New ECMO Workgroup and Spring Meeting Signal a New Era of Collaboration in Cardiovascular Care
- 2 days ago
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Charlottesville, VA — Before the formal start of the Spring Quarterly Meeting, something new—and potentially transformative—took place within the Virginia Cardiac Services Quality Initiative (VCSQI).
For the first time, clinicians from across Virginia gathered for a dedicated ECMO Workgroup, launching what leaders hope will become a cornerstone for advancing one of the most complex areas in cardiovascular care.
Guided by workgroup champions Brandi Brummer (VCU), Dustin Money (UVA), and John Miller (VCU), the session immediately set a different tone—one grounded not in theory, but in the realities of clinical practice.
A Closer Look at the Reality of ECMO
Led by Brummer and supported by her fellow champions, the session offered an in-depth look at the structure behind ECMO care—one that extends far beyond a single team or department.
At its core, ECMO is a coordinated system requiring alignment between respiratory therapy, perfusion, nursing, physicians, and data oversight. Even within a single institution, those components can be fragmented. Across institutions, the differences become even more pronounced.
That complexity was not avoided—it was the focus.
Participants examined how programs are structured, how responsibilities are distributed, and how decisions are made in real time under pressure.
Staffing Pressures Surface as a Shared Challenge
While programs varied in structure, one issue proved universal: staffing.
Discussions led by the workgroup champions highlighted persistent challenges in maintaining consistent ECMO coverage, particularly overnight. Even well-established programs acknowledged gaps that require constant coordination, contingency planning, and, at times, external support.
In some cases, ECMO specialists manage multiple patients when resources are tight. In others, teams rely heavily on frontline staff to identify when conditions are no longer safe and require escalation.
The conversation reflected a level of honesty that underscored why this workgroup matters.
Training and Adaptation Take Center Stage
As the discussion shifted to workforce development, it became clear that ECMO expertise is not something that develops passively.
Programs described highly structured training pathways, combining classroom instruction, simulation, and extensive bedside experience. Many also emphasized the importance of ongoing education, with quarterly training sessions, case reviews, and emergency simulations built into program design.
New roles are also emerging. Several institutions have begun implementing “ECMO primers”—team members trained to assist with circuit setup and rapid response—helping to reduce delays during critical moments.
The message was clear: sustaining an ECMO program requires continuous investment in people, not just technology.
No One Model—But Shared Learning
One of the most impactful aspects of the session came during open discussion, where participants—guided by leaders like Money and Miller—began comparing how their programs operate.
Some institutions rely on perfusion-led models. Others have developed respiratory therapy–driven teams. Some operate independently of perfusion altogether, while others use hybrid approaches.
Rather than debating which model was best, the group focused on understanding why each approach works in its specific environment.
That exchange highlighted the true purpose of the workgroup: shared learning without judgment.
Evidence Begins to Shape Practice
The session concluded with a journal club discussion led by John Miller, examining emerging research on distal perfusion strategies and limb ischemia.
The findings challenged commonly used approaches and prompted thoughtful discussion among attendees about whether practice changes may be warranted.
More importantly, it reinforced a cultural shift—one that prioritizes evidence, curiosity, and continuous improvement.
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From Workgroup to Statewide Impact
Immediately following the ECMO session, the broader Spring Quarterly Meeting expanded the conversation to the full VCSQI network.
While the workgroup focused on depth, the quarterly meeting focused on scale—bringing together clinicians, administrators, and leaders from across the state to align around shared priorities.
Leadership updates pointed to continued growth within the organization, including expanded membership, new governance structures, and ongoing discussions around data transparency.
One topic in particular drew attention: the potential move toward more open reporting of performance data across participating programs.
Data Reveals Both Progress and Opportunity
At the core of the Spring Quarterly Meeting was one of VCSQI’s most powerful assets: its data.
But this wasn’t a passive review of numbers.
It was a focused discussion on what the data is revealing—and what must happen next.
With a growing repository of patient data across multiple registries, the Virginia Cardiac Services Quality Initiative continues to provide participating organizations with a clear view into performance across the state.
That visibility is beginning to change how organizations think about improvement.
Moving Beyond Reporting to Action
Rather than simply presenting outcomes, the discussion emphasized how data should be used:
To identify variation across institutions
To uncover gaps in care delivery
To highlight top-performing programs
To drive targeted quality improvement efforts
The message was direct: data alone does not improve outcomes—action does.
And increasingly, VCSQI is positioning itself as the bridge between the two.
Variation Tells the Story
One of the most important themes to emerge from the data review was variation.
Across key measures—ranging from procedural outcomes to care delivery practices—differences between institutions remain.
But leaders were clear in how that variation should be interpreted.
Not as failure.
But as opportunity.
Because within that variation lies something critical:
Evidence that better outcomes are already being achieved—just not everywhere yet.
And that creates a path forward:
Learn from high performers
Share strategies across institutions
Reduce unwarranted variation over time
Connecting Data to the Bedside
Importantly, the discussion did not remain at the system level.
There was a clear emphasis on translating data into real-world impact:
Improving clinical decision-making
Standardizing care where appropriate
Reducing complications and variation
Enhancing patient outcomes and experience
The goal is not just better reports—it’s better care at the bedside.
A Clear Direction Forward
By the end of the session, the direction was clear.
VCSQI is moving toward a model where:
Data is more accessible
Insights are more actionable
Collaboration is more intentional
And improvement is more measurable
For participating organizations, the expectation is evolving as well.
It’s no longer enough to receive the data.
