FINAL OUTCOMES REPORT

Transcription

1 OVERVIEW FINAL OUTCOMES REPORT The annual Endovascular Advances: A Hands On Preceptorship Program is a continuing medical education series designed to provide physicians with hands on training in all aspects of managing peripheral, arterial, and venous disease, including diagnosis and treatment. Approved attendees were trained during 1 of 16 two day programs under the direct supervision of faculty at each participating program site. Attendees gained exposure to procedures for atherectomy, AV access, crossing strategies, CTO, and stent placement. This report encompasses outcomes for the year 2017, continuing into the first quarter of Total Activities: 16 Certified by the Academy for Continued Healthcare Learning (ACHL) for up to 16.5 AMA PRA Category 1 Credits (amount of credit varied by site) Supported by an educational grant from Boston Scientific Corporation (Grant ID: CV_24160_0809) Total Participants: 35 CME/CE Certificates Generated: 20 ACTIVITIES Date Faculty Hospital Location # of Credits March John Ross, MD Regional Medical Orangeburg, SC 16 March Jim Joye, DO Silicon Valley Mountain View, CA 15.5 Interventional March Michael Silva, MD The University of Galveston, TX 15 Texas medical Branch (UTMB) April Steve Henao, MD Heart Hospital of Albuquerque, NM 16.5 New Mexico at Lovelace Medical May 2 3 John Ross, MD Regional Medical Orangeburg, SC 16 May 8 9 John Ross, MD Regional Medical Orangeburg, SC 16 May Rajesh Dave, MD Holy Spirit Hospital Camp Hill, PA 12 June John Ross, MD Regional Medical Orangeburg, SC 16 June Steve Henao, MD Heart Hospital of Albuquerque, NM 16.5 New Mexico at Lovelace Medical August Steve Henao, MD Heart Hospital of New Mexico at Albuquerque, NM 16.5

2 Lovelace Medical September 5 6 John Ross, MD Regional Medical October 5 6 Michael Silva, MD The University of Texas medical Branch (UTMB) October Jim Joye, DO Silicon Valley Interventional October Steve Henao, MD Heart Hospital of New Mexico at Lovelace Medical October John Ross, MD Regional Medical December 6 7 Jim Joye, DO Silicon Valley Interventional Orangeburg, SC 16 Galveston, TX 15 Mountain View, CA 15.5 Albuquerque, NM 16.5 Orangeburg, SC 16 Mountain View, CA 15.5 Learning Objectives Peripheral Analyze risk assessment and diagnostic methods in peripheral arterial disease Compare and contrast medical, surgical, and endovascular treatment options for peripheral arterial disease Formulate strategies to manage potential complications AV Access Evaluate devices for maintaining access in patients with renal disease Perform arteriovenous fistula and graft surgeries and ensure maintenance Demonstrate endovascular thrombectomy techniques Evaluate and create proper dialysis access and patient management Carotid Analyze risk assessment and diagnostic methods in carotid artery disease Compare and contrast medical, surgical, and endovascular treatment options for carotid artery disease Formulate strategies to manage potential complications

3 EXECUTIVE SUMMARY Level 1 & 2: Faculty were highly rated, with an overall average rating of 4.97 (out of 5.00) Quality of educational content was highly rated as well (3.93 out of 5.0) Learners strongly felt they were able to achieve the learning objectives of the course (average rating of 4.83 out of 5.0) 100% of learners would recommend this activity to a colleague 100% of learners felt the activity was fair and balanced, and did not perceive any bias or commercialism towards any product or drug in this activity Level 3 & 4: 100% of learners felt this activity improved their knowledge, while 93% felt it improved (or would improve) their competence 93% of participants anticipate this activity will improve their performance, noting higher comfort in performing procedures as a result of this experience. 73% of participants anticipate this activity will improve their patient outcomes, based on increased knowledge and experience with the array of treatment options to choose from. 79% of learners plan to change their practice after participating in the activity o 43% plan to update management approaches for complications o 71% plan to secure new equipment and/or devices for their facilities o 21% indicated they would utilize a different imaging technique Up to 228 patients will be impacted monthly by these changes. Educational Impact: Participants are better able to perform dialysis access procedures and endovascular interventions. Participants report that they plan to acquire new equipment/technology and update their current management approaches to complications. Participants also report improved confidence and experience based on their participation in this course, which may translate into improved performance of procedures.

