SCAI's LEED: LAAO program is a micro-fellowship that pairs experienced LAAO operators with Equity champions in a novel bi-directional exchange of expertise to address unmet needs in interventional cardiology:
- Increase the number of LAAO operators who are experienced in addressing unmet needs in the community to improve access and health inequities.
- Increase the participation of women and Underrepresented in Medicine (URiM) physicians in structural heart interventions such as LAAO to improve outreach to underserved patients and communities.
- Establish opportunities for exchanges and collaborations to advance the careers of all physicians who are dedicated to improving access to interventional therapies.
Program Overview
The inaugural LEED: LAAO cohort will consist of four LAAO Leaders and eight Equity Leaders.
Each LAAO Leader selected for this program will host two Equity Leaders at their institution, approximately five to six months apart. This will provide consistency in LAAO training and exposure to different equity perspectives.
- LAAO Leaders will be established implanters of the WATCHMAN™ Left Atrial Appendage Closure Device, interested in teaching, mentoring, expanding their equity toolkit for outreach, and enhancing the equity skills of their team to address health inequities and unmet needs in their local communities.
- Equity Leaders will be experienced interventional cardiologists, experts in championing effective outreach and community-based initiatives that reduce healthcare disparities, and are interested in expanding their structural heart intervention skillsets to include LAAO procedures*.
During each micro-fellowship, the LAAO Leader will host their Equity Leader partner at their institution for a two-day exchange that includes:
- LAAO Education
- Live teaching* and best practices through two consecutive WATCHMAN LAAC lab days by the LAAO Leader (goal of eight implants over two days).
- Equity/Outreach Conversations (audience to be determined by LAAO Leader, i.e., hospital-based population health or health equity teams, attendings, trainees, cath lab staff, or research staff).
- Host institution dinner honoring the visiting Equity Leader
- A breakfast education session on the topic of expanding access, partnering with local communities, or improving health equity metrics led by the Equity Leader
- (Optional) A Grand Rounds or similar format presentation by the Equity Leader
See sample exchange itinerary below.
Equity Leaders will receive a stipend for their travel time and expenses. The Equity/LAAO Leaders' planning dinner, the host institution dinner, and breakfast education session will be supported by the LEED: LAAO program, as outlined in the Stipend and Reimbursement Policy section below.
*Note, this program complements but does not replace training provided by Boston Scientific. All Equity Leaders are expected to have completed their industry-required WATCHMAN LAAC training by the time of their fellowship exchange.
Program Requirements
- Attend the LEED: LAAO Fellowship kick-off call, which will take place in early February 2025
- Recommended: training in unconscious (or implicit) bias or community partnership building - recommended for all participants who have not completed similar training within the past two years.
- LAAO Leaders' institution - host a two-day exchange for each Equity Leader. The first exchange should occur by May 31, 2025, and the second exchange should occur five–to six months later. Each exchange should include:
- Observership of two consecutive in-person lab days with the LAAO Leader for Equity Leader, with three to five WATCHMAN LAAC implants scheduled per day (goal eight cases over two days) with simultaneous training to include pre-clinical evaluation; imaging assessment; procedural planning; device selection; atypical anatomy; training of clinical staff; procedure steps; inpatient care; medical therapy; post- implant imaging and follow up.
- A planning dinner attended by the two leaders to discuss scheduled WATCHMAN LAAC cases and the LAAO Leader's local outreach projects of interest (LEED: LAAO sponsored).
- Dinner for Equity Leader, LAAO Leader, and relevant host institution staff (i.e., hospital-based population health or health equity teams, attendings, trainees, cath lab staff or research staff). Up to eight people (LEED: LAAO sponsored).
- Breakfast educational event led by the Equity leader Up to 15 people (LEED: LAAO sponsored).
- (Optional) A Grand Rounds or similar format presentation by the Equity Leader
- Creation of outreach and health equity resources/outputs:
- Presentation on a community-based partnership or health equity-related topic by the Equity leader that can be recorded and shared as a health equity resource on SCAI's website.
- LAAO Leader to identify and complete a project or activity that addresses community-based outreach or health inequities/access with an observable, pre-defined output that can be shared on SCAI's website within nine to twelve months of fellowship initiation. This may encompass the results of the HAV-HELP partnership with Boston Scientific.
- LAAO Leader to complete a virtual review of Equity Leader's planned initial cases in the 30 days following the exchange.
- Complete program evaluations via a baseline, 30-day, and six-month questionnaire, and a qualitative interview with program participants.
Who Can Apply
All applicants must be US-based board-certified interventional cardiologists who have completed their interventional cardiology fellowship and are current SCAI members and meet the LAAO or Equity Leader eligibility criteria listed below.
LAAO Leader Eligibility Criteria
- Have performed at least 100 lifetime WATCHMAN LAAC implants.
- Have a high monthly case volume that can support program’s educational components i.e., able to schedule at least eight WATCHMAN LAAC implants over two consecutive lab days.
- Be working under a hospital program that currently participates in the NCDR LAAO Registry.
Equity Leader Eligibility Criteria
- Have completed at least 15 of the required 25 transseptal punctures through an intact septum at the time of application submission. Boston Scientific’s Access Solutions team can work with applicants to identify training opportunities to complete the minimum 25 transseptal punctures required to be a primary implanter by the time of the exchange.
