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Congratulations! & Welcome to the ACC Board of Governors! . Congratulations! You’re an ACC Governor! Now what?. 2009 Board of Governors Leadership Forum. Jane E. Schauer, M.D., Ph.D., F.A.C.C., Chair John G. Harold, M.D., F.A.C.C., Chair-Elect. 2009 ACC Leadership Institute.

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congratulations you re an acc governor now what
Congratulations!You’re an ACC Governor! Now what?

2009 Board of Governors Leadership Forum

Jane E. Schauer, M.D., Ph.D., F.A.C.C., Chair

John G. Harold, M.D., F.A.C.C., Chair-Elect

inside heart house

2009 ACC Leadership Institute

Inside Heart House

Overview of the Strategy and Operations of the American College of Cardiology

Mike Votaw, CFO


Brendan Mullen, Strategic Planning


roadmap for discussion
Roadmap for Discussion

Focusing the ACC

Operational Organization

Strategy Development

driving strategic and operational focus

Focusing the ACC

Driving Strategic and Operational Focus

Universe of Potential ACC Impact

ACC Mission and 2012 Vision

Strategy Map

Impact Refinement

Operational Organization

Strategic Planning Process

Balanced Scorecard

New Initiative Development

Balanced Scorecard Monitoring and Operational Implementation

BOT Initiative Approval

the college s mission vision
The College’s Mission & Vision



The mission of the American College of Cardiology is to advocate for quality cardiovascular care through education, research promotion, development and application of standards and guidelines, and to influence health care policy.

By 2012, the ACC/ACCF will be the premier professional society in cardiovascular medicine, dedicated to the highest quality care that is patient-centered, evidence-based and cost effective.

managing the acc9

ACC Mission Areas


Managing the ACC
interfacing heart house with the outside world


Core Missions




Interfacing Heart House with the Outside World

External Stakeholders: Policy Makers, Federal Agencies, Commercial Payers, Quality Institutions, Hospitals, Health Systems, Patients, Public

Internal Stakeholders: ACC Members, Trustees, Governors, Committee Chairs, Committee Members

strategic priorities by mission area
Strategic Priorities by Mission Area
  • Science & Quality
  • Define clinical standards through guidelines and measures
  • Evaluate patient outcomes and clinical practice
  • Improve care
  • Representative Initiatives and Activities
  • IC3 and NCDR
  • Era of the Patient
  • Clinical decision support and Cardiopath
  • Education
  • Focus on general clinical cardiology
  • Scientifically-based clinical content
  • Assessment-driven educational planning
  • Methodologies to maximize clinician and patient learning
  • Representative Initiatives and Activities
  • Lifelong learning portfolio and MOC
  • Best-in-class regulatory compliance
  • Patient-centered, team-based care pilot
  • Advocacy
  • Engage membership in the political process
  • Increase influence in legislation and politics
  • Drive policy to advance ACC objectives (including Health System Reform)
  • Representative Initiatives and Activities
  • Quality First and Health System Reform
  • Expanding influence of the PAC
  • Driving reach at the state level
  • Membership & Engagement
  • Member involvement and satisfaction
  • Value of FACC designation
  • Domestic and international collaboration
  • Cardiovascular workforce
  • Representative Initiatives and Activities
  • Expansion and integration of Sections and Councils
  • International strategy development
  • Cardiovascular leadership institute
practicing what we preach
Practicing What We Preach

The Balanced Scorecard: Embracing Data-Driven Strategic Management

2009 strategic planning timeline and milestones

Strategy Development

2009 Strategic Planning Timeline and Milestones















BOT Retreat

(Late July, Colorado Springs, CO)

EC & BOT Mtgs.

(Late March, Orlando)

EC Retreat

(Early May, Washington, DC)

Environmental Scanning

Go / No-Go Decision Point

  • ES Workgroup
  • BOT
  • BOG
  • Committee Chairs
  • Strategic Planning

Initiative Proposals

  • BOT
  • BOG
  • Committee Chairs
  • Staff

Resource Allocation Analysis

  • Strategic Planning
  • Finance
  • Business Development
  • Staff

Budgeting & Ops Planning

  • BFIC
  • Finance
roles responsibilities
Roles & Responsibilities

Leadership plays a pivotal role in strategic planning, with responsibilities as follows:

  • Executive Committee (EC) – serves as strategic planning committee
    • BOG has input via 3 voting EC members
  • Board of Trustees (BOT) – sets priorities, reviews quarterly progress in achieving strategy, serves as initiative liaisons
  • Environmental Scanning Work Group – BOT work group that reviews internal and external trends to support identification and development of new initiatives
    • BOG has input into final report through the trend prioritization process
  • Budget Finance and Investment Committee (BFIC) – reviews quarterly progress, recommends approval of annual budget
  • Board of Governors (BOG):
    • Participates in Environmental Scanning process
    • Knowledgeable about initiatives and enhance communications to membership
    • Propose potential initiatives to BOT via Executive Committee
  • Executive Staff Liaisons:
    • Keep BOT and member liaisons up to date
    • No formal reporting
top 3 bog strategy contributions
Top 3 BOG Strategy Contributions
  • Contribute to Environmental Scanning through idea generation and trend prioritization
  • Propose initiatives to EC through BOG Steering Committee
  • Communicate ACC strategic priorities and initiatives to members through state chapters
top 4 bot strategy contributions
Top 4 BOT Strategy Contributions
  • Contribute to Environmental Scanning through idea generation and trend prioritization
  • Propose new initiatives directly, through the executive committee, or staff liaisons
  • Set overall strategic direction of College and prioritize new initiatives at late-summer strategic planning retreat
  • Serve as new initiative liaison
acc mission statement
ACC Mission Statement

