Need for a Cardiogenic Shock Team Collaborative—Promoting a Team‐Based Model of Care to Improve Outcomes and Identify Best Practices

Author:

Senman Balimkiz1ORCID,Jentzer Jacob C.2ORCID,Barnett Christopher F.3ORCID,Bartos Jason A.4ORCID,Berg David D.5ORCID,Chih Sharon6ORCID,Drakos Stavros G.7ORCID,Dudzinski David M.8ORCID,Elliott Andrea4ORCID,Gage Ann9,Horowitz James M.10ORCID,Miller P. Elliott11ORCID,Sinha Shashank S.12ORCID,Tehrani Behnam N.12,Yuriditsky Eugene10ORCID,Vallabhajosyula Saraschandra13ORCID,Katz Jason N.14ORCID

Affiliation:

1. Division of Cardiology Duke University Durham NC USA

2. Department of Cardiovascular Medicine Mayo Clinic Rochester MN USA

3. Division of Cardiology, Department of Medicine University of California San Francisco San Francisco CA USA

4. Department of Medicine‐Cardiovascular Division University of Minnesota Minneapolis MN USA

5. Division of Cardiovascular Medicine Brigham and Women’s Hospital and Harvard Medical School Boston MA USA

6. Ottawa Heart Institute Ottawa Ontario Canada

7. Department of Medicine, Division of Cardiovascular Medicine and Nora Eccles Harrison Cardiovascular Research and Training Institute University of Utah School of Medicine Salt Lake City UT USA

8. Department of Cardiology Massachusetts General Hospital Boston MA USA

9. Department of Cardiovascular Medicine Centennial Medical Center Nashville TN USA

10. Division of Cardiology New York University Grossman School of Medicine New York NY USA

11. Section of Cardiovascular Medicine, Yale School of Medicine New Haven CT USA

12. Inova Schar Heart and Vascular, Inova Fairfax Medical Campus Falls Church VA USA

13. Division of Cardiology, Department of Medicine Warren Alpert Medical School of Brown University and Lifespan Cardiovascular Institute Providence RI USA

14. Division of Cardiology NYU Grossman School of Medicine & Bellevue Hospital Center New York NY USA

Abstract

Cardiogenic shock continues to carry a high mortality rate despite contemporary care, with no breakthrough therapies shown to improve survival over the past few decades. It is a time‐sensitive condition that commonly results in cardiovascular complications and multisystem organ failure, necessitating multidisciplinary expertise. Managing patients with cardiogenic shock remains challenging even in well‐resourced settings, and an important subgroup of patients may require cardiac replacement therapy. As a result, the idea of leveraging the collective cognitive and procedural proficiencies of multiple providers in a collaborative, team‐based approach to care (the “shock team”) has been advocated by professional societies and implemented at select high‐volume clinical centers. A slowly maturing evidence base has suggested that cardiogenic shock teams may improve patient outcomes. Although several registries exist that are beginning to inform care, particularly around therapeutic strategies of pharmacologic and mechanical circulatory support, none of these are currently focused on the shock team approach, multispecialty partnership, education, or process improvement. We propose the creation of a Cardiogenic Shock Team Collaborative—akin to the successful Pulmonary Embolism Response Team Consortium—with a goal to promote sharing of care protocols, education of stakeholders, and discovery of how process and performance may influence patient outcomes, quality, resource consumption, and costs of care.

Publisher

Ovid Technologies (Wolters Kluwer Health)

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