The Vascular Quality Initiative (VQI) Fellows in Training (FIT) program is a success, said leaders as they provided a one-year review.
FIT introduces residents and fellows in vascular surgery and medicine to the SVS Patient Safety Organization (PSO). Fellows worked closely with their mentors to participate in VQI regional meetings. They also participated in quality charter development, the quality improvement process and research initiatives using VQI data. FIT is run in collaboration with the Association of Program Directors in Vascular Surgery (APDVS).
Adam Johnson, MD, a vascular surgeon at Duke Health in Durham, North Carolina, briefly reviewed the first year of the program during the recent VQI Annual Meeting in June. During the session, founding VQI Medical Director Jack Cronenwett, MD, announced the recipients of the second-year scholarship that bears his name.
Year one included 16 mentors and 16 fellows representing 10 of the VQI’s 18 regions, said Johnson. Over the year, the fellows have submitted projects to research advisory committees, with refinement following review and data analysis. Some of the projects were included in the poster presentations at the annual meeting. Mentors were “very satisfied” with the projects overall, and trainees were “very or somewhat satisfied” with the program, Johnson said.
Leaders added virtual meetings, to which mentors will be added this coming year; formalized the curriculum and made it more readily available; and helped provide local leadership in the aftermath of a few mentor changes. For year two, organizers will promote engagement via presentations by fellows at regional meetings, he said.
The five scholarship winners will continue work with the program, receiving individual funding to continue their research and/or work more closely with VQI staff and committees. Scholarships are awarded in either the research or quality categories.
Quality
For 2023–24, the FIT fellows and mentors in the quality category are: Hanna Dakour Aridi, MD, from Indiana University Health-Methodist in Indianapolis—mentored by Michael Murphy, MD—who has studied postoperative day-one discharge, which is used as a quality-of-care indicator after carotid revascularization. Her project involved reviewing records of 122,560 elective carotid interventions in the VQI to identify drivers of increased length of stay.
Christine Kariya, MD, from the University of Vermont Medical Center in Burlington, Vermont—mentored by Danny Bertges, MD—is working to incorporate patient-reported outcome measures (PROMs) into the electronic medical record (EMR) and VQI registries.
Research
In the research category, Caronae Howell, MD, from University of Utah Hospital and Clinics/The University of Arizona—who is mentored by Benjamin Brooks, MD—is studying racial and ethnic disparities in revascularization options for chronic limb-threatening ischemia (CLTI), with a study designed to compare anatomic patterns of disease and limb-salvage outcomes among patients from racial and ethnic groups undergoing first-time revascularization for lower-extremity CLTI.
Brianna Krafcik, MD (mentor Phil Goodney, MD), from Dartmouth Hitchcock Medical Center in Lebanon, New Hampshire, is using the carotid endarterectomy and carotid stenting VQI modules to compare indirect quality-of-life measures such as length of stay, new neurologic events, frailty, and new medications between carotid endarterectomy and transcarotid artery revascularization (TCAR).
Lastly, Ben Li, MD, from Toronto General Hospital in Toronto, Canada—mentored by Graham Roche-Nagle, MD—is developing machine learning algorithms to predict outcomes following major vascular surgery using the VQI database. He used VQI data to develop robust machine-learning models that accurately predict outcomes following carotid endarterectomy.