“The mission of the American College of Cardiology is to advocate for quality cardiovascular care—through education, research promotion, development and application of standards and guidelines—and to influence health care policy.”

acc goals
ACC Goals
  • Turn cardiovascular knowledge into practice
  • Increase the value of membership.
  • Promote innovation, people and culture
  • Manage financial and legal responsibilities
bog chapters history
BOG/Chapters History

1949 – College Founded

1951 – College chartered BOG & 22 Chapters

1954 – BOG and Chapters abolished

1957 – BOG reactivated with 35 US and 3 Canadian Governors

Mid 60’s – BOG grew to current 66 members

1986 – Chapters reintroduced

2006 – CCA Liaison appointed to BOG

2007 – CCA’s, FIT’s, MA’s and AA’s approved to vote in the BOG elections, FIT representative appointed to BOG

2009 – Chapters grow to 48 strong

acc leadership
ACC Leadership

Exec Comm

BOG Leaders

Steering Comm

who they are


- Elected leaders of College

- Representatives of membership

- Diverse with unique perspectives

- Majority are in private practice


- Responsible for decision making, policy setting

- Guardians of College resources

- Many members are former BOG

bot bog


  • Sets ACC direction
  • Sets ACC policy
  • Manages financial responsibilities
  • Relays “grassroots” needs and concerns to BOT
  • Lobby for better cv care environment on local level
  • Implement quality projects on local level
  • Educates membership on ACC initiatives and value
bog steering committee
BOG Steering Committee
  • Set BOG agenda with Governors input
  • Review requests from Governors/Chapters
  • Bring requests to BOT for discussion and decision
  • Review requests from National ACC
  • Conflict resolution
bog steering committee april 2008 april 2009
BOG Steering CommitteeApril 2008 – April 2009

George P. Rodgers, Immediate Past Chair, Texas

Jane E. Schauer, Chair, New Mexico

John G. Harold, Chair-elect, California

Richard Kovacs, Incoming Chair-elect, Indiana

Michael Widmer, Oregon

Jose Rivera Del Rio, Puerto Rico

Blair D. Erb, Jr., Montana

Ganpat G. Thakker, West Virginia 

Margo Minissian CCA, Georgia 

board of governors mission statement
Board of Governors Mission Statement

“The Mission of the Board of Governors shall be to ensure bi-directional communication between the members of the College and its Leadership, while promoting the core missions of the College through actions at the Chapter, non-Chapter, and member level”.

  • 66 Current Governors
    • 50 U.S. States, D.C., Puerto Rico, 2 for PA, NY, CA, 5 Canada, 1 Mexico, 3 Military, 2 other Gov entities (Public Health, Veterans Affairs)
  • 21 Governors-Elect
    • Elected Dec 2007
    • Assume governorship March 2009
  • 24 Incoming Governors-Elect
    • Elected Dec 2008
    • Assume governorship March 2010

In the U.S., 48 chapters represent 47 states and Puerto Rico.

governors chapter presidents
Governors/Chapter Presidents….
  • Provide Rapid Environmental Scanning
  • Are the Primary contact for State Issues
  • Relay ACC’s goals & initiatives to members
  • Represent membership and BOG on committees and task forces
  • Make collective recommendations to BOT
  • Mentor future leaders
  • Facilitate an effective response to state and local issues.
  • Provide opportunity for members to participate in College activities.
  • Provide networking and support opportunities that create a “cardiovascular community” of membership.
bog working toward effective
  • Member Involvement
  • Education
  • Advocacy
  • Quality

To improve cardiovascular patient care

overview of boards committees councils and sections
Overview of Boards, Committees, Councils and Sections

John G. Harold, M.D., F.A.C.C., Chair-elect, BOG

resources for chapters
Resources for Chapters
  • Nearly 200 committees, councils, management boards, editorial boards, work groups, task forces, and subcommittees of the College
  • Seven Councils approved by BOT
    • Adult Congenital and Pediatric Cardiology Council
    • Interventional Scientific Council
    • Imaging Council
    • Surgeon Scientific Council
    • Women in Cardiology Council
    • International Council
    • Cardiovascular Team Council
acc committees
Committees :

comprised of ACC members (+ outsiders) appointed by the President

identify/respond to relevant topics within Education, Quality, Advocacy, Membership, Governance etc

empowered to make recommendations, carry out work or special projects, to research, to work with staff to implement programs, to develop strategies to meet the mission of the committee and the College

can be sunsetted

ACC Committees

Committee Creation

  • Creation approval by EC, reports to BOT
governor members on committees
Governor Members on Committees
  • Governor committee members will report to the BOG and the BOG Steering Committee. 
  • BOG representatives on committees keep lines of communication open between the committee and the BOG.
  • Provide reports to the BOG and BOG Steering Committee on committee activities
  • Help identify opportunities for BOG involvement
  • Participate fully in the committees activities
  • Participate in BOG Steering Committee calls when appropriate
committees as resources
Committees as Resources
  • Committees offer expertise in College functions, ie, Advocacy, Education, Guidelines, etc.
  • Chapters can leverage committee member expertise to advance Chapter goals
acc member councils sections
Council & Section Definition

