SVS LAUNCHES WEBBASED PERIOPERATIVE CARE GUIDE

By Beth Bales

The Society for Vascular Surgery (SVS) has launched its “Management Guide on the Perioperative Care of Patients with Vascular Disease,” a multidisciplinary resource for care of patients with vascular disease who require an intervention.

The American Society of Anesthesiologists, the Society for Vascular Medicine and the Society for Vascular Nursing all helped develop the guide, supported through an unrestricted educational grant from Janssen Pharmaceuticals, Inc.

The resource provides information on the medical and non-medical management of vascular patients in the perioperative period: 1) 30 to 90 days before intervention, 2) during the intervention, and 3) 30 to 90 days post-intervention.

With mobile-responsive design and easy, intuitive navigation, it is ideal for on-the-go use by busy members of the entire vascular team, from trainees, to surgeons, anesthesiologists, internists, vascular nurses and allied health members.

It covers the procedures and conditions that encompass the most common vascular disorders. Each section outlines factors for each stage. Pre-operative care for abdominal non-aortic pathology, for example, lists such factors as patient history, including specific elements to assess for certain conditions; physical examination; imaging; medical management and lifestyle changes; risk stratification and risk assessment; preoperative lab tests recommended; and medication adjustments to make prior to intervention.

The guide then provides similarly detailed information and recommended steps for the intraoperative and postoperative phases.

To develop the guide, the SVS brought together experts who represent key members of the perioperative team, including vascular surgeons, anesthesiologists, vascular medicine specialists, vascular nurses and

Advocacy

SVS MEMBER DAVID HAN, MD, HAS BEEN re-elected to the American Medical Association (AMA) Relative Values Scale (RVS) Update Committee (RUC). Han’s two-year term runs from March 2023 and ends in February 2025.

physician assistants. “We don’t intend that this new guide replace any of the documents and protocols or local practices,” said Rabih Chaer. MD, chair of the authoring group. Instead, as stated in the guide’s introduction, “It provides guidance that can be used by individual institutions to build their own perioperative management protocols and design educational programming, and complements the Enhanced Recovery After Surgery (ERAS) guidelines that the SVS is developing. The document will help facilities address comorbidities and other risk factors that can affect postoperative outcomes and reduce the use of redundant and/or unnecessary tests.”

Government Grand Rounds: Culture of engagement

By Andrew Kenney

WELCOME

BACK TO GOVERNMENT GRAND ROUNDS,

Rabih Chaer

where the Society for Vascular Surgery Advocacy Council discusses how sustained advocacy engagement is important for all SVS members.

It’s more of a complete 360-degree view of the care of patients who need a vascular intervention, involving all aspects and all team members involved in that care, he said. “The procedure is important, of course,” he said. “But all aspects of perioperative care—from medication compliance to follow-up care—are critical to ensure successful outcomes. This is one of our first official resources that articulates the entire patient experience.”

View the guide, which also includes conclusions, the definitions of approximately 125 terms from abdominal aortic aneurysm to Vitamin-K antagonist, and more than 160 references, at vascular. org/PMG. Users can also download the guide at the site.

While “advocacy” continues to rank high among SVS member priorities, many remain unsure how to support SVS advocacy-related programs, what activities are available and how to measure success along the way. This series aims to answer those questions through the many useful tools of advocacy. Last month, the Council shared the importance of perspective and examined how advocacy can be used as a tool to protect. But how do we use that tool and what are the driving factors behind that tool’s effectiveness? One of the key drivers of success in advocacy is engagement.

Many have probably heard of the term “grassroots” before, but what exactly does that mean in the context of advocacy? Grassroots is often defined as “the basic level of society or of an organization” or something that is “basic, fundamental.” In advocacy, we use this term to describe the efforts that every-day citizens go through to help shape the government, often through sending letters to Congress, protesting in public spaces or organizing their own awareness campaign. These efforts are the bread and butter of what it means to advocate.

The SVS engages in grassroots activities through a few programs, designed to connect SVS members with their lawmakers to create tangible channels for vascular surgeons to personally advocate on issues that significantly impact the specialty. The REACH 535 program establishes a concrete mechanism for the SVS to amplify its advocacy efforts by ensuring we can quickly engage with the 535 decision-makers on Capitol Hill. This engagement with lawmakers is what drives change. (Visit vascular.org/REACH535form to sign up for REACH 535.) To create a strong foundation for grassroots advocacy, the SVS needs to establish a culture of engagement. This culture looks like taking the opportunity to engage with lawmakers via Voter Voice, signing up for REACH 535, and donating to the SVS PAC. When we work together to strengthen our collective voice, we simultaneously expand our impact on Capitol Hill.

These facets of engagement, when done together, help to amplify the entirety of the effort. One letter sent may not change the course of a bill, but organized, collective action from thousands of vascular surgeons could permanently alter the trajectory of a proposed policy or pending piece of legislation. For more information on how to engage with the SVS’ Advocacy programs, visit vascular.org/advocacy or contact svsadvocacy@vascularsociety.org

ANDREW KENNEY is SVS advocacy coordinator.

Medicaid Services (CMS). CMS considers input from the RUC Relative Value Units (RVUs) when making payment decisions.

Han will serve on the committee as one of a handful of members from surgical subspecialities; most seats are held permanently by major national medical specialty societies. The committee provides input to CMS.

RUC. He was named in late 2020 as the AMA alternative representative to the RUC and alternative vice chair. His three-year term began in March 2021.

This is the third time Han will serve in that capacity. He currently is vice chair of the Society for Vascular Surgery (SVS) Coding Committee and will continue as the vice chair of the AMA RUC Practice Expense Subcommittee.

The RUC is the multispecialty committee that makes relative value recommendations for new, revised and potentially misvalued services to the Centers for Medicare &

“Many other specialty societies have permanent seats on the committee. We, as a small subspecialty, do not; instead, our members can be elected on a rotating basis with other small subspecialties,” said Matthew Sideman, MD, chair of the SVS Advocacy Council.

Sideman said Han supports the SVS’ mission of advocacy and payment reform. He is professor of surgery and chief of the division of vascular surgery at SSM Health St. Louis University in St. Louis, Missouri.

Fellow SVS member, and longtime SVS coding expert, Robert Zwolak, MD, serves in a leadership role on the

“Dr. Han will be and has been a valuable asset to the RUC Committee,” said SVS President Michael C. Dalsing, MD. “He understands the complexity, processes, and nuances involved in coding and all the other elements that go into reimbursement rates, which are an integral part of the medical world we live and practice in.”

“I am grateful for working with such a talented team of individuals who work tirelessly on behalf of our specialty to ensure that vascular surgeons are fairly valued for the work we do,” said Han.

“I truly stand on the shoulders of giants with regards to the team as well as those who have come before me. I hope that I can play a similar role in helping the next generation continue to advocate for the highest quality and most sustainable and equitable care.”—Beth Bales

I’M AMAZED BY THE HIGH-QUALITY MODERATORS AND DISCUSSION. THE DEBATES WERE EDUCATIONAL AND FRANKLY A LOT OF FUN TO WATCH.

CX IS THE BEST OPPORTUNITY TO NETWORK WITH FRIENDS FROM THE INTERNATIONAL VASCULAR COMMUNITY FROM ALL CORNERS OF THE GLOBE.

EXCELLENT MEETING COVERING THE MOST UP-TO-DATE INFORMATION ON THE IMPORTANT ASPECTS OF VASCULAR SURGERY.