4 Pre/Post Comparison/Intent to Change 1 5 Point Scale: 5=Excellent; 4=Good; 3= Satisfactory, 2=Fair; 1=Poor Peripheral Artery Disease and/or Carotid Artery Disease: How would you rate your current ability to perform the following? Utilization of risk assessment tools (CVD risk calculator, ABI, or other) Selection of appropriate diagnostic methods and treatment options Technical execution of endovascular procedures Development of management strategies for complications with endovascular revascularization Pre Post N = 14 pre/9 post Renal Disease: I CURRENTLY/NOW PLAN TO to perform the following for patients with renal disease who require dialysis access: Catheter placement Arteriovenous fistula Arteriovenous graft surgery Pre Post N = 6 pre/3 post

5 Dialysis Access: How would you rate your ability to perform the following?: Selection of appropriate access types and locations Technical execution of catheter placement Arteriovenous fistula and graft surgeries Pre Post N = 6 pre/9 1 5 Point Scale: 5=Always; 3=Sometimes; 1=Never Selection of Therapy: I now plan to use endovascular therapies as first line treatment in patients with the following conditions: Peripheral arterial disease N = 9 post Carotid arterial disease

6 5 Guidance on Diagnostic and Treatment Options: I now plan to apply the following information in my selection of diagnostic and treatment options for my patients with carotid artery disease or peripheral artery disease: N = 9 post Evidence based clinical guidelines Case Studies Recent clinical trial findings Faculty Evaluation Scale: 5= Excellent; 4=Good; 3=Satisfactory; 2=Fair; 1=Poor Faculty Name Ability to effectively convey the subject matter Ability to present scientifically rigorous information Ability to adjust to the knowledge and experience level of the audience Expertise on the subject matter James Joye, DO John Ross, MD, FACS Michael B. Silva, Jr., MD, FACS Rajesh Dave, MD Steve Henao, MD, FACC

7 Activity Evaluation 1. Please rate the following learning objectives to indicate if you are better able to: Scale: 5=Excellent; 4=Good; 3=Satisfactory; 2=Fair; 1=Poor Rating Carotid A. Analyze risk assessment and diagnostic methods in carotid arterial disease 5.00 B. Compare and contrast medical, surgical, and endovascular treatment options for carotid arterial disease 5.00 C. Formulate strategies to manage potential complications 5.00 AV Access D. Evaluate devices for maintaining access in patients with renal disease 5.00 E. Perform arteriovenous fistula and graft surgeries and ensure maintenance 4.60 F. Demonstrate endovascular thrombectomy techniques 4.80 G. Evaluate and create proper dialysis access and patient management 4.20 Peripheral H. Analyze risk assessment and diagnostic methods in peripheral arterial disease I. Compare and contrast medical, surgical, and endovascular treatment options for peripheral arterial disease J. Formulate strategies to manage potential complications 5.00

8 2. Objectivity and balance A. Excellent 93% B. Good 7% C. Satisfactory 0% D. Fair 0% E. Poor 0% 3. Did you perceive any bias or commercialism towards any product or drug in this activity? A. No 100% B. Yes. If yes, please explain 0% 4. Please evaluate by marking the appropriate response Scale: 4=Excellent; 3=Good; 2=Fair; 1=Poor Rating A. Quality of educational content 3.93 B. Level of instruction 3.80 C. Effectiveness of teaching method used 3.87 D. Time allotted for question and answer session(s) 3.80 E. Facilities, technical arrangements, efficiently supported this activity 3.93 F. Appropriateness and effectiveness of active learning strategies (questions, cases, discussion, etc) 3.93