A group of members who align themselves around an area of clinical or professional interest

Sections are governed by their respective governing Council

Councils work across various committees in the College to advance professional interests and priorities of College member Sections

Benefits to Members

Increased member involvement and leadership opportunities

Better meets members’ needs for education, advocacy, clinical tools

Enhances collaboration and partnership opportunities with existing societies

Benefits to the College

Increased loyalty

Membership growth

Increased opportunities for grant support

ACC Member Councils & Sections

Outside Organization Liaisons





The Council is the initial POC for collaborations and/or strategic partnerships with the College on Section initiatives.

Overview - Member Section Governance

American College of Cardiology

Board of Trustees

  • Councils
  • As a representative body of the Section the Council;
  • is responsible for developing an overarching strategy for ACC’s Section related initiatives
  • coordinates activities and supports development of initiatives
  • prepares an integrated report to the BOT on tSection related initiatives of the College
  • Works with other ACC committees as appropriate and provides support on proposals submitted to BOT
  • Related Committees
  • Education
  • Science & Quality
  • Advocacy
  • Membership

Member Sections

In 2008 over 7,000 members

The focus of the Council is on identifying the vision and strategies for section related initiatives of the College. The Board maintains its oversight role, and relationships, with internal committees and external organizations.

councils and sections as resources
Councils and Sections as Resources
  • Offer Chapter members the opportunity to participate in work directly impacting their specific professional interest
  • Sections and Councils have developed initiatives promoting and advancing specific CV specialty interests
    • Provides the Chapters additional insight into needs and priorities of members with those specific professional interests
  • Sections and Councils strengthen expertise through collaborating with relevant ACC committees
chapters sections collaborating
Chapters & Sections Collaborating
  • CCA Chapter liaisons
  • WIC Chapter networking grants
  • Pennsylvania Chapter provided grant for ACPC Advocacy initiative
  • Chapters can send representatives to Council/Section meetings
continued collaborations
Continued Collaborations
  • Consider leveraging Section leadership for support of relevant Chapter initiatives
  • Remind Chapter membership of Section opportunities and activities at Annual Meeting and throughout the year
  • Consider integrating Section initiatives into Chapter priorities and programming
  • Provide information to members about the Section
  • Encourage involvement!
leverage college resources
Leverage College Resources
  • ACC Committees can provide expertise in College initiatives related to advocacy, science & quality and education
  • ACC Sections and Councils can provide collaboration opportunities, avenues for communicating with members and insight into professional priorities and interests.
the wide open space
The Wide Open Space

More interactive and unstructured BOG dialogue for creative brainstorming and idea swaps to

  • Foster authentic dialogue
  • Stimulate meaningful deliberations
  • Discuss the “elephant in the room”
  • Engage all members of the board, not just the most vocal
  • Help others achieve their chapter’s mission
next step along the journey from no chapter left behind to no member left behind
No Chapter Left Behind

Goal: Supporting Chapter Resources



Management Tools

Goal Setting

No Member Left Behind

Goal: Supporting Individual Members, in BOG and Chapters

Strengthening your voice and purpose

Enhanced bi-directional communication

Next Step along the Journey...From “No Chapter Left Behind to “No Member Left Behind”
  • Working closely with Dr. Janet Wright
  • Continued support of ACC Quality initiatives, such as NCDR
  • Increased support of ACC appropriateness criteria
  • Increased sharing of “best practices” and quality tools from institutions and chapter members
advocacy pac
  • Increased political education and member involvement in lobbying efforts and political issues
  • More state-to-state discussions among BOG members about state issues/efforts
  • Increased PAC fundraising
  • More relationship building with legislators
  • Promotion of Advocacy grant funding from ACC to Chapters
  • Realizing the BOG vision of ACC-provided CME for Chapter meetings
  • Help facilitate Life-Long Learning projects
  • Encourage members to contact their Governors with ideas and issues
cca and fit chapter integration
CCA and FIT Chapter Integration
  • Further integration of FITs and CCAs into Chapters
    • Through BOG FIT/CCA Representatives
  • Encourage FIT/CCA members to voice thoughts and ideas to the BOG through their representatives
  • Empower the grassroots to contribute their thoughts through their Governors
  • Convey the views, needs, thoughts and fears of the grassroots to the Board of Trustees
who s next the importance of succession planning
Who’s Next?: The Importance of Succession Planning

George P. Rodgers, M.D., F.A.C.C.

