To substantially improve Cardiovascular-Thoracic patient outcomes and comfort through the training and development of professional Critical Care teams in hospitals in the USA and around the world.

FACTS-Care (the Foundation for the Advancement of Cardiothoracic Surgical Care) was founded to take CVT Critical Care to the next level of excellence:

The mission of FACTS-Care is to substantially improve Cardiovascular-Thoracic patient outcomes and comfort through the training and development of professional Critical Care teams in hospitals in the USA and around the world.

As a result, patients will receive safer, more effective and seamless perioperative care and optimal recovery from cardiovascular, lung and other chest surgeries.

As a hub resource, FACTS-Care can gather and disseminate information, provide consultative expertise, promote and provide training, and share resources in the complex and ever-changing field of CVT medicine. The need is acutely felt by patients and medical professionals alike.

The cardiovascular-thoracic (CVT) surgical patient lies in the balance:
Between life and death, surgery and recovery.


There is a growing crisis in the field of CVT Critical Care.

Every hour of every day, thousands of people - from infants to elders - undergo cardiovascular-thoracic surgery for treatment of disease, disorder and malady associated with the heart, the lung, and the esophagus. In a given year, thousands of people undergo esophageal surgery, tens of thousands of people undergo lung surgery, and hundreds of thousands of people undergo cardiovascular surgery.

Despite continued medical progress, there is a growing crisis in the field of CVT Critical Care due to a shortage of CVT surgeons and experienced critical care personnel. As CVT intensive care units depend more and more on healthcare professionals from multiple disciplines, these specialists must be trained in the rapidly changing medical advances, including new technologies that are improving patient care and saving lives. In addition to surgeons and nurses, these dedicated men and women are anesthesiologists, physician intensivists & interventionalists, physician assistants, perfusionists, respiratory therapists, pharmacists, and nutritionists.

FACTS-Care was founded to take CVT Critical Care to the next level of excellence by providing multi-disciplinary educational activities to train CVT Critical Care professionals and promote medical practice safety.

"Cardiothoracic surgery continues to evolve rapidly. The latest advances are being provided to patients of all ages, some very elderly and with extensive disease. The cardiothoracic surgical (CTS) critical care for these patients is increasingly challenging with new medications, protocols, and advanced technology. The complexity of care requires a multi-disciplinary team. With the progressive national shortage of critical care physicians, nurses and other intensive care personnel, multi-disciplinary educational programs are essential to provide the latest information and training in CTS critical care."
Delos M. Cosgrove, MD
(CEO & President, Cleveland Clinic)

Studies show that there is a crisis in critical care. The problems are due to a number of factors. There is a growing shortage of critical care physicians and nurses and, despite the many hardworking, conscientious health care professionals in ICU?s, the latest medical knowledge and technology may not be applied, and medical errors occur.

FACTS-Care was created in response to major challenges in the care of CVT patients:

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A rapid evolution in critical care concepts, pharmacology and technology.

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The unique physiologic states and complications experienced by CVT patients

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The aging CVT patient population with more advanced primary disease and associated conditions.

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Major changes in surgical techniques and technology

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Newly-adopted national regulations limiting house staff work hours that accentuate the shortage of critical care staff.

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The difficulty in providing comfortable care with patients subjected to multiple negative sensory inputs including monitoring sounds, alarms, technical language, and procedures.

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The increasing number of disciplines included in the CVT critical care team.

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The well-documented compromises in medical practice safety.


These challenges were coupled with a major limitation:

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The lack of multi-disciplinary educational activities for health care professionals that focus on the specialty of CVT critical care.


FACTS-Care addresses the challenges by creating multi-disciplinary programs to share technical expertise, educate professionals involved in CVT critical care, encourage research, and promote this emerging specialty field.