- Have confirmed with Boston Scientific that they are eligible for the WATCHMAN LAAC training program and be willing to complete all Boston Scientific training program requirements in 12 weeks if selected for LEED: LAAO program.
- Meet program requirements in the National Coverage Determination for LAAO
- Be able to maintain skills by performing >=25 TSPs and >12 LAAOs over each two-year period as per the SCAI/HRS Expert Consensus Statement on Transcatheter LAAO.
Application Process
Applications should be emailed to Justine Mascarenhas no later than January 14, 2025, and meet the following requirements.
Equity Leader Application Requirements
Please include the following in your application. Applications will be evaluated using these criteria.
- Equity Leader Application Form
- Statement of Intent:
- Describe your work as a community-based outreach or health-equity champion and prior equity-related work (include projects, committees, unique focus of previous work or research, past accomplishments or awards, and future goals in health equity leadership).
- Data establishing your community's needs and describing your interest in addressing access using LAAO (include examples of personal skillsets or experiences that can address the need established for your community).
- Describe how you intend to expand LAAO access to underserved patients and communities using LAAO skills (include whether this will lead to greater access, and how).
- Explain how your personal or professional background or experience makes you ideally suited to this role, or how this program would personally benefit your career (you may include details of upbringing or personal barriers to advancement; past training or research experiences; location and focus of current hospital).
- Detail the leadership roles you have obtained and ongoing or completed projects in these roles in community organizations, local institutions, industry, and/or professional societies.
- Describe key features of the quality improvement program at your institution.
- At least 1 letter of support demonstrating support for new or additions to existing LAAO program.
LAAO Leader Application Requirements
Please include the following in your application. Applications will be evaluated using these criteria.
- LAAO Leader Application Form
- Statement of commitment from your hospital for visiting physicians/external observers.
- Statement of support from the population health/community outreach/health equity leadership at your hospital (e.g., chief people or human resources officer, chief diversity officer, director of health equity/population health/community outreach) to partnering in the LEED: LAAO program and committing their support to educational activities that share and showcase the Equity Leader's knowledge and expertise at your institution during two separate Equity Leaders' visits.
- Statement of Intent including:
- A description of your personal LAAO experience and related skillsets, educator and/or thought leadership activities, and key features of the quality improvement programs at your institution.
- A demonstration of your early efforts to gain greater awareness of unmet needs in your local community (including early pre-engagement meetings with local equity leadership, training, reviews of guidelines or participation in educational seminars, or support for others at health equity events).
- (Optional) Letter of recommendation from a peer or learner regarding your teaching skill sets and demonstrating how your activities support inclusion and belonging in the workplace.
Evaluation
Applications will be reviewed and selected by the LEED: LAAO leadership team using Equity and LAAO Leaders' scoring matrices.
Four LAAO Leaders and eight Equity Leaders will be selected for the inaugural year of the program.
Following the application review, the LEED: LAAO Leadership team will pair LAAO and Equity Leaders and determine which Equity Leaders will be in the first vs second exchange cycle.
Successful applicants will be informed about the program committee's decision by the end of January 2025 and required to sign a Memorandum of Agreement officially accepting their fellowships and committing them to meeting the program's requirements.
Further Information
Sample Exchange Itinerary
Wednesday
| 5:00 PM | Equity Leader check-in to hotel |
| 7:00 PM | LAAO Leader and Equity Leader planning dinner (sponsored) |
Thursday
| 8:00 AM | Equity Leader Grand Rounds (optional) |
| 9:00 AM - 5:00 PM | LAAO implants in the cath lab |
| 6:30 PM | Equity Leader, LAAO Leader, and invited staff dinner (sponsored) |
Friday
| 7:00 AM | Equity Leader-led educational breakfast conference (sponsored) |
| 8:00 AM - 5:00 PM | LAAO implants in the cath lab |
| 6:00 PM | Equity Leader and LAAO Leader debrief |
Saturday
| Morning | Equity Leader departure |
Sample Timeline to Meet Program Requirements
Equity Leader |
LAAO Leader |
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| Immediately on Acceptance |
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Phase I Twelve Weeks Prior to Exchange |
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Phase II Eight Weeks Prior to Exchange |
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Phase III Exchange |
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Phase IV Four Weeks Following Exchange |
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Phase V Six Months Following Exchange
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Stipend and Reimbursement Policy
LEED: LAAO will provide support for the following program components:
- Equity Leaders: $5,000 stipend (to acknowledge lost clinical time/use of paid time off or vacation allowance) + reimbursement for travel and accommodations for the two-day exchange at LAAO Leader’s host institution, per SCAI’s faculty travel policy
- Educational activities in partnership with LAAO Leader’s host institution:
- Planning dinner for the two leaders
- Leadership dinner for Equity Leader, LAAO Leader, and host institution leadership (up to eight people)
- Breakfast educational event led by the Equity Leader with invited fellows, cath lab staff, and/or research staff (up to 15 people)
Acknowledgements
SCAI gratefully acknowledges Boston Scientific as a founding supporter of the SCAI LEED: LAAO Fellowship Program.
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