Immediate Past-Chair, BOG

what is succession planning
What is Succession Planning?
  • Process used to hand over control
  • Identifies future leaders
  • Develops potential successors through mentoring
  • Trains the successor long before his/her term begins
  • Ensures smooth transition of Governorship
  • Guarantees Chapter/State/Region continued growth
  • Avoids backwards steps
  • Finds the best person for the job
  • Increased preparation for leadership
  • Greater Member Satisfaction
qualities of potential successors
Qualities of Potential Successors
  • Dedicated
  • Motivated
  • Chapter and ACC Knowledge
  • Engaged in Chapter
  • Prior involvement in Chapter/State Activities
  • Open minded
  • Energetic
quick tips
Quick Tips
  • Develop an action plan
  • Utilize BOG Roles and Responsibilities list to determine the right fit
  • Appoint likely candidates to positions of leadership in the chapter
  • Once successor is elected gradually transfer responsibilities
  • Communicate, Communicate, Communicate
developing a succession plan
Developing a Succession Plan
  • Think about the below questions:
    • What do you do every day?
    • What do you do once a week
    • What do you do monthly? Quarterly? Annually?
    • What do you do when it needs to be done, or check on intermittently?
  • Examine long term goals and objectives
ic3 and quality
IC3 and Quality

Janet Wright, M.D., F.A.C.C., Senior Vice President, Quality

d2b sustain the gain

D2B-Sustain the Gain

ACC Quality 2009

Transitions in Care-Heart Failure

Patient Centered Care


The IC3 Program


Help clinicians thrive in a performance-based reimbursement system through thesystematic practice,timely reporting,and continuous improvement of quality




Cardiac Care

outpatient performance measures
Outpatient Performance Measures

CAD, Afib, HTN,

Heart failure,

Diabetes, Rehab






quality improvement
Quality improvement
  • Practice workflow redesign
  • Transactional quality and management
  • Incentives

Office-based quality improvement program that enables participants to select, based on practice characteristics, the most appropriate level of engagement

What is it?


The IC3 Program








community building
Community Building

The IC3 national network of practices dedicated to high quality CV care.

Interactive communication.

Best practices.


Educational programming.

Clinical guideline updates.

Selection of EHR vendors.

Billing and coding.

data collection
Data Collection

Office-based registry.

Collect and use patient care data more effectively.

Coordinate care.


Demonstrate quality of care.

performance improvement
Performance Improvement

Practice assessment.

QI tools.

Decision support


recognition and rewards
Recognition and Rewards






tipping points


New insights on care delivery.

Impact of program.

Practice-Based Research Network.


Current ACC/AHA Performance Measures

  • CAD Performance Measures
  • BP Measurement
  • Symptom & Activity Assessment
  • Smoking Assessment
  • Anti-platelet Therapy
  • Lipid Profile
  • Use of Lipid Therapy
  • -blocker post-MI
  • ACE/ARB in EF & DM
  • Screening for Diabetes
  • CHF PerformanceMeasures
  • LVEF Assessment
  • Weight Measurements
  • BP Measurements
  • Clinical Symptom Assessment
  • Activity Assessment
  • Signs of Volume Overload
  • Patient Education
  • -blocker in EF
  • ACE/ARB in EF
  • Warfarin for Afib
  • Initial Lab Tests
current acc aha performance measures
Current ACC/AHA Performance Measures

Afib Performance Measures

Thromboembolic Risk


Age ≥75



Heart failure or EF

Warfarin use in High-risk pts

Monthly INR in pts on warfarin

  • Cardiac Rehabilitation PMs
  • Referral to a Rehab Program
    • Within 12 months of
      • ACS
      • PCI
      • CABG
      • Valve Surgery
      • Transplant
    • Stable Angina
  • Diabetes Performance Measures
    • Poor HbA1c (>9%)
    • LDL Control (<100)
    • BP Control (<140/80)

2009: prepare practices to succeed 2010: make quality business case 2011: link learning, performance, $ 2012: Quality First Network

Quality Vision, near and far

education chapter cme ce

Education & Chapter CME/CE

Christina Chadwick, RN, MSN

Associate Director, CE Accreditation and Compliance

Friday, January 30, 2009

what is cme
What is CME?
  • Continuing medical education consists of educational activities, which serve to maintain, develop, or increase the knowledge, skills, professional performance, and relationships that a physician uses to provide services for patients, the public, or the profession
  • The content of CME is that body of knowledge and skills generally recognized and accepted by the profession as within the basic medical sciences, the discipline of clinical medicine, and the provision of health care to the public

(Sources: ACCME and AMA)

what is ce
What is CE?
  • Systematic professional learning experiences designed to augment the knowledge, skills, and attitudes of nurses and therefore enrich the nurses' contributions to quality health care and their pursuit of professional career goals.

(Source: ANCC)

how do chapters play into cme ce
How do Chapters play into CME/CE?
  • Joint Sponsorship (ACCME Definition): ACCME accredited providers that plan and present one or more activities with non-ACCME accredited providers are engaging in “Joint Sponsorship/Co-Providership.” The non-accredited provider is the “joint sponsor.” The accredited provider is the “primary sponsor”.
  • Co-providership (ANCC Definition): The process for planning, developing and implementing an educational activity by two or more organizations or agencies.
chapter s role
Chapter’s Role
  • Chapter President and Chapter Executive will serve as key contacts
  • Complete ACCF Training Modules
  • Assure compliance throughout the planning, implementation, and evaluation process
getting started with joint sponsorship and or co providership
Getting Started with Joint Sponsorship and/or Co-providership


1. Log onto

2. Place cursor on “Education” on left column.

3. Scroll down to “CME/CE Training & Resources”

4. Click on “Training Lessons”

5. Complete Lessons 1, 5, 6, 3A (if applying for CME),

and 3B (if applying for CE)

6. Click on Joint Sponsorship Toolkit

7. Complete the Certification Request Form (CRF)

**Applications must be received no later than four (4)

months prior to the activity**

how to contact us
How to contact us?