"A new specialty of cardiothoracic surgical [CTS] critical care has emerged as a reflection and a result of the unique physiologic changes and unique complications associated with cardiothoracic surgery, and the rapid evolution in the care of CTS patients. The specialty crosses the disciplines of medicine and surgery and involves a spectrum of health care professionals." Nevin M. Katz, MD (President, FACTS-Care, Journal of Thoracic & Cardiovascular Surgery, Nov. 2007)

"Traditionally, perfusionists have worked primarily in the operating room. With the increasing use of circulatory assist devices and ECMO in the ICU, perfusionists are now an integral part of the ICU team providing care to the cardiac surgical patient. It is key that all members of the multi-disciplinary team share a basic understanding of the management principles and technology used." David Palanzo, CCP (Executive Director, American Academy of Cardiovascular Perfusion)




The Annual Cardiovascular-Thoracic Critical Care Conferences

In 2004, leaders of FACTS-Care created an international CME conference, "Cardiothoracic Surgical Critical Care". Since that time the conference has been held annually. With the merging of the fields of cardiac surgery, interventional cardiology and interventional vascular radiology, the program agenda has become broader to include the care of patients undergoing endovascular and percutaneous procedures. Accordingly, the conference title has been revised to "Cardiovascular-Thoracic Critical Care."

The Guiding Principles of these Unique Conferences are:

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Direct Focus on the Specialty of CVT Critical Care

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Multi-Disciplinary: Directed to Surgeons, Interventionalists, Intensivists, Anesthesiologists, Critical Care Nurses, Nurse Practitioners, Physician Assistants, Perfusionists, Pharmacists, Respiratory Therapists

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Latest Information Presented by Experts & World Authorities

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Broad Agenda to include Care after Endovascular Procedures

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Emphasis on Team Synergy to Optimize Safety and the Patient Experience

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Discussions of the Professional Workplace Environment

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Active Dialogue through Audience-Panel Discussions and Workshops

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Exhibits of Latest Technology and Pharmacology


The annual conferences are being expanded to include the use of medical simulation to enhance the educational experience. The workshops are designed to meet the specific needs of the multi-disciplinary specialties.






Introduction

The history of cardiothoracic surgery has been characterized by a continual evolution in concepts, techniques, and the associated technology. Although not quite as dramatic, the concepts, pharmacology, and technology involved with the critical care of Cardiovascular Thoracic (CVT) surgical patients have also continued to evolve. The changes in CVT critical care are a reflection of developments in the surgery itself as well as in the general field of critical care.

It is clear from clinical practice that CVT care requires a detailed knowledge of multiple medical and surgical disciplines. Correspondingly, a team of health care professionals provides CVT critical care. The involved disciplines extend not only across the fields of medicine and surgery, such as cardiothoracic surgery, anesthesiology, cardiology, pulmonology, nephrology, gastrointestinal medicine, neurology, hematology, endocrinology, infectious disease medicine, but also extend across paramedical disciplines. These include nursing, extra-corporeal perfusion, interventional radiology, respiratory therapy, physical therapy, speech pathology, and nutrition. Practitioners include not only cardiothoracic surgeons, but critical care physicians, other sub-specialty physicians, nurses, physician assistants, nurse practitioners, perfusionists, respiratory therapists, nutritionists, and pharmacists.

A Specialty

Thus, in defining the breadth of the specialty, in order to provide for its growth and the education of the entire team, it is important to recognize that the specialty is indeed cross disciplinary. Optimal CVT critical care is dependent on members of this multi-disciplinary team sharing a broad understanding of the inherent complexities.

The challenges of the specialty are to increase clinical precision, therapeutic effectiveness, safety and patient comfort. In this era, the increased acuity of patients undergoing cardiothoracic surgery and the range and complexity of the procedures involved, place continuing demands on the expertise of the CVT critical care team.

Another challenge to the team caring for CVT patients is that cardiothoracic surgery has incorporated a continual evolution in technology. Minimally invasive surgical techniques include video assisted thoracic surgery (VATS), robotically assisted surgery, peripheral perfusion systems, off bypass surgery, and percutaneous interventional procedures. The use of these new techniques requires new understanding of postoperative care requirements, potential complications and changes in postoperative care protocols.

