receive reimburse- physician groups, and additional contributions ment for eligible cases. VQI allows data collection for VQI projects are provided by corporate for CREST-2 participation and works with industry and supporters. regulatory agencies in the Registry Assessment of Pe- ripheral Interventional Devices (RAPID) and Superficial Popliteal EvidEnce Development (SPEED) projects. 8. Development: The SVS PSO is currently working on enhancements to VQI’s PVI and Hemodialysis regis- tries, and two new registries are nearing completion – the Vascular Medicine Registry and the Venous Stent VascularVascularRegistry. Quality Quality Initiative® Initiative® 4 SVS VQI 2018 Annual Report YEAR IN REVIEW 2017/2018 YEAR IN REVIEW 2017/2018 Bard LifeStent® Popliteal Artery Initial work has been completed on defining a Technology Improvements VQI Activity Stent Project set of core data elements as well as unique with External This post-approval surveillance project is device identifiers.The current phase involves Through M2S Outcomes Reporting designed to further evaluate the Bard analyzing device performance. The 4th Annual Stakeholders LifeStent® for treatment of popliteal artery Meeting was held recently in Silver Spring, MD. atherosclerosis. It will enroll 74 patients with Daniel Bertges, MD, University of Vermont Registry Revisions New Quarterly Dashboards Medical Center, presented a preliminary MEDICAL DEVICE two-year follow up, and remains open for Transition to the newly revised CAS registry was completed, with These Registry-specific reports allow physicians and centers to compare member participation. analysis of endovascular device performance in MANUFACTURE PROJECTS the superficial femoral and popliteal artery mapping of old registry data elements such that all data are available to their performance to regional and national benchmarks on dozens of location. The goal is to share data from multiple centers in the Analytic Engine. Enhancements to the PVI registry included process and outcome measures. Medtronic IN.PACT Admiral DCB the addition of drawings to illustrate TASC grading and regular updates to TCAR Surveillance Project registries to provide a larger database for ISR Project analysis. The FDA hopes to use this real-world devices through GUDID data importing. Semi-Annual Regional Reporting This project is designed to collect one-year This