Contact Information:

For questions please contact any of the following College staff at


Christina Chadwick, CE (Nursing) Accreditation, ext.6375,

Karen Thompson, CME Accreditation, ext.6650,

Maria Ortiz, Chapter CME/CE, ext.6388,

DEADLINES for CME/CE Certification Form (CRF):

Jan 09 ►Proposal Deadline for May 09 Activities

Feb 09 ►Proposal Deadline for June 09 Activities


American College of CardiologyMembership Types & Selected DemographicsFellow, Associate Fellow, MemberFellow-in-TrainingInternational AssociateCardiac Care AssociatePractice Administrator

Pat Miyamoto

Membership Strategy & Services

fellow of the american college of cardiology f a c c
Fellow of the American College of CardiologyF.A.C.C.
  • (a) Certification by both a primary specialty board and an applicable subspecialty board (American Board of Medical Specialties or the Advisory Board for Osteopathic Specialists of the American Osteopathic Association).
  • Lacking board certification: important scientific contributions over a period of years to a cardiovascular field. 
  • (b) Evidence from his/her community of recognition as a specialist and consultant or as a scientist.
  • Master of the ACC, (MACC): An FACC past president or elected by the Board of Trustees.  
associate fellow
Associate Fellow
  • (a) Board certification by a primary specialty board which holds membership in the American Board of Medical Specialties or the Advisory Board for Osteopathic Specialists of the American Osteopathic Association,
  • Plus evidence of formal cardiovascular training and other evidence from his/her community of having attained peer recognition as a consultant. 
  • (b)  In lieu of the above, important scientific contributions and shall have devoted the major share of his/her efforts over a period of years to the cardiovascular field. 
member affiliate
  • Satisfactorily completed a formal cardiovascular related training program in fulfillment of requirements for admission to an examination
  • by a subspecialty board which holds membership in the ABMS or the ABOS of the AOA.
  • Lacking board certification, candidates are expected to provide evidence from the local community of having attained peer recognition as practicing cardiovascular specialists.
  • International Requirements for Fellow, Associate Fellow, and Member modified due to variability in attaining boards, and publishing expectations.  
fellow in training fit
Fellow-in-Training (FIT)
  • Currently engaged in a formal cardiovascular related training program in fulfillment of requirements for admission to an examination
  • by a subspecialty board which holds membership in the American Board of Medical Specialties or the Advisory Board for Osteopathic Specialists of the American Osteopathic Association.
  • No application process, names obtained from cardiovascular training program directors.
  • FITs are advanced into initial “Member” type upon completion of training where they benefit from one year of reduced dues; and automatically advanced to full dues-paying Member status after the initial year unless the individualchooses to apply for Fellow or full Member status earlier.
international associate
International Associate
  • An additional category of membership for early career international candidates who are working toward establishing peer recognition in the community.
  • Requires one letter of sponsorship from an ACC Fellow, or Associate Fellow, or Member.
  • Verification letter confirming current hospital and/or academic appointments. 
cardiac care associate
Cardiac Care Associate
  • Registered Nurse (RN), Nurse Practitioner (NP), Clinical Nurse Specialist (CNS), Physician Assistant (PA), or Clinical Pharmacist
  • who works in cardiovascular care and holds an appropriate license(s) and/or state certification(s).
  • ACC national non-voting category of membership that can be appointed to national committees, task forces and working groups.  The category is ineligible to hold ACC national office.
  • Chapters allowed to engage CCAs in voting for Governor and CCA Liaison.
practice administrator
Practice Administrator
  • New membership category 2008
  • 88 members to date
  • Available to practice administrators and managing physicians in cardiovascular healthcare settings
  • Benefits: JACC online; Cardiosource; practice management information: advocacy updates, news, networking, leadership opportunities
acc membership programs
ACC Membership Programs
  • Membership information & applications:
  • Membership, Human Resources & Operations Division
  • Cathleen Gates,
  • Membership Strategy & Services
  • Pat Miyamoto,
  • Member Communities (Councils, FITs, CCAs, etc.)
  • Stephanie Bailes,
national cardiovascular data registry

National CardiovascularData Registry

Kathleen Hewitt, MSN, RN, CPHQ, AVP

Barb Christensen, MS, RN, Senior Director, Registry Services

Kristi Mitchell, MPH, Senior Director, Research, Development, and Quality Products

what is the ncdr
What is the NCDR?
  • Suite of Hospital and Office-Based Quality Improvement Programs
    • measure and quantify outcomes
    • Identify gaps in the delivery of quality cardiovascular patient care
  • Our Mission is to:
    • improve patient care
    • Provide knowledge and tools
    • Implement quality initiatives
    • Support research
how is ncdr being used
How is NCDR being Used
  • by Researchers?
    • Outcomes research
    • Post Market Surveillance
  • by Health Plans?
    • Several Plans require
    • participation
    • as a requirement for
    • preferred provider
    • programs.
    • Performance
    • Measurement Tool
  • by ACC?
    • To support members on
    • advocacy issues
    • Needs assessment
    • Scientific insights

NCDR at a Glance Today…

  • Guidelines Develop.
  • Educational Needs Assess.
  • Market Intelligence


Reporting Services













Research &

Publication Services









Quality Improvement

Registry Studies

More Registry QI Tools

(ACTION, IC3, etc)