Creation of a Conference

Given the complexity of the field of CVT critical care and the multi-disciplinary nature of the CVT team, it is important that the members of the team have a broad understanding of the field including its latest advances. This approach of ensuring that members of the team are ?on the same page? provides the optimal environment for coordination and implementation of management procedures and protocols.

Accordingly, a conference, CTS Critical Care: A Cross-Disciplinary Specialty of Evolving Concepts and Therapeutics, was created to bring together members of those providing care for CVT patients in order to provide a forum for the sharing of ideas and expertise.

The conference, which took place April 14-16, 2004, was endorsed by the American College of Chest Physicians and the Society of Critical Care Medicine. Physician and nursing CME credits were provided.

Topics were chosen to highlight the challenges of the multiple disciplines involved. In that all body systems are affected by cardiothoracic surgery, the program was organized to include material related to each of the body systems. Because of time limitations for this first conference, emphasis was particularly placed on the cardiovascular, respiratory, renal, gastrointestinal, hematologic, metabolic, and microbiologic systems. It was recognized that important issues in CVT critical care involve multiple systems and hence such issues need to be addressed with a broad perspective.

Response from the over 250 participants from 31 states and 11 countries was remarkably positive and enthusiastic. Sessions were fully attended and continued beyond the times allotted despite excellent weather. Discussion at the symposium extended well beyond its time frame despite the earlier full day's activities. Clearly, the conference documented a real dedication and interest among the participants who represented multiple disciplines involved in CVT critical care. The basic concepts that CVT critical care was a specialty, and that it was cross disciplinary, resonated among the participants. There was considerable interest and speculation about how the specialty should develop in the future.

The Future

It became evident from the conferences that a dialogue among members of the involved disciplines was desired and would be productive in terms of the advancement of the specialty.

It was noted that the major meetings of thoracic surgical organizations and critical care organizations provide valuable presentations and activities relevant to CVT critical care, but the former are primarily focused on surgical aspects and the latter on more general issues in critical care. It is also of note that the surgical meetings are attended primarily by surgeons and the critical care meetings primarily by critical care physicians and nurses.

Consideration was given as to whether existing organizations in critical care or surgery could provide the forum for the educational activities and addressing the important issues which confront the CVT team. It was felt that an organization made up of members from the multi-disciplinary CVT team would provide a unique venue for these activities, and would be complementary rather than competitive with existing organizations.

The Foundation and the Society

In order to best facilitate the development of a new organization dedicated the advancement of patient care, the Foundation for the Advancement of Cardiothoracic Surgical Care (FACTS Care) was founded as a 501(c)(3) non-profit. Its mission is to create and implement solutions for the ongoing challenges of providing care for CVT patients.

As a primary means to accomplish the mission, FACTS Care will act as the parent organization for a new international CVT Critical Care Society that will promote dissemination of the latest concepts, pharmacology, and technology relevant to CVT critical care to the health care professional team involved and to provide a forum for dialogue and sharing of expertise in the care of CVT patients.

Again, it was felt that an organization made up of members from the multi-disciplinary CVT team would provide a unique venue for these activities, and would be complementary rather than competitive with the activities of the major associations and societies of surgery and medicine.



Nevin Katz, M.D. - Biography

Nevin M. Katz, M.D. was born in Dayton, Ohio, and obtained his MD from Case Western Reserve University. He completed a residency in General Surgery at the Massachusetts General Hospital, a chief residency in Cardiovascular Surgery at the Children's Hospital in Boston, and a fellowship and residency in Cardiothoracic Surgery at the University of Alabama.
Dr. Katz joined the full time faculty of Georgetown University in 1980, rose to Professor of Surgery, and initiated and directed the Heart Transplant Program. In 2001, Dr. Katz joined the faculty of George Washington University as Clinical Professor of Surgery and changed his focus to the new evolving specialty, cardiothoracic surgical critical care. In 2004, Dr. Katz created, and since then has directed, the annual CME conferences, "Cardiovascular-Thoracic (CVT) Critical Care." In August 2005, Dr. Katz founded the Foundation for the Advancement of CardioThoracic Surgical Care (FACTS-Care), which provides multi-disciplinary educational activities focused on the specialty of CVT Critical Care. He continues as FACTS-Care President and Executive Director.