The expectation is to engage with it—to question it, to act on it, and to use it as a catalyst for change.
Recognizing the People Behind the Work
While data, strategy, and innovation shaped the evening, one of the most powerful moments of the Spring Quarterly Meeting centered on something equally important:
the people driving the work forward.
Through the annual Collaborator of the Year Awards, the Virginia Cardiac Services Quality Initiative (VCSQI) took time to recognize individuals whose contributions extend far beyond their formal roles—those who consistently show up, support others, and turn insight into action.
This year’s nominees reflected the depth and strength
of the collaborative:
Megan Vaughan (Bon Secours), recognized for her statewide leadership and ability to connect teams and ideas across institutions
Ali Harned (Inova), honored for her work in advancing process improvement and influencing system-wide clinical practices
Nancy Fauber (UVA), celebrated for her exceptional ability to translate complex data into actionable insights that strengthen care delivery
Eve Dallas (UVA), acknowledged for her leadership in advancing perfusion practices and fostering cross-institutional collaboration
Melanie Johnson (Carilion), recognized for uniting stakeholders and driving meaningful regional engagement
Peter O'Brien, MD (Centra Lynchburg), nominated for his visionary leadership in founding and advancing the Virginia Heart Attack Coalition (VHAC) and strengthening collaboration across cardiovascular systems statewide
Honoring Excellence—and Longstanding Contribution
The 2025 Collaborator of the Year Award was presented to Nancy Fauber, whose behind-the-scenes contributions have played a critical role in shaping data-driven improvement across the network.
Described by colleagues as someone who can always be counted on for answers—or to find them—Ferber exemplifies the often unseen but essential work that powers quality improvement efforts.
In addition, this year’s recognition carried a deeper significance.
Both Eve Dallas and Dr. O'Brien have been consistently nominated over multiple years, reflecting their sustained impact and leadership within the collaborative.
Following discussion with the Board, it was acknowledged that while board members have traditionally been excluded from award eligibility, their contributions extend far beyond governance. Both individuals have played active, hands-on roles in advancing initiatives, supporting peers, and strengthening collaboration across the network.
As a result, they were formally recognized as 2025 honorees, honoring not just a single year of impact—but a pattern of continued leadership and commitment to VCSQI’s mission.
More Than Awards
What stood out most about this portion of the evening was not just the recognition itself, but what it represented.
These individuals are not working in isolation. They are:
Sharing knowledge across institutions
Supporting peers in real time
Driving improvements that extend beyond their own organizations
And in doing so, they embody the very purpose of VCSQI.
Because while data identifies opportunities, it is people—like those recognized that evening—who turn those opportunities into meaningful change.
Innovation Challenges Traditional Models
Special Presentation: Universal Bed Model Improves Outcomes and Length of Stay After CABG
Paul Wehman, MD, Bon Secours - Memorial Regional Medical Center,
Bon Secours - St. Mary's Hospital
The evening concluded with a keynote presentation from Dr. Brody Wehman (Bon Secours - Memorial Regional Medical Center, Bon Secours - St. Mary's Hospital), who introduced what may be one of the most compelling care delivery innovations discussed that night: the Universal Bed Model.
At its core, the model challenges a long-standing assumption in hospital care—that patients must move through multiple units as they recover.
Instead, the Universal Bed Model keeps the patient in one room for the entirety of their hospital stay, with the level of care adjusting around them.
For cardiac surgery patients, this means eliminating the traditional progression from ICU to step-down units—removing transitions that, while routine, can introduce delays, inefficiencies, and risk.
Dr. Wehman walked attendees through both the rationale and the results.
Rethinking a System Built on Movement
In traditional care models, patient transfers are often seen as necessary milestones in recovery. But Dr. Wayman challenged that perspective, highlighting several inherent issues:
Delays in transferring patients out of the ICU due to bed availability
Increased risk during handoffs between care teams
Disruptions to patient recovery, including sleep and overall comfort
Fragmentation of care across multiple units and staff
In contrast, the Universal Bed Model brings the care to the patient—allowing acuity to shift without requiring physical relocation.
Measurable Impact on Outcomes
What made the presentation particularly compelling was not just the concept—but the data behind it.
Early results from implementation showed:
Reduced ICU and overall length of stay
Fewer complications, including infections
Improved response to clinical deterioration (failure-to-rescue)
Enhanced patient satisfaction, driven by continuity of care
The model also demonstrated operational benefits, including improved efficiency in rounding, reduced time spent on transfers, and better alignment across care teams.
A Better Experience for Patients—and Staff
Beyond the metrics, Dr. Wayman emphasized the human impact.
Patients benefit from:
A quieter, more stable recovery environment
Fewer disruptions during critical healing periods
Stronger relationships with consistent care teams
At the same time, staff experience improvements in workflow and job satisfaction, particularly among nurses who are able to follow patients through their full recovery journey rather than only a portion of it.
Not Without Challenges
Dr. Wayman was equally transparent about the complexity of implementation.
Transitioning to this model requires:
Significant coordination between clinical and administrative leadership
Careful redesign of staffing models and nursing ratios
Cross-training staff to manage varying levels of patient acuity
Strong buy-in across disciplines
In short, it’s not a quick fix—it’s a structural change.
But one that, based on early results, appears to be worth the effort.
A Model That Sparks a Bigger Question
Perhaps the most important takeaway from the presentation wasn’t just the model itself—but what it represents.
It challenges attendees to rethink:
How many of our current practices exist because they are optimal—and how many exist simply because they are familiar?
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