Field Base Consultant potential partnership with AHA

ICD Longitudinal

multispecialty representation
Multispecialty Representation


  • Society for Cardiovascular Angiography and Intervention


  • Heart Rhythm Society


  • Society for Cardiovascular Angiography and Intervention
  • Society for Interventional Radiology
  • American Academy of Neurology
  • American Academy of Neurosurgery
  • Society of Vascular Medicine and Biology


  • American Heart Association
  • Chest Pain Centers Society


NCDR Management Board


Scientific Oversight Committee

ACTION Registry

CathPCI Registry

CARE Registry

ICD Registry



IMPACT Registry


QI Subcommittee

Research &


data quality program
Data Quality Program
  • Online field checks for completeness and consistency
  • Electronic Data Quality Reports
  • National On-Site Audit Program
    • Annual
    • Nurse abstractors go on-site to audit charts



Analytics and Reporting Services

Secondary Uses of Data

Quality Improvement

ncdr research
NCDR Research
  • Effectiveness
    • Diffusion of new technologies
  • Post Market Surveillance
    • Adverse/sentinel events
    • Identify device performance trends,
    • Inappropriate off-label use,
    • Hypotheses for follow up studies
  • Quality Improvement and Translational Research
    • Effectiveness of P4P
    • Guideline adherence
    • Performance measure development, implementation, validation
ncdr research110
NCDR Research
  • Informing Public policy
    • Evidence-based reimbursement
    • State regulations/CON
  • Growing interest to assess patient quality of life and functional status
    • Linking with SAQ
  • Intense interest in assessing efficiency, ROI,
    • linking with administrative data (CMS, health plans)
ncdr analytics reporting services
NCDR Analytics & Reporting Services
  • Key strategy to encourage registry participation and physician-directed health system reform
    • Payers
      • Blue Cross Blue Shield Association;
      • United Healthcare Services
      • WellPoint Inc
    • Hospital Systems
      • Mountainstar Division
      • HCA
    • State and Federal Regulatory Agencies (CMS; WV, MA, PA)

Growing business…..

states relying on ncdr reporting
States Relying on NCDR Reporting

CathPCI Registry

  • Massachusetts Department of Health
    • legislative mandate
  • West Virginia Health Care Authority
    • legislative mandate
  • Michigan Department of Community Health
    • certificate of need regulation
  • Pennsylvania Department of Health
    • settlement with hospitals providing caths without surgical backup
  • New Jersey Department of Health
    • integrated into regulations
states considering adopting ncdr
States Considering Adopting NCDR

CathPCI Registry:

  • Maryland Health Care Commission
  • California
    • Health care reform legislation set for November 2008 ballot
    • Counties creating STEMI coordinating center models
  • Washington Department of Health
ncdr analytic and reporting projects
NCDR Analytic and Reporting Projects

Centers for Medicare and Medicaid (CMS)

  • ICD Registry -
    • Requirement as part of coverage with evidence determination (CED)
  • CARE Registry
    • Export for national coverage determination (NCD)
  • IC3 Program
    • Recognized for 2008 Physician Quality Reporting Initiative (PQRI)

CathPCI Registry Health Plan Projects

  • WellPoint Inc.
  • Blue Cross Blue Shield Association
  • United Healthcare Services
acc sexual harassment policy
ACC Sexual Harassment Policy

Cathy Gates, Sr. Vice President, Membership, Human Resources & Operations

acc leadership orientation 2009 fiduciary duties and ethical governance
ACC Leadership Orientation 2009Fiduciary Duties and Ethical Governance

Thomas E. Arend, Jr., Esq.

