Cardiac PET Scan Working Group
This working group serves as a standing expert clinical panel for matters pertaining to cardiac Positron Emission Tomography (PET). The cardiac PET Scan Working Group monitors the use of cardiac PET scans in Ontario. The group leads efforts with respect to cardiac-specific indications, including standardized referral management, ongoing quality improvement, and knowledge translation activities. In addition, the group provides the necessary cardiac clinical expertise to inform the deliberations of the Ontario PET Steering Committee (managed by Cancer Care Ontario).
Cardiovascular Chronic Disease Management Working Group
This group focuses on key aspects of the continuum of care for patients living with cardiovascular disease as a chronic disease. The group has focused on developing an inventory of services and identifying opportunities to enhance prevention and cardiovascular rehabilitation services in Ontario. This working group is well positioned to develop synergies with other chronic disease management initiatives underway in Ontario and has begun work in this area. Most recently the group has focused on chronic diseases including chronic self-management models. The group is establishing a common evaluative framework project.
Cath/PCI Working Group
The focus of this working group is on quality of care in the field of interventional cardiology, including diagnostic cardiac catheterization (cath) and PCI, identifying best practices and standards and enhancing the system of data collection, monitoring and reporting.
CV Surgery Working Group
This group’s membership includes the leaders of each of the 11 cardiac surgery programs in Ontario. The group is committed to standardization and implementation of best practices to ensure cardiac surgery outcomes in Ontario remain among the very best worldwide. The working group monitors the case mix and outcomes of patients undergoing cardiac surgery in Ontario and works broadly with key partners in the sector (provincially and nationally) on joint initiatives, such as monitoring and reporting outcomes, and blood conservation strategies.
Echocardiography Working Group
In 2012, the CCN Echocardiography working Group developed standards and recommendations for the provision of echocardiography services in Ontario. This group's current priority is to ensure that patients undergoing echocardiographic examinations in Ontario receive high quality, timely, and clinically appropriate services. This working group is serving as the clinical advisory committee for the Ontario Echocardiography Quality Improvement project, with a focus on developing voluntary accreditation programs for providers to meet the defined standards.
Heart Failure Working Group
The focus of this working group is to examine the current state of heart failure care in Ontario and to make recommendations for system improvements to ensure patients are able to access appropriate levels of heart failure care in community, primary care and acute care settings. This group focuses on identifying and addressing barriers in support of optimal care. The group has recently developed a comprehensive set of recommendations and an implementation strategy to ensure best practices are put in place, through a coordinated networked system of hub and spoke programs that offer resources for patient self-management and support for primary care providers.
Heart Rhythm Working Group
This working group considers all aspects of cardiac arrhythmia management including device implants (e.g. pacemakers, implantable cardioverter defibrillators (ICDs), cardiac resynchronization therapy); diagnostic electrophysiology studies (EPS) and interventional procedures such as standard and complex ablations. In 2011, CCN published "Recommendations for Permanent Pacemaker Services in Ontario" to establish standards and best practices to support the care of patients requiring permanent pacemaker devices. In addition, CCN has undertaken a review to define appropriate use criteria for atrial fibrillation interventions (e.g. ablations).
STEMI/EMS Working Group
The focus of this working group is on building capacity to effectively manage myocardial infarctions (specifically, STEMI) across Ontario. Through a collaborative effort between PCI providers, non PCI hospitals, emergency services (EMS) and base hospitals, this working group has examined in detail the current state of STEMI care in Ontario. A key performance metric is the time to treatment, and this working group has developed recommendations to ensure best practices are in place for management of STEMI in Ontario, including: early diagnosis, timely access to intervention, and leveraging better use of pre-hospital (EMS) resources to achieve better patient outcomes. The recommendations also highlight the need to work with rural and remote communities to standardize care and address access and transportation issues to improve the system.
Transcatheter Therapeutics and New Technology (T3 Working Group)
The focus of this group is to review the evidence relevant to new technology, and manage a coordinated approach to the implementation of new technology into clinical practice. Most recently, this working group has undertaken to monitor and report on TAVI procedures in Ontario including developing processes for standardization in-patient referrals, assessment, and follow-up.
Vascular Care Working Group
The vascular care working group (VCWG) was established as part of the Vascular Services Quality Strategy for Ontario. The focus of the VCWG pertains to the delivery of acute care vascular services in Ontario, including vascular diagnostic testing and intervention, (including surgery and endovascular care). Membership includes clinical and administrative expertise from across the province, representing academic health sciences centres and large community hospitals across eight LHINs. Recent activity has been to define a work plan aligned with the recommendations of the Vascular Services Quality Strategy for Ontario. In addition, a subcommittee of the VCWG was established to advise on the development of best-practice clinical pathways, and to recommend indicators of quality outcomes for selected vascular interventions identified as Quality Based Procedures (QBP) within the MOHLTC Health System Funding Reform initiative. In addition to the highly specialized clinical expertise provided through the working group’s members, a broad network of system leaders, administrators and policy planners are also available to support CCN’s efforts in addressing emerging issues and improving standard of care and efficiency within the cardiac system. CCN is very active in a growing number of collaborations and partnerships with other parts of the health care sector and with organizations in Ontario representing other disease groups with mandates similar to CCN. The goal is to align efforts, share resources where possible, and coordinate strategies to better integrate care.