2016 tctmd heart team survey

2016 TCTMD
HEART TEAM SURVEY
In January 2016, TCTMD sent out a survey
request to our subscribers seeking their
opinions on the Heart Team both in
concept and practice. Overall, 254 people
responded. Here are their thoughts.
Who responded?
Job Titles
Referring Cardiologist
2.4%
2.4%
Nurse Practitioner
Anesthesiologist
>1
1 -2
3 -4
5-6
7+
Imaging Specialist
4.7%
Coordinator
Cardiac Surgeon
Nurse
4.7%
6.3%
9.1%
64.2%
What type of practice
Years of Heart
Team experience
Cath Lab Technician
3.5%
Fellow
Other
1.2%
0.8%
0.8%
Interventional
Cardiologist
6.3%
11.8%
ACADEMIC /
TEACHING HOSPITAL
53.9%
COMMUNITY/
PRIVATE PRACTICE
40.9%
5.1%
OTHER
21.7%
Gender
18.5%
78.3%
20.9%
41.7%
MEN
WOMEN
0.8% — Prefer not to answer
Region
Age
NORTH
53.1%
AMERICA
US – South: 14.6%
US – Midwest 14.2%
US – Northeast: 10.6%
US – West: 5.9%
US – Mid-Atlantic: 3.1%
Other North America: 4.7%
30.7%
EUROPE
AFRICA
6.7%
5.9%
ASIA
2.8%
SOUTH
AMERICA
AUSTRALIA
0.8%
Ethnicity
25-34
35-44
45-54
55-64
65+
5.5%
26.4%
28.3%
29.9%
Negative
Difficult
Survey participants
chose up to 3
Time-saving
Necessary
Positive
Hispanic/
Latino
Asian
African American
8.3%
9.1%
9.8%
68.9%
9.1%
At which stage(s) of care is the Heart Team involved in your practice?
INITIAL ASSESSMENT AND DIAGNOSIS
42.9%
85.4%
TREATMENT SELECTION
Neutral
Efficient
Multidisciplinary
Collaborative
Cost-effective
Beneficial
Inconsistent
White
0.8%
Prefer not to answer
How do you describe the Heart Team?
Prefer not
to answer
3.1% Other
0.8% Black/
56.7%
PROCEDURE
FOLLOW-UP
26.8%
OF NOTE:
19.7% said they use the Heart Team during all four stages
29.1% said they only use it for treatment selection
6.7% said only during the procedure
4.3% said only for initial assessment and diagnosis
0.8% said only for follow-up
Who benefits most from the Heart Team?
“Whoever makes
most revenue”
“No one”
72.0%
PATIENT
tctmd.com
12.6%
CARDIAC
SURGEON
7.1%
INTERVENTIONAL
CARDIOLOGIST
1.6%
NONPHYSICIAN
STAFF
6.7%
OTHER
“Hospitalist”
“Health system”
Who thinks the Heart Team works well in practice?
BY PRACTICE
BY POSITION
100%
80%
66.9%
81.3%
Overall, 71.7% responded “well” or “very well”—with the rest responding “neutral,” “poorly,” or “very poorly.”
76.1%
73.0%
69.2%
BY GENDER
BY REGION
83.0%
72.4%
66.7%
68.9%
60%
71.7%
SAID “WELL”
OR “VERY WELL”
OVERALL
40%
20%
0%
Interventional Cardiac Nonphysician
staff
cardiologists surgeons
Academic / Community/
Teaching
Private
hospital
practice
What works best about the Heart Team?
“Streamlined appointments; cardiologist
and Cardiothoracic surgeon see patients
in the same day, if possible.”
– Nurse
“Better patient care, more
efficient procedures, and
fewer errors and missed
opportunities.”
– Cath lab technician
“Keeps maverick operators under control.”
– Interventional cardiologist
“Multiple disciplines bring multiple points
of view.”
“Interaction and collegiality
between surgery and
cardiology.”
– Interventional cardiologist
US
Women
Europe
Men
What are the biggest barriers that prevent your Heart Team
from functioning optimally?
“Physicians still feeling ‘superior’ to other
staff and communication breakdowns.”
“Multiple Cardiothoracic
surgeon buy-in.”
“Pressure from hospital to send more
patients to surgery.”
“Not being reimbursed for
all the additional time and
effort required.”
– Nurse
– Interventional cardiologist
– Coordinator
– Cardiac surgeon
“Difficulty in getting all stakeholders together at the same time.”
– Interventional cardiologist
– Interventional cardiologist
How necessary is the Heart Team for...
84.3%
of respondents say
the Heart Team
NEEDS IMPROVEMENT
IN PRACTICE
PATIENT CARE?
31.9%
24.4%
PROFESSIONAL
DECISION MAKING?
47.6%
11.8%
Necessary Unnecessary
say they have received some form of
FORMAL EDUCATION/TRAINING
about the Heart Team.
7.1%
Necessary Unnecessary
Does the patient belong on the
Heart Team?
31.5%
of respondents are very unsatisfied or unsatisfied
with how their ADMINISTRATION SUPPORTS
TEAMWORK AT THEIR INSTITUTION.
How valued do you feel by other
members of the Heart Team? (scale of 1-10)
YES
48.4%
NO
51.6%
8
CATH LAB TECHNICIAN
8.19
7.27
FELLOW
7.59
OVERALL
6
4
PHYSICIAN ASSISTANT
NURSE PRACTITIONER
NURSE
ANESTHESIOLOGIST
COORDINATOR
2
0
7.31
REFERRING CARDIOLOGIST
Interventional Cardiac Nonphysician
staff
cardiologists surgeons
tctmd.com
“They are the center of the
discussion and should have the last
decision on their treatment options.”
– Interventional cardiologist
“[Patients] are the reason we exist.”
– Nurse
“[Their presence would] limit the
team from speaking out frankly.”
FREQUENTLY
OFTEN
17.4%
13.8%
SOMETIMES
18.6%
RARELY
18.6%
– Nurse practitioner
“The patient, unless he or she is a
doctor, does not have the competence
to engage in such a discussion.”
31.6%
NEVER
– Interventional cardiologist
How much do you value other members of the Heart Team? (scale of 1-10)
SOCIAL WORKER
10
In practice, how often does
the patient participate in
the Heart Team?
IMAGING SPECIALIST
CARDIAC SURGEON
INTERVENTIONAL CARDIOLOGIST
5.62
6.24
6.28
6.45
“The coordinator is
single most important
member of team.”
“The more staff involved
in the treatment process,
...the better.”
“The referring
cardiologist is the
most important—
without patients
there is no program.”
“Palliative care is [also]
a vital member of the
team.”
– Interventional cardiologist
6.50
6.61
6.88
7.00
7.47
7.64
8.32
9.47
– Interventional cardiologist
– Interventional cardiologist
– Interventional cardiologist
“We rarely require a social worker.”
– Cardiac surgeon