American College of Cardiology

January 2009

corporate structure and tax exemption
Corporate Structure and Tax Exemption
  • ACC/ACCF Structure
    • Nonprofit
    • District of Columbia
  • Section 501(c)(6) professional society and business/trade associations
    • Member Organization
    • Unlimited lobbying
    • Political Action Committee
  • Section 501(c)(3) charitable and educational organizations
    • Public benefit
    • Private inurement prohibited
    • “Excess benefits” law
    • Ban on political activity
    • Restrictions on lobbying
acc accf trustees
ACC/ACCF Trustees
  • Trustees, Officers, Staff, Committee Members (will refer to as “Directors”) have Fiduciary Duties of Care, Loyalty, and Obedience
  • Compliance with Duties protects from personal liability
  • Important to understand these
  • Increased legal and financial scrutiny of nonprofit corporations and boards
duty of care
Duty of Care
  • Most Important
  • Must Act
    • Honestly
    • Good Faith
    • Informed
business judgment rule
Business Judgment Rule
  • Care measured by business judgment rule
  • Motivation, intention, openness and fair dealing
  • Protects Trustees from personal liability when acting in accordance with duties
duty of loyalty
Duty of Loyalty
  • Must act -
    • Only in best interests of organization
  • Should not -
    • Usurp corporate opportunity
    • Directly compete with organization
conflicts of interest
Conflicts of Interest
  • When a Trustee participates in the corporation work and at the same time has other professional, business, or volunteer responsibilities that could bias the Trustee one way or another.
rules regarding conflicts of interest
Rules Regarding Conflicts of Interest
  • Actual or potential conflicts must be disclosed
  • Recusal from deliberation and/or vote may be advisable or necessary
  • Resignation may be advisable or necessary
  • Board can enforce these rules
duty of obedience
Duty of Obedience
  • Obligation to faithfully pursue the organization’s purpose or mission
  • Purpose/mission are as stated in governing documents
    • Certificate of Incorporation
    • Bylaws
    • Policies
  • An important obligation that fits under all duties
  • Trustees must not disclose information about the corporation that is confidential or not authorized for disclosure
  • Financial, personnel, etc.
other requirements
Other Requirements
  • ACC Code of Ethics
  • IRS Tax Exempt Organization Rules
legal risk management and liability protections
Legal Risk Management and Liability Protections
  • Observe Fiduciary Duties
  • Corporate Status
  • Insurance
  • Indemnification
  • Contractual Protection (waivers and releases)
  • Volunteer Protection Statutes
insurance coverage
Insurance Coverage
  • Comprehensive General Liability (“CGL”)
  • Directors and Officers (“D&O”)
  • Errors and Omissions (“E&O”)
  • Provides coverage for antitrust, certification or accreditation, employment practices, infringement, etc.
chapter structure
Chapter Structure
  • Share ACC’s mission, goals and logo.
  • Come in all shapes & sizes
  • Are incorporated separately from ACC National and are their own entity
  • Are non-profit organizations with legal and financial responsibilities
chapter structure133
Chapter Structure
  • Governor/Chapter President
  • Chapter Executive
  • Executive Committee
  • Council
    • CCA Ex-officio Councilor
    • FIT Ex-officio Councilor
    • Practice Administrator Ex-officio Councilor
  • Committees
    • Education; Advocacy; Quality, CCA, FIT
strong chapters need
Strong Chapters Need…
  • Dedicated, energetic Chapter Executive
  • Dedicated, energetic Chapter President
  • Nucleus of Champions
  • Membership Input
  • Strategic Goals with Timeline
  • Involved Council with defined responsibilities
pitfalls to avoid
Pitfalls to Avoid
  • Ineffective, unresponsive Chapter management
  • No strategic goals or clear direction
  • Lack of understanding of members’ wants and needs
  • Lack of communication with membership
  • Unused resources – other interested volunteers
  • Ineffective time management – the “I’m too busy” pitfall
responsibilities of a chapter president
Responsibilitiesof a Chapter President
  • Chapter meets federal and state requirements
  • Responsible for, clear, recorded and unbiased past and future financial records
  • Clear and constant communication with the Chapter Executive
  • Goals strategic, within available resources, clearly delegated, set with timeline and a review process
  • Conducts performance reviews of Chapter Executive
responsibilities of a chapter executive
Responsibilities of a Chapter Executive
  • Operations
  • Financial Services
  • Data and Document record keeping
  • Governance assistance
  • Meeting and Event planning
  • Facilitate communication to/from members
  • Attend ACC Natl meetings for Chapter Executives

*Full list in Chapter Operations Checklist Sample Contract

responsibilities of a governor elect
Responsibilities of a Governor-Elect
  • Pay attention!
  • Have regular phone calls/meetings with current Governor & Chapter Executive
  • Shadow Governors to mtgs when possible
  • Develop transition plan with Governor, Chapter Executive
  • Read Natl/Chapter Emails and Updates
  • Ask questions!
the rewards
  • Professional educational growth
  • Professional visibility
  • Social contribution
  • Mentoring opportunity
  • Personal satisfaction
all done now what

Board of Trustees



An Advocacy Program is Like a Fire Extinguisher

You maintain it, have it at the ready, and hope that you never have to use it.

the coat of credibility
The “Coat of Credibility”

Most Trusted Occupations in the U.S.

The Harris Poll® #61, August 8, 2006

“Would you generally trust each of the following types of people to tell the truth?”

Doctors– 85%

Police Officers – 76%

Clergymen – 75%

Judges – 70%

Members of Congress – 35%*

Lawyers – 27%

* In a July 13, 2008 Gallup Poll, the congressional approval rating was 14%.


Perceptions of Advocacy

  • Not my job
  • Someone else will take care of it
  • I don’t have the time
  • Nothing I do will make a difference

The Reality Is…

  • Advocacy is a partnership
  • Policymakers need to hear from you.
  • ACC staff and lobbyists can’t speak from experience; they aren’t directly affected
  • Physician leadership is critical

Keys to A Successful Advocacy Infrastructure

  • Alliance with state medical association
  • Alliance with AHA and other state groups
  • Strong advocacy committee
  • Identification of your grasstops and key contacts
  • Established relationship with legislators

State/National Partnership

  • ACC Advocacy staff partners with chapters to coordinate state government relations efforts. ACC Advocacy assists our chapters in a number of ways, including:
  • Grassroots mobilization
  • Legislative tracking and analysis
  • Lobbying and legislative strategy
  • Planning and executing lobby days

State/National Partnership

  • ACC Advocacy staff partners with chapters to coordinate state government relations efforts. ACC Advocacy assists our chapters in a number of ways, including:
  • Preparing and presenting legislative testimony
  • Building relationships with policymakers: Cardiologist for a Day; policy panels; promoting ACC quality programs; “Heart Healthy” days
  • Strategic coalition development: medical society; physician specialty groups; American Heart Association; industry 
maryland heart healthy day february 29 2008
Maryland Heart Healthy DayFebruary 29, 2008