In July 2010, Dr. Katz joined the full-time faculty of the Johns Hopkins University Division of Cardiac Surgery focusing on cardiovascular surgical critical care. Over the next 5 years, he assisted with development of the Cardiovascular Surgery ICU (CVSICU) and served as an intensivist in the CVSICU. He continues on the Johns Hopkins faculty and participates in critical care research. He has had a continuing interest in developing strategies to prevent and manage the acute kidney injury associated with cardiac surgery. He participated in the Acute Dialysis Quality Initiative (ADQI) VI of 2007, ADQI VII of 2008, and the International Vicenza Course on Critical Care Nephrology in 2010, 2013, 2015, and 2016.

His professional memberships include the American Association for Thoracic Surgery (AATS), the American College of Cardiology, and The Society of Thoracic Surgeons (STS). He was the Co-Director of the AATS and STS Annual Meeting CT Critical Care Symposia for 2010, 2014.

In 2008 Dr. Katz was appointed to the Editorial Board of The Journal of Thoracic and Cardiovascular Surgery, and in 2012, he became its Associate Editor for Perioperative Management.



Zack Beckman, CCP
Cardiovascular Perfusion
Inova Fairfax Hospital
Falls Church, VA

Joseph F. Dasta, MSc
Professor Emeritus,
The Ohio State University College of Pharmacy
Columbus, OH
Adjunct Professor
University of Texas College of Pharmacy
Round Rock, TX

Myra F. Ellis, RN, MSN, CCRN
Clinical Nurse IV
Duke Medical Pavilion 7 West (CTICU)
Duke University Hospital
Durham, NC

Daniel Engelman, MD
Medical Director
Heart, Vascular, and Critical Care Surgical Services
Baystate Medical Center
Springfield, MA

David C. Fitzgerald, CCP
Assistant Director and Instructor
Division of Cardiovascular Perfusion
Department of Health Professions
Medical University of South Carolina
Charleston, SC

Charles M. Geller, MD
Chief, Cardiothoracic Surgery
Crozer-Keystone Health System
Professor of Surgery
Temple University School of Medicine
Philadelphia, PA

Jonathan W. Haft, MD
Director, Extra-Corporeal Life Support
Associate Director Cardiovascular Intensive Care Units
Associate Professor of Surgery & Anesthesia
University of Michigan
Ann Arbor, MI

Nevin M. Katz, MD
President & Executive Director, FACTS-Care
Associate Professor of Surgery, Johns Hopkins University
Baltimore, MD
Clinical Professor Surgery, The George Washington University
Washington, DC

 


Nevin M. Katz, MD
President / Executive Director

Daniel Engelman, MD
Vice President

Mary J. Zellinger, CRNP
Secretary / Treasurer

Jerrold H. Levy, MD
Professor of Anesthesiology
Co-Director, Cardiothoracic ICU
Duke University Medical Center
Durham, NC

Robert E. Molyneaux, PA-C
Clinical Director Procedure Service
Physician Assistant Surgical Critical Care Services
MedStar Washington Hospital Center
Washington, DC

Charles E. Murphy, MD
Medical Director, CVICU
Chief Safety Officer, IHVI
Inova Heart & Vascular Institute
Falls Church, VA

Namrata Patil, MD, MPH
Director, Thoracic Intermediate Care Unit
Associate Surgeon
Brigham & Womens?s Hospital
Instructor in Surgery
Harvard Medical School
Boston, MA

Mary J. Zellinger, RN, MN, ANP, CCRN
Clinical Nurse Specialist
Cardiovascular & Critical Care Services
Emory University Hospital
Atlanta, GA

 
















































































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