VCSQI-VHAC Shock Survey 2024

Question Title

1. Contact Info (Required.)

Name *

Organization *

Email Address *

Phone Number

Question Title

2. Does your organization have a shock management protocol? (Required.)

Yes

Question Title

3. ) Does your institution have a dedicated shock team? (Required.)

Yes

Question Title

4. Is your shock team available on a 24-7 basis? (Required.)

Yes

We don’t have a Shock Team

Question Title

5. Does your institution have a call line for cardiogenic shock management? (Required.)

Yes

We don’t have a Shock Team

Question Title

6. Does your institution have a 24-7 capable cardiac cath lab with primary PCI capability? (Required.)

Yes

Question Title

7. Does your institution provide destination advanced heart failure services? (Required.)

Yes – Bridge to Transplant (BTT) or Destination Therapy (DT) LVAD only

Yes – LVAD and transplant

Question Title

8. Please choose the category which would best describe your institution’s shock classification in a regionalized shock network: (Required.)

Level 1 Shock center: LVAD/transplant, High Risk PCI, ECMO and Impella capabilities.

Level 2 Shock Center –24/7 cardiac cath lab with primary PCI and IABP capability. May be able to implant Impella and ECMO on site but would transfer to Level 1 center for LVAD and/or transplant evaluation if destination therapies needed.

Level 3 Shock Center – Non-PCI capable with primary referrals to Level 1 and Level 2 centers.

Question Title

9. Which of the following best describes your practice with regards to utilizing pulmonary arterial catheters to diagnose cardiogenic shock? (Required.)

Almost always (>80% of cases)

Most Times (60-80% of cases)

Sometimes (40-60% of cases)

Rarely (20-40% of cases)

Almost Never (<20% of cases).

Question Title

10. Which of the following best describes your practice with utilizing pulmonary arterial catheters to manage cardiogenic shock patients with mechanical circulatory support? (Required.)

Almost always (>80% of cases)

Most Time (60-80% of cases)

Sometimes (40-60% of cases)

Rarely (20-40% of cases)

Almost never (<20% of cases).

Question Title

11. Does your institution use any risk scores or staging systems in the stratification of patients with cardiogenic shock? (Required.)

Yes

VCSQI-VHAC Shock Survey 2024

Question Title

* 1. Contact Info (Required.)

Question Title

* 2. Does your organization have a shock management protocol? (Required.)

Question Title

* 3. ) Does your institution have a dedicated shock team? (Required.)

Question Title

* 4. Is your shock team available on a 24-7 basis? (Required.)

Question Title

* 5. Does your institution have a call line for cardiogenic shock management? (Required.)

Question Title

* 6. Does your institution have a 24-7 capable cardiac cath lab with primary PCI capability? (Required.)

Question Title

* 7. Does your institution provide destination advanced heart failure services? (Required.)

Question Title

* 8. Please choose the category which would best describe your institution’s shock classification in a regionalized shock network: (Required.)

Question Title

* 9. Which of the following best describes your practice with regards to utilizing pulmonary arterial catheters to diagnose cardiogenic shock? (Required.)

Question Title

* 10. Which of the following best describes your practice with utilizing pulmonary arterial catheters to manage cardiogenic shock patients with mechanical circulatory support? (Required.)

Question Title

* 11. Does your institution use any risk scores or staging systems in the stratification of patients with cardiogenic shock? (Required.)

1. Contact Info (Required.)

2. Does your organization have a shock management protocol? (Required.)

3. ) Does your institution have a dedicated shock team? (Required.)

4. Is your shock team available on a 24-7 basis? (Required.)

5. Does your institution have a call line for cardiogenic shock management? (Required.)

6. Does your institution have a 24-7