The Maryland chapter provided blood pressure tests, BMI analyses, and EKGs to more than 50 participants elected officials and staff.

colorado cardiologist for a day march 24 25 2008
Colorado “Cardiologist for a Day”March 24-25, 2008

Two Colorado practices provided Rep. Doug Lamborn as well as staff from the offices of Reps. Diana DeGette, Mark Udall, and Ed Perlmutter with a tour of their facilities.

michigan lobby day april 23 2008
Michigan Lobby DayApril 23, 2008

From L-R:Claire Duvernoy, MD, Sanjay Bhojraj, MD, Alan Silverman, DO, David Lanfear, MD, and Frank Pelosi, MD


Upcoming Advocacy Events

  • Arizona Legislative Day: February 2-3
  • Maryland Heart Healthy Day: February 5
  • Indiana Legislative Day: February 11-12
  • Nevada Legislative Day: March 4-5
  • National Lieutenant Governors Association Meeting: March 11-13
  • Alabama Legislative Day: March 25-26
  • ACC Annual Scientific Session
  • Ohio Legislative Day: May 4-5

ACC Legislative Conference

  • Sept. 13-15, Washington, D.C.
  • Analysis of complex health policy issues
  • Meetings with legislators and regulatory experts
  • Political experts, seasoned policy veterans
  • Networking opportunities with colleagues
chapter affairs staff resources
Chapter Affairs Staff & Resources

Jayne P. Jordan

Associate Director, New & Emerging Chapters

January 30, 2009

physician governor chapter president three hats one person
Physician/Governor/Chapter President: Three Hats, One Person

National Focus: College


State Focus: Chapter

Governors elected in states with Chapters automatically become the Chapter Presidents because of ACC bylaws.

chapters are







Chapters are:
  • Share
    • Members
    • ACC Mission & Goals
    • ACC Logo
  • Vary by size
what do chapters staff do for you
Group Bonding

Leadership Forum

March meeting

Legislative Forum

Chapter Executive Workshop

Your Advocate

Between ACC & Chapter

Internally within ACC


Chapter Awards Program

Strategic planning

Chapter Executive search

Member Development

ACC One Stop Resource

ACC Institutional knowledge

Staff Points of Contact

ACC tools

BOG Updates weekly

Chapter Operations manual

Chapter Extranet

Membership database

Chapter billing

Financial management software

Initiative Tool Kits

Support for Chapter Programs

Quality Improvement Initiatives

Advocacy Efforts

Education & CME/CEU


Member Involvement

What Do Chapters Staff Do for You?
on the committee and leadership side
On the Committee and Leadership Side …..

Marthea Wilson

  • Handles all Committee Appointments with Incoming President
  • Assigns BOG Representatives to various Committees
  • Handles logistics of online disclosure submissions

Shannon Hughes

  • Responsible for all Leadership Programs, including the Leadership Forum
  • Member Leadership and Development
chapters team
Kristin Try

BOG and Chapters

External Affairs

International Affairs

Jayne Jordan

Assists new and emerging Chapters

Primary Staff Liaison

BOG Steering


Chapters Team
more chapters team
More Chapters Team

Helen Smith

  • Primary Staff liaison
    • Chapters
    • Chapter Finance Workgroup
    • Chapter Executives Steering Committee
    • Chapter Extranet
    • BOG Updates

Taryn Gold

  • Supports Chapter Staff and BOG Members
    • RSVPs and BOG Meeting Logistics
    • National speakers at Chapter Meetings
    • Governor elections
    • Chapter dues
chapter affairs extranet
Chapter Affairs Extranet

contact information
Contact Information

BOG & Chapters:

Taryn Gold,, Ext. 6248Jayne Purcell Jordan,, Ext. 6609Helen C. Smith,, Ext. 6269Kristin L. Try,, Ext. 6696

Committee Appointments, Disclosures:

MartheaWilson,, Ext. 6230

Member Leadership and Development Programs:

Shannon Hughes,, Ext. 6243

resources for all governors
Resources for All Governors
  • BOG Meetings
    • (Jan Leadership Forum, Mar ACC Sci Session, Sept Legislative Conference)
  • ACC National Staff
  • BOG Update Weekly E-Newsletters
  • Dedicated website –
  • BOG Steering Committee
  • Fellow Governors
  • Target emails
additional resources for chapters
Additional Resources for Chapters
  • Chapter Executive
  • Chapter Council
  • Chapter Operations Check List
  • Financial Management Templates
  • ACC Chapter Staff
  • ACC Advocacy Staff
  • Set STRATEGIC achievable GOALS with timeline and review process
  • Have scheduled times for touchbase with Chapter Executive and Council
  • Give 20 mins/day to Chapter business
  • Check e-mail daily
  • Create energized team around you
  • Delegate
  • Run organized meetings and calls with expected action items
  • Chapter Executive
  • ACC Chapter Staff
    • Kristin Try, Sr. Director (Ext. 6996)
    • Jayne Purcell Jordan (Ext. 6609)
    • Helen Smith (Ext. 6269)
    • Taryn Gold (Ext. 6248)
  • BOG Chair Leadership
    • Jane E. Schauer (3/08– 3/09)
    • John G. Harold (3/09 – 3/10)
  • Other Governors
  • BOG Steering Committee