Accreditation for Cardiovascular Excellence (ACE) is thrilled to announce that we are participating in the Society for Cardiovascular Angiography & Interventions (SCAI) Scientific Sessions, April 28 – May 1, 2021. ACE Chief Medical Officer, Bonnie Weiner, MD, MSEC, MBA, MSCAI, will be presenting new accreditation science – Ongoing Review is Necessary for Maintaining Quality – as a part of the on-demand abstract sessions. ACE’s presentation can be found with the other Quality Improvement sessions at https://scai.confex.com/scai/2021/meetingapp.cgi/Session/3472.

The Scientific Sessions provide a phenomenal opportunity for healthcare leaders to collaborate, share information, and take best practices back to their home organizations. ACE has a particularly wide perspective of this collaborative context – as a physician-run nonprofit accrediting body, ACE has reviewed more than 100 facilities performing catheter-based cardiovascular procedures and 7,023 individual cases over the past 11 years.

New Accreditation Science: Third-party Review Continues to be Necessary

Taking the opportunity provided by the Scientific Sessions to share ACE’s accreditation experience with a wider audience, ACE took a deep dive into our accreditation data to try and pin down the essential value of third-party review. The primary takeaway from ACE’s review of the accreditation data is that quality improvement is an ongoing process.

Much like the shift across the healthcare space from episodic care to an emphasis on continuous, holistic care, quality improvement at the organizational level benefits greatly from taking a long-term and ongoing perspective.

As such, ACE builds relationships with our institutional partners that are facilitative of quality, rather than evaluative of quality. Prioritizing facilitation over assessment in this way means that ACE must work with each individual facility whom we accredit to understand the unique processes, capacity, and culture of the organization, and only then work from this starting point outward towards the mutual goal of quality improvement.

New accreditation science from ACE: insight from subsequent reviews over times suggest third-party review continues to be necessary. Quality Matters.

More specifically, the data highlighted by ACE’s abstract featured in this year’s Scientific Sessions revealed that while a single accreditation cycle resulted in quality improvement (in documentation, angiographic quality, indications, patient outcomes, and other parameters), in order to sustain these improvements over time, multiple accreditation cycles are necessary.

This is likely due to the natural changes in practice, clinical guidelines, leadership, organizational culture, and staff which occur over time. It may also occur due to clinician “drift” from consistently fulfilling evidence-based practice standards.

To reduce variability amidst this fluctuating environment requires not only that measurements of quality need to regularly be taken, but also that the “measuring stick” itself needs to evolve.

That is why ACE frequently reviews accreditation standards against organizational outcomes, to ensure that the parameters examined throughout the accreditation process are those which actually have a tangible impact on the quality of care delivered by an institution. ACE is enabled to do this important work, in part, because of a critical third-party perspective.

ACE’s data suggests that internal processes for random case and practice review may not be sufficient for quality improvement, and that the two-year accreditation cycle provides valuable insight for organizational management in a repeatable, predictable way.

This being the case, the value of third-party review is partially that it provides the necessary distance to offer an unbiased perspective of organizational processes, while simultaneously facilitating, rather than merely assessing practice, by tailoring resources, guidance, and support to unique organizational circumstances.

We hope you will be able to join us at the SCAI Scientific Sessions to dig a bit deeper into these and other concepts April 28 – May 1, 2021! ACE is committed to continuing to build the evidence base of accreditation and third-party review by developing and presenting new accreditation science at SCAI and beyond.

A guiding principle of ACE’s philosophy is that collaboration is the surest route to sustained quality improvement, so your thoughts, comments, and participation at the meeting will be much appreciated. ACE’s staff is privileged to work with some of the most tenacious, committed, and insightful professionals in healthcare, and we thank you for your ongoing efforts every day!

Zack McElgunn
Zack McElgunn is the director of customer services of Accreditation for Cardiovascular Excellence (ACE) and a Quality Matters contributor. ACE is an independent, physician-led organization that evaluates and monitors facilities providing cardiovascular care.

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