Setting a High Standard for Veteran’s in Michigan

The VA Ann Arbor Healthcare System is providing cutting edge surgical care for veterans needing heart valve replacement. What was once only possible with open heart surgery, a special VA surgical team can now do through catheter assisted valve placement. TAVR, Transcatheter Aortic Valve Replacement, began being offered there earlier this year, and is already achieving notable success.

The procedure, which is currently only being performed at six VA health centers nationwide, offers alternative care for patients not healthy enough to undergo open heart surgery. The decreased hospitalization and recovery time, along with a dramatic increase in quality of life, is creating some exciting opportunities for veterans needing care.

The key to success can be found in the medical team’s hard work and dedication to patients. Teamwork for TAVR occurs on multiple levels. Administrative level teamwork and support was needed to get the program established and work thorough the high standards set by the VA. Interdisciplinary teams are formed before and during the surgical event, relying on strong communication. On procedure day, care is coordinated with a team including multiple disciplines: NPs, RNs, Cardiologists, Cardiology surgeons, anesthesiologists, radiologists, operating room techs, and catheterization lab techs. During the one day per week set aside for procedures, the staff spends the entire day together, in and out of surgery sharing meals and getting to know each other.

Teamwork is coordinated through Lead Surgeon Dr. Paul Grossman and Nurse Manager Barbara Clarke. For Dr. Grossman, working with the TAVR team has been extremely rewarding. He has enjoyed the new and challenging work technically, as well as working closely with other staff members, and seeing the dramatic patient outcomes. He has seen staff develop close working relationships, with a lot of respect for one another, crediting the social aspect of team building.

For Barbara Clarke, teamwork has included choosing the right staff and bringing the right skill sets together. Beyond technical skill, attitude is of top importance, with flexibility and communication necessary for success. In the team, everyone must understand their role and know who and how to communicate with. The team has huddles weekly to review upcoming cases, and the day of the procedure a robust total case review meeting occurs. After an intense collaborative surgical event, the patient outcome is what matters the most. Within a day or two, significant improvement can be seen in the patient’s energy level and color. Making a visible and striking difference in a veteran’s life inspires the team on to greater success.

To learn more about the TAVR team, the procedure, and their dramatic successes visit: www.annarbor.va.gov/features/TAVR.asp

To learn more about team development and facilitation opportunities, contact Stacie Longwell Hill at [email protected].