From the Adult Congenital and Pediatric Cardiology Section Quality Measures Developed for Pediatric Ambulatory Care The Leadership Council of the Adult Congenital and Pediatric Cardiology Section (ACPC) has successfully developed quality measures for pediatric ambulatory care. This in turn has led to the development of the ACPC Quality Network as a mechanism to test existing metrics for pediatric cardiology, according to a Council Perspective published Jan. 30 in the Journal of the American College of Cardiology. ACC’s ACPC Section developed the ACPC Quality Network to give participants and practices an avenue to review and pilot sets of congenital heart disease (CHD) quality metrics across several domains in pediatric cardiology and CHD. Devyani Chowdhury, MBBS, FACC, a member of the ACPC Section Leadership Council, et al., reviewed the process by which the Council approved the 18 quality metrics for ambulatory pediatric cardiology. This began by identifying five areas of interest that lacked evidence to guide practice or were crosscutting clinical issues, including chest pain, infection prevention, Kawasaki disease, Tetralogy of Fallot and transposition of the great arteries (TGA) after an arterial switch operation. In developing metrics for consideration, five teams – one per focus area – reviewed published studies that would guide ambulatory practice of pediatric cardiology and identified key decisions and challenges in their focus area. After the five teams submitted a total of 44 proposed quality measures, an expert panel was formed to review each measure, and a four-week open comment period followed the panel’s discussions. The ACPC Section Leadership Council approved 18 quality measures: three related to chest pain, three to infection prevention, seven to Kawasaki disease, four to TGA and one to Tetralogy of Fallot. “The ACPC Section and Leadership Council used a facilitated RAND process to create a set of quality measures for ambulatory pediatric cardiology that was more successful than prior attempts,” the authors explain. They add that the approved metrics still require testing, and that moving forward, the “ACPC Quality Network is expected to support this testing.” “In the future, new metrics will be proposed and vetted by Section members who identify an area or gap in care – and a corresponding metric can be developed to test,” explains Kathy J. Jenkins, MD, MPH, FACC, an author of the study and program director of the ACPC Quality Network. “The network is intended to be a flexible tool – allowing for metrics to be discarded, as the need to improve in a certain area becomes less necessary, and replaced with newer ones – where the community agrees a reasonable way to measure practice has been identified.” From the Women in Cardiology Section An Advocate For Women in Cardiology: An Interview with Robert A. Harrington, MD, MACC Robert A. Harrington, MD, MACC, is an interventional cardiologist, professor of medicine and chairman of the Department of Medicine at Stanford University. In a recent interview with Hena Patel, MD, a Fellow in Training at Rush University in Chicago, Harrington discusses gender disparities in cardiology and his involvement with the ACC’s Women in Cardiology (WIC) Section. As the first man to become a member of WIC, what motivated you to join? After I gave a presentation on the principles of compensation in a department of medicine during ACC.16, Claire S. Duvernoy, MD, FACC, chair of the WIC Section Leadership Council, asked if I would consider joining. She noted the group needed men who are leaders and that my points on equality and fairness regarding compensation were the type of perspectives that would be considered important in WIC discussions. I was honored to join and try to help. Interestingly, my four daughters have been impressed that this is one of the true honors that I have had in medicine! How has your involvement with the WIC Section been received by your male colleagues? Not as many of my colleagues know about the issues and the group as well as they should. But, ACC leadership, including Richard A. Chazal, MD, FACC, president of the ACC, and C. Michael Valentine, MD, FACC, vice president of the ACC, have been hugely supportive and attended the recent WIC leadership meeting in Washington, DC. Do you think more men cardiologists will be interested in joining? They should be interested, as the issues of mentorship, opportunity, fairness, transparency and equality are critically important ones to our specialty, regardless of gender. As a specialty, we also need to better understand why we are not attracting the most talented medical residents into the field. Right now, approximately 50 percent of U.S. medical students and 40 – 42 percent of U.S. internal medicine residents are women, yet only 15 – 20 percent of cardiology fellows are women. This is an important issue – to be sure we’re recruiting the best and the brightest into our field. As a leader in cardiology, you have mentored many successful cardiologists. What do you see as the structure for mentorship for women? Women and men require much of the same from mentorship: advice, counsel, networking, work-life balance assistance, opportunities, specific assistance with projects, introductions, etc. But women also need women who are role models to emulate. Given the gender realities in academic cardiology, male leaders need to be attentive to what is needed for career growth for women and perhaps even be willing to help a bit more while we all work on the distribution issues. We need a commitment from male leaders in cardiovascular medicine to be engaged in creating an environment for training, for clinical practice and for research that is inclusive of all those who want to bring their talents to the field. We also need to create opportunities for women in our subspecialties to join leadership ranks.I suggest that more men get involved in mentoring women in cardiology, supporting women in leadership, and in becoming members of activities such as ACC’s WIC Section.
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