Quality Improvement Projects 2021

Newcastle Cardio-Oncology Program

Calvary Mater Newcastle – Hunter Medical Research Institute – Hunter New England Local Health District – University of Newcastle

1. Developed EHR referral pathways for both cardiologist-led and nurse-led Cardio-Oncology clinic with full integration into all notes
2. Created a dedicated “patient resources” document specifically designed for awareness of cardiovascular disease during cancer treatment

For more information contact:

Dr. Aaron Sverdlov

Aaron.Sverdlov@newcastle.edu.au

Cleveland Clinic, Florida

1. Cardio-Oncology clinic model with 4 components: clinical care, education, research, and active involvement in professional societies; program's physical presence at the cancer center improved access to care, reduced time to appointments, expedited testing and enhanced cardioprotective strategies to minimize treatment delays or interruptions from suspected cardiotoxicity.
2. Established a working group collaboration between cardiologists and oncologists with Florida Chapters of ACC and ASCO; assessed gaps in knowledge and access to care and developed an online educational program for practitioners
3. Developed a multistate and international collaborative advocacy network with cardiologists and oncologists: conducted the first cardio-oncology international survey on COVID 19 impact on cardio oncology practices (more than 1,200 worldwide responders) and this network was also the base to launch the G-COR (Global Cardio-Oncology Registry)

For more information contact:

Dr. Diego Sadler

sadlerd@ccf.org

University of Alabama, Birmingham

1. Created EMR consult for cardio-oncology consults to track volumes and improve access.
2. Implemented Echo GLS (strain) for all cardio-oncology patients by creating a Cardio-Oncology tab in our echo order sets. This identifies patient as cancer patient needing strain evaluation.
3. Created a multidisciplinary SWAT team to address immune related adverse events related to immunotherapy including MD’s from oncology, cardiology, and others.

For more information contact:

Dr. Carrie Lenneman

clenneman@uabmc.edu

Universitätsmedizin Essen

1. Published a Cardio-Oncology consensus paper of the German Society of Cardiology including Standard of Procedure (SOP) protocols with pocket guides for trainees
2. Dedicated website: Cardio-Oncology Essen with a dedicated Cardio-Oncology nurse
3. Training positions in cardio-oncology for young resident doctors

For more information contact:

Dr. Matthias Totszeck

matthiastotzeck@me.com

West Virginia University

1. Introduction and Implementation of WVU Cardio-Oncology referral process and Cancer Therapeutics Cardiac Surveillance Protocols
2. Dedicated EMR order for Cardio-Oncology Echocardiogram Incorporating (serial) Deformation Imaging into Cardio-oncology Screening Protocols and decision tool to aid surveillance
3. Introduction of the WVU Cancer Center Survivorship Program: Task Force: Cardiovascular Health Optimization and Cardiotoxicity Surveillance

For more information contact:

Dr. Christopher Bianco

matthiastotzeck@me.com

Duke Cardio-Oncology Program

1. Cardiovascular Risk Stratification In Breast Cancer Patients Receiving Cancer Therapy (CRIBIT). A cardiovascular risk stratification (CRIBIT) tool was built for early-stage breast cancer patients starting adjuvant cancer therapy and placed in the EMR
2. Cardiovascular Risk profile and Treatment Patterns in Hormone Receptor-positive (HR +) HER2 - Advanced Breast Cancer: A Retrospective Cohort Study (CAREB).
3. Identifying Cardio-Oncology Needs of Cancer Patients (ICON). The goal of this study was to identify the Cardio-Oncology needs of cancer patients receiving potentially cardiotoxic cancer therapies across the Duke network over 3 years (2018-2020).

For more information contact:

Dr. Susan Dent

Susan.Dent@Duke.edu

Washington University in St. Louis

1. Dedicated inpatient cardio-oncology consult service that sees all patients in the inpatient cancer center as well as any patients with active cancer treatment or concern for amyloidosis.
2. Dedicated inpatient cardio-oncology consult service that sees all patients in the inpatient cancer center as well as any patients with active cancer treatment or concern for amyloidosis.
3. Improved efficiency of outpatient consults by streamlining the consult process including standard questions asked to all new patients being seen in cardiology (Do you have cancer or a history of cancer?, etc.), a dedicated email to reach the CO team (Cardiooncology@wustl.edu), as well as availability by phone/email.
4. Weekly Cardio-Oncology conference including physicians, nurse practitioner, fellows and nurses to discuss and collaborate on complex patients as well as discuss recent publications and research updates.

For more information contact:

Dr. Joshua Mitchell

jdmitchell@wustl.edu

Center of Postgraduate Medical Education, Poland

1. Defining CV toxicity of first and second generation BTK inhibitors
2. Angiotensin system inhibitors may improve outcomes of patients with castration-resistant prostate cancer during abiraterone acetate treatment
3. Designing and participating in multicenter trials for many forms of cancer and prevention of thrombosis

For more information contact:

Dr. Sebastian Szmit

s.szmit@gmail.com

Royal Brompton Hospital

1. Investigated the impact of Covid-19 on service delivery in Cardio-Oncology care
2. Integrated cardiology and oncology clinical information into a single electronic healthcare record
3. Promoted baseline CV risk stratification in patients undergoing cancer therapy, according to ICOS guidelines

For more information contact:

Dr. Alex Lyon

a.lyon@imperial.ac.uk

University of Chicago Medicine

1. Modified physician order entry to identify patients with cancer and quantify LVEF and GLS in all Echos and facilitate prompt scheduling
2. Implementing GLS acquisition on all patients to capture patients not pre-identified as having cancer
3. Established a drug reference guide for trainees in Cardio-Oncology clinic to assist in clinical assessments and standardizing diagnostic evaluation

For more information contact:

Dr. Jeanne DeCara

jdecara@medicine.bsd.uchicago.edu

University Medical Center Utrecht

1. Developing a straightforward healthcare pathway for early screening with cardiotoxic treatment incorporated into the electronic patient record
2. Published this pathway in the National Cardiology journal resulting in the development of 10 new Cardio-Oncology units in the country
3. Launching a national Cardio-Oncology registry (ONCOR) to continuously evaluate current practices and facilitate research programs

For more information contact:

Dr. Arco Teske

a.j.teske-2@umcutrecht.nl

University College London Hospital

1. Developed UCLH targeted surveillance echocardiographic protocol for cancer patients which formed basis of 2021 national cardio-oncology imaging guidelines in the UK
2. Initiated protected exclusive echocardiography lists for different cancer conditions - breast cancer surveillance patients, new lymphoma patients, CAR T cell patients etc to improve quality and audit of processes
3. Developed cardiovascular risk scoring algorithm for MPN patients using pre-existing cardiovascular risk tool

For more information contact:

Dr. Arjun Ghosh

drarjunghosh@gmail.com

UCLA Cardio-Oncology Program

1. Integrated Cardio-Oncology education in general cardiology fellowship
2. Established an outpatient clinic experience for general cardiology fellows and other trainees interested in Cardio-Oncology,
3. Created a mentorship system for research opportunities and to inspire future generations to pursue Cardio-Oncology

For more information contact:

Dr. Eric Yang

ehyang@mednet.ucla.edu