The AVI Model of Care Change Management Forum, which is comprised of representation from all 11 surgical advanced cardiac hospitals in Ontario, CorHealth Ontario, and the Ministry of Health, has met three times since September 2019. Forum discussions to date have reinforced a shared goal to ensure that all persons with aortic stenosis receive evidence-based care, including timely and equitable access to AVI treatments – either surgical aortic valve replacement (SAVR) or transcatheter aortic valve implantation (TAVI).
Forum meetings have been well attended, with excellent representation and demonstration of commitment from all participating hospitals. The Forum has allowed for robust discussion and information sharing about how persons with aortic stenosis are currently being managed at each hospital and what changes may need to take place as treatment options continue to advance.
Co-design is grounded in the concept of including all stakeholders who are impacted by complex problems to jointly participate in the creation of solutions. To this end the Forum members are beginning to articulate a draft model of AVI care. Once the model of AVI care has been finalized by the Forum it will serve as the framework with which hospitals can work to align themselves.
The current co-design phase of work (Phase 1) will continue to the end of March 2020, with the Forum continuing to refine the model and identify key metrics required to measure the model’s impact. In addition, hospitals will begin to identify local changes required at their hospital in order to align with the model. Phase 2 will commence in April 2020 when a modification of the existing PPB funding line items for TAVI and SAVI are combined to reflect a single AVI patient cohort. Change management activities will take place at the 11 participating hospitals in order to support implementation of the model and ongoing model evaluation and refinement activities will also occur throughout Phase 2.
To ensure the AVI Model of Care embraces patient informed decisions for their aortic stenosis treatment, incorporating patients’ and caregivers’ views and lived experiences is seen as an essential aspect of the co-design process. In alignment with CorHealth’s strategy for patient & family engagement and the concepts of co-design, the AVI Model of Care Change Management Forum has recruited 6 patients and caregivers to actively participate in the discussions and model co-design.