8 in 8 Series

The Missing Data: Why Medicare Claims Data Matter to You
Obtaining Medicare claims data to use with the STS National Database data is a top advocacy priority. With this data, clinician-led clinical data registries can facilitate outcomes-based research that improves health care quality and efficiency, as well as provide insight into appropriate Value-based reimbursement. This video examines the importance of registry access to Medicare claims data, current regulatory barriers, and how STS is advocating to improve access.

Presenter:
Alan M. Speir, MD
Chair, STS Council on Health Policy and Relationships

Grassroots Advocacy
Grassroots advocacy is ground-up support to advance a common goal. Participation by STS members in grassroots advocacy efforts is fundamental to helping the specialty, as well as improving access to quality care for cardiothoracic surgery patients. This video discusses the basics of grassroots advocacy, why it is important for members at every career level—from residents to experienced surgeons—to get involved, and how to get started with help from the STS Government Relations team.

Presenter:
Seth Wolf
University of Vermont Larner College of Medicine

Surgical Specialties at Risk
The Centers for Medicare & Medicaid Services plans to cut Medicare reimbursement for cardiothoracic surgeons by 8% beginning in January 2021, despite the pandemic and warnings that the cuts will jeopardize the financial viability of hospitals/clinical practices and negatively impact access to quality care for patients. This video examines the background of these cuts, what STS and its members have done to urge Congressional action, and what you can do to help fight these devastating cuts.

Presenter:
Stephen J. Lahey, MD
Chair, STS Workforce on Health Policy, Reform, and Advocacy

Payment Bundling
The Bundled Payments for Care Improvement (BPCI) Advanced Model is part of continuing efforts by the Centers for Medicare & Medicaid Services to implement voluntary episode payment models. This video discusses the continuum of risk-based payment models, an overview of the BPCI Advanced program, winners and losers in this payment model, and opportunities for savings. 

Presenter:
Keith A. Horvath, MD
Association of American Medical Colleges

Disclaimer: The Centers for Medicare & Medicaid Services (CMS) did not produce or endorse these materials nor does CMS assume responsibility for or make any guarantees of the completeness, accuracy, or reliability of any information contained herein. 

STS-PAC
STS-PAC is the only political action committee that exclusively represents cardiothoracic surgery and is the Society’s primary mechanism for influencing the policymaking process. This video defines the role of a political action committee and provides an overview of STS-PAC, including how it’s governed, who can contribute, how contributions are used, and accomplishments made possible through support from STS-PAC.

Presenter:
Keith S. Naunheim, MD
Chair, STS-PAC Board of Advisors
STS Past President 

Disclaimer: Contributions to STS-PAC are voluntary and not tax deductible for federal income tax purposes. You have the right to decline to contribute without any reprisal against your STS membership. Your contribution must be made using a credit card, check or money order, and must be drawn on a personal account to be used to support federal candidates. You must be a US citizen or lawfully admitted permanent US resident to contribute. Federal law requires us to use our best efforts to collect and report the name, mailing address, occupation, and name of employer of each individual whose contributions exceed $200 in a calendar year. Federal law prohibits STS and STS-PAC from soliciting contributions from persons outside STS’s restricted class. STS’s restricted class includes individuals who are dues-paying members or non-dues-paying members with voting rights, and who are US citizens or lawfully admitted permanent US residents.

Right Ventricular Failure in Cardiac Surgery
Right ventricular (RV) failure occurs when the right ventricle does not maintain enough blood flow through the pulmonary circulation to achieve adequate left ventricular filling. This video reviews the pathophysiology, diagnosis, and management of RV failure after cardiac surgery.

Presenters: 
Nathalie Roy, MD 
Harvard University, Boston Children’s Hospital

Hitoshi Hirose MD, PhD
Thomas Jefferson University

Opioid Reduction Strategies in Cardiac Surgery
Cardiac surgery is an underappreciated contributor to the opioid crisis, with patients commonly utilizing opioid prescriptions months after their index procedure. This video addresses the historical basis for opioid-based anesthesia and analgesia in cardiac surgery and describes five programmatic strategies to reduce the perioperative use of opioids.  