9 5. Please rate the importance of your reasons for attending this educational activity: Scale: 4=Excellent; 3=Good; 2=Fair; 1=Poor Rating A. Institutional requirement 2.75 B. Topics 4.87 C. Faculty reputations 4.67 D. Interaction with colleagues 4.53 E. CME/CE credit Please rate the projected impact of this activity on your knowledge, competence, performance and patients outcomes: This activity increased my knowledge. A. Yes If yes, please describe: 100% Do some procedures I had the opportunity to see in real time many endovascular products On creations and options for the ESRD patients Global It will affect all 3 aspects of my practice Atherectomy approach Utilizing different wires to get up and over; increased applications of the Jetstream atherectomy device This was an excellent course. It was hands on with good patient volume The course definitely expanded my competence with CAS, and likely will impact the outcome of my patients. Great introduction to percutaneous methods for maintenance of dialysis access Highlighted certain finer points More comfortable dealing with ESRD population and their management Complexity

10 B. No 0% C. No Change 0% 7. This activity increased my competence. A. Yes If yes, please describe: 93% I learned some techniques that I had not utilized before Understanding different options Global Learning latest concepts on endovascular interventions. Using Jetstream Utilizing different wires to get up and over; increased applications of the Jetstream atherectomy device I learnt how to use Filter wire The detailed and thorough review of the procedure steps and potential complications improved my knowledge, competence, and confidence in this particular procedure. Hands on training was invaluable Picked up some technical pointers Increased knowledge B. No 0% C. No Change 7%

11 8. This activity will improve my performance. A. Yes If yes, please describe: 93% For doing carotid stents I will be able to select some techniques more appropriate to the patient needs Global New techniques learned in this course Retro pedal access Utilizing different wires to get up and over; increased applications of the Jetstream atherectomy device Learnt how to treat reduced flow post stent deployment More comfortable applying percutaneous techniques for maintaining access Application go above 7 and 8 Complex cases B. No 0% C. No Change 7% 9. This activity will improve my patient outcomes. A. Yes. If yes, please describe: 73% Global More robust and more options now available Better debulking and hopefully less stent employment Learn how to manage and prevent complications The management of complications definitely will impact the outcome of my patients. In addition, the prevention of complications with a good surgical technique will help me

12 I expect to be able to offer a better service to my patients Treat complications B. No 0% C. No Change 27% 10. Please identify how you will change your practice as a result of attending this activity (select all that apply) A. Utilize a different imaging technique 21% B. Secure new equipment or devices for my facility 71% C. Update management approaches for complications 43% D. This activity validated my current practice; no changes will be made 21% E. Other. Please specify: 7% Motivate me to learn more about vascular surgery 11. Number of patients affected by these changes each month: A. 0 0% B % C % D % E. > 50 7%

13 13. Effect of changes on patient care: A. Significant effect 36% B. Some effect 64% C. Minimal effect 0% D. No effect 0% 14. Please indicate any barriers you perceive in implementing these changes. (select all that apply) A. Lack of experience 21% B. Lack of opportunity (patients) 14% C. Lack of resources (equipment) 21% D. Lack of administrative support 14% E. Lack of time to assess/counsel patients 0% F. Reimbursement/insurance issues 14% G. Patient compliance issues 0% H. Lack of consensus or professional guidelines 0% I. Cost 7% J. No barriers 50% K. Other, please specify: 0% 15. Will you attempt to address these barriers in order to implement changes in your competence, performance, and/or patients outcomes? A. Yes? How? 36% Get more training and educate senior leadership and referring community

14 Adopt cost effective techniques Will try to market myself Established better network with nephrologists B. No? Why Not? 0% C. N/A 64% 16. How many years have you been in practice? A % B % C % D. >16 43% 17. Would you recommend this activity to a colleague? A. Yes 100% B. No 0% 18. How did you first hear about this activity? (Choose only 1) A. Institution Calendar 7% B. Flyer 0% C. Colleague 36% D. E mail 36% E. Other: 21% Phone contact

15 Boston scientific rep (2) 19. EDUCATIONAL NEEDS A. What topic areas would you like to see in future activities? Vein ablation course Excellent course because of Dr. Henao's skills and evidence based approach and knowledge The course was perfect Salvage of AV access with DRIL, RUDI etc B. General comments: Excellent Very well organized course. Great training course. Concentrated on the percutaneous strategies. More hands on No. of Respondents 7 No. of Respondents who skipped this question 9