VCSQI Fall Quarterly Meeting — Recap
- Sherri White
- Oct 13
- 5 min read
Updated: Oct 15
The 2025 VCSQI Fall Quarterly Meeting convened at Lewis Ginter Botanical Garden in Richmond, where leadership focused on execution: tighten board priorities, use cost/quality data to drive action, and scale what works. The sessions moved from strategy to operations—TAVR efficiency, Patient Blood Management, and the ECMO initiative—keeping the spotlight on measurable outcomes and real savings.
Dr. Robert Lancey (VCSQI Chair) set the tone for the evening by reaffirming VCSQI’s role as
one of the few truly functioning statewide cardiovascular quality collaboratives in the country. He recognized the collective resilience of our partners and emphasized that while much has been accomplished, the expectations are rising.
The Board’s current strategic push centers on three fronts:
Accelerating collaboration beyond traditional hospital walls, including bringing ambulatory cath labs and ASCs into active participation rather than leaving them as data blind spots.
Establishing structure around critical problem areas, such as the development of an aortic dissection task force designed to triage complex cases more safely across the state.
Shifting administration conversations from “quality is good” to “quality is financially irrefutable” by quantifying cost savings tied to complication reduction.
The message was clear: VCSQI’s direction is not maintenance — it is expansion and standardization with sharper coordination and visible return on value.
VCSQI ECMO / ELSO Workgroup
Eve Dallas (UVA) and Dustin Money (UVA) announced the formal launch of a new statewide initiative to organize and standardize ECMO care across Virginia. Early survey responses showed overwhelming enthusiasm from physicians, nurses, and coordinators, confirming that most centers are already independently managing full cannulate-to-decannulate programs — yet doing so in isolation. With an estimated 400–500 ECMO patients statewide each year, the team emphasized that it’s time to connect those efforts under a shared structure. The goal: build a coordinated ECMO network with aligned referral pathways, defined protocols, and transparent outcomes tracking. Virginia is also preparing early for upcoming ELSO certification standards, positioning itself to lead rather than react. The new DOMO platform will enable peer-level data sharing across institutions, finally giving visibility into real-world performance. Leadership is already forming, with Brandy Brummer (VCU) stepping in to co-lead alongside Dustin Money (UVA). The first milestone of this initiative is the ECMO Preliminary Workgroup Call on November 5, 2025, open to all centers ready to be part of building the state’s first coordinated ECMO system.
Cost and Quality Data Review — VCSQI
Eddie Fonner (Executive Director and Chief of Data Science) delivered a direct analysis of current registry data, illustrating performance trends across member programs. The takeaway was both validating and cautionary: while gains in key areas are evident, variation between institutions remains wider than acceptable, particularly in complication rates and post-op resource utilization.
The emphasis was on data as leverage, not archive. Eddie challenged members to treat quality reports as operational directives rather than passive dashboards. Several improvement opportunities were identified where clear playbooks already exist — the differentiator is execution. Integrating data-driven decision-making into daily clinical workflow, not quarterly reporting, is now the expectation.
VHAC Updates
Dr. Peter O’Brien (Co-Founder, VHAC) reframed VHAC’s mission through a systems lens: Virginia’s cardiovascular care network has matured beyond isolated STEMI pathways into a coordinated organism of EMS, cath labs, clinical workgroups, and statewide registries. He highlighted how the best work occurs when VCSQI and VHAC function as one ecosystem rather than two adjacent efforts.
Notable achievements were reinforced — 99% statewide access to prehospital 12-lead capability, first medical contact-to-device time consistently under 70 minutes, and the continued growth of the STEMI registry to 28 participating PCI centers. However, he cautioned that emerging threats — including emergency department delays and persistent disparities in care delivery — demand renewed attention.
The call moving forward: maintain gains, chase blind spots, and recruit remaining PCI centers into the data structure before policy forces it on them.
Angiogram Film Reviews — Independent QA That Changes Practice
The VCSQI Angiogram Film Review offers a free, independent read of cath cases to strip bias from case review and surface practical improvements in both technique and decision-making. Teams submit de-identified films; reviewers provide focused feedback on access, imaging quality, lesion assessment, device selection, and timing—so you leave with specific fixes you can apply at the next conference, not generalities. It’s a fast way to validate “how we do it here,” align on standards across operators, and convert variation into documented improvement. Interested in participating in this initiative?
Choose your participation level for the Angiogram Film Reviews—opt in (with primary contact info) or opt out—using the buttons below.
Improving Efficiency in Performing TAVR Procedure
Mohammed Quader, MD from Virginia Commonwealth University delivered a concise but impactful walkthrough of efficiency evolution in TAVR after more than 1,000 cases. The core message was that technical expertise is no longer the bottleneck — operational precision is.
Efficiency gains came not from new devices but from tightened pre-procedure assessment, disciplined patient selection, and role clarity across the procedural team. The most successful programs treat TAVR as a standardized process rather than a heroic intervention. A properly executed pre-huddle and realistic discharge pathway saves more hours — and reduces more complications — than any intraoperative trick.
His takeaway: centers with volume but no throughput discipline will hit a ceiling. Those who systematize TAVR like an assembly line will set the standard.
Implementation of a Patient Blood Management Program: Challenges Abound!
Karen E. Singh, MD, FASE from the University of Virginia, closed the night with a candid look at the uphill battle of blood management implementation. PBM, she stressed, is not a transfusion protocol — it is a full-scale cultural shift that demands alignment across surgeons, anesthesiologists, perfusion, nursing, and supply chain.
The barriers she outlined were not clinical — they were institutional hesitancy, inconsistent accountability, and logistical inertia. Even when the evidence is overwhelming, PBM fails when ownership is diffused. The takeaway was unambiguous: success requires formal governance, defined metrics, and enforced compliance rather than education alone.
PBM’s relevance to outcomes is no longer theoretical. Its adoption is now a benchmark of seriousness in evidence-based cardiovascular care.
Action Items & Follow-Up
Claim CME/CEU Credits: Complete the post-event survey using the activity code within the next 6 days to receive your credits.
Join the ECMO Workgroup (Nov 5, 2025): Interested in helping shape statewide ECMO coordination and certification standards? Email Sherri@vcsqi.org to be included.
Explore the MACPAQ Angiography Audit Program: Centers looking for objective feedback or benchmarking support are invited to reach out to Sherri@vcsqi.org for details on participation.
Interested in Contributing Registry Data (PCI / STEMI / TVT)? We welcome additional centers to join the statewide data network — please contact Eddie@vcsqi.org to discuss onboarding options.
As we continue refining future Quarterly meetings, we invite feedback on both format and content — what worked, what ran long, and what you want to see more (or less) of in upcoming sessions. Whether your suggestions are logistical or programmatic, they directly guide how we shape agendas going forward. Please send feedback to Sherri at Sherri@vcsqi.org or via https://www.surveymonkey.com/r/8RX9YBP.
Thank you to our sponsors for backing the work, our speakers for bringing data and real solutions, and every attendee who showed up ready to push standards forward. Thanks as well to the partners and supporters who spread the word and helped fill the room at Lewis Ginter. We move faster because you do. For follow-ups or materials, contact Sherri@vcsqi.org.
And lastly — please mark your calendars.
VCSQI Winter Quarterly Meeting — Thursday, December 4.
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