Presenter:
Michael C. Grant, MD, MSE
Johns Hopkins Medicine

ECMO Circuit Monitoring: The Essentials of Pressure and Flow 
Understanding the dynamics of extracorporeal membrane oxygenation (ECMO) circuit pressure and flow is essential to guide decisions, including how much ECMO blood flow is appropriate during management, weaning, and specific clinical scenarios such as North-South or Harlequin syndrome. This video highlights the circuit-patient management interface for physicians.  

Presenters:
Rita Karianna Milewski, MD, PhD, MSEd
University of Pennsylvania

Cory M. Alwardt, PhD 
Mayo Clinic

Diagnostic Ultrasound for Postop Hypotension
Point-of-Care Ultrasound (POCUS) is a bedside tool that increasingly is available in the health care setting. This video will demonstrate how to obtain images easily and how they can help clinicians diagnose and treat postoperative hypotension in critically ill patients.  

Presenters:
Jeffrey R. Kangas, MD
Detroit Medical Center

Frank A. Baciewicz Jr., MD
Wayne State University 

Toxicity of Inadequate Pericardial Drainage After Surgery: Implications for Patient Recovery
Postoperative atrial fibrillation is the most common complication following heart surgery. This video will describe potential inflammatory components that contribute to this problem found in the pericardial space.  

Presenter:
Spencer J. Melby, MD
Barnes Jewish Hospital, Washington University in St. Louis

Ideal Ventilatory Settings for Venovenous ECMO
This video sheds light on ventilatory management in the use of venovenous extracorporeal membrane oxygenation (ECMO), highlighting contemporary evidence to guide bedside decision-making.

Presenters:
J.W. Awori Hayanga, MD, MPH
West Virginia University Medicine

HelenMari Merritt-Genore, DO
Methodist Health System

Lactate and Cardiac Surgery
Lactate production is a consequence of cardiac surgery and cardiopulmonary bypass. Patients with elevated lactate levels have increased 30-day mortality. This video addresses the etiology of elevated lactate and aggressive treatment to ensure the best postoperative outcome.

Presenters:
Shahnur Ahmed 
Wayne State University 

Frank A. Baciewicz Jr., MD
Wayne State University 

Postoperative Delirium
This video highlights the importance of considering delirium as a medical emergency in the postoperative cardiac surgery patient. It defines postoperative delirium, identifies patients who are at risk, and explains the diagnostic process, as well as how to provide care.

Presenters:
Rita Karianna Milewski, MD, PhD, MSEd
University of Pennsylvania

Rakesh C. Arora, MD
University of Manitoba

Vasoplegic Shock
Vasoplegic shock after cardiopulmonary bypass is characterized by refractory hypotension and high cardiac output with systemic vasodilatation. It also is associated with increased mortality. In this video, the latest strategies to prevent, mitigate, and treat this common problem are discussed.

Presenter: 
Subhasis Chatterjee, MD
Baylor College of Medicine

Contributor:
Joseph Rabin, MD
University of Maryland Medical Center

ECMO in Lung Transplantation
Extracorporeal membrane oxygenation (ECMO) is an invaluable tool in lung transplantation. Originally developed to support patients in critical heart or respiratory failure, it often is used as a bridge to organ transplant, during lung transplant surgery, and for severe primary graft dysfunction. This video highlights the essentials of ECMO in lung transplantation with a focus on intraoperative management.

Presenter: 
Mauricio Villavicencio, MD, MBA
Massachusetts General Hospital

LVAD Implantation via Thoracotomy
This video addresses the options for left ventricular assist device (LVAD) implantation via thoracotomy and covers topics, including the benefits of different surgical approaches, cannulation strategies, and special considerations for patients with a short/leftward aorta, left internal mammary artery grafts, or mediastinal adhesions.

Presenter:
Jay D. Pal, MD
University of Colorado

Lung Resection in Patients with Marginal Pulmonary Function
This video covers risk assessment and stratification, as well as operative and non-operative treatment options for lung resection in patients with marginal pulmonary function. The presenters recommend that surgeons integrate all available data in a careful process of joint decision-making, resulting in an individualized approach that is compatible with the preferences and goals of the patient.

Presenters: 
Janet P. Edwards, MD
University of Calgary

Robert E. Merritt, MD
Ohio State Wexner Medical Center