Quality assessment and continuous quality improvement are essential to the practice of interventional cardiology, and interventional fellowship training programs should include specific education and experience in these areas to ensure new interventional cardiologists are prepared to make quality an integral part of their future practice. New recommendations for quality core curriculum in adult and pediatric interventional fellowship programs were released today by the Society for Cardiovascular Angiography and Interventions (SCAI) during its 2015 Scientific Sessions in San Diego.

"As interventional cardiology evolves, procedures are becoming more complex and diverse. Quality assessment and quality improvement are essential to ensuring that the right patient receives the right procedure at the right time and in the right way," said Joaquin E. Cigarroa, MD, FSCAI, the senior author of the paper. "While cardiovascular professional societies have actively developed new clinical guidelines, expert consensus statements and appropriate use criteria, this is the first consensus statement to define the best framework for teaching quality to new interventional cardiology fellows."

The new expert consensus statement outlines specific key components that should be included in fellowship programs, including training in specific interventional cardiology metrics used to assess quality; participation in a quality improvement project with a physician mentor; and active participation in key elements of the quality process, including peer review, the morbidity and mortality (M&M) conference – during which physician colleagues review cases that had adverse outcomes and provide feedback – and appropriate data registries.

According to the expert panel, Fellows-in-Training (FITs) should understand the appropriate use of percutaneous coronary intervention (PCI), based on published appropriate use criteria. They should also present their own cases during M&M, including formal written summaries and a presentation of the case that outlines areas for improvement. They also should understand performance metrics and reports available through common data registries, including the American College of Cardiology National Cardiovascular Data Registry (NCDR) and the NCDR CathPCI Registry®. Pediatric specialists should be familiar with the NCDR IMPACT® registry's metrics. The paper outlines specific metrics and registry reports FITs should understand.

Finally, FITs should be familiar with common techniques used in quality improvement programs, such as root-cause analysis, six sigma and lean, which were developed in industries such as manufacturing and are now commonly used in health care. They should also understand team-based approaches to quality and how to lead a quality project within an organization.

"Fellowship programs are designed to train new physicians to become skilled interventional cardiologists, and essential to that training is a thorough understanding of quality. The new expert consensus document provides a foundation of critical elements that should be included in this training," said Charles Chambers, MD, FSCAI, SCAI 2014-15 President and a coauthor of the document.

The paper, "SCAI Core Curriculum for Adult and Pediatric Interventional Fellowship Training in Continuous Quality Assessment and Improvement," is published online in Catheterization and Cardiovascular Interventions.