B-33 | We Get Better When We Measure: Building a Cardiogenic Shock Program, Tampa General Experience

Cardiogenic Shock (c shock) has high morbidity and mortality. With advances in interventional, heart failure cardiology and MCS, the need of instituting a structured c shock program to expedite care and improve patient outcome has been identified. Tampa General Hospital, 1000 bed academic facility identified the need for a c shock program and selected the following key elements: infrastructure, operational, quality metrics, to implement the program that launched in February 2022. Team members include: interventional and heart failure cardiologists, CT surgeons, intensivists, MCS coordinators and care comm. Single call activation occurs via calling the code line which assembles all team members. Criteria for activation: newly recognized c shock, clinical deterioration requiring escalation, improved clinical condition requiring deescalation or change in strategy; and algorithms were socialized throughout the hospital. Activation goals were delineated: hemodynamic and clinical criteria, contraindications, resources to support patient needs, suitability for advanced therapies. All discussions are recorded and cases are discussed at weekly and monthly conferences. Multiple metrics are tracked. In 2021 key physician champions were identified, committee was formed, protocols, activation process and outreach finalized and registry joined. Program went live 2/2022 after hospital wide education and socialization. To date more than 500 alerts on over 300 patients have occurred. There was 160% increase in c shock alerts and 50% increase in patients (pts) from 2022 to 2023. Average time alert to team assembly decreased from 15 min to under 4 min. Average time to decision decreased from 15 min to under 8 min. Mortality improved from 56% at the inception of the program to 42% 12/2023. Implementation of a hospital wide multidisciplinary team is paramount for improved outcome and survival of c shock patients. Currently our team is planning to expand the c shock services to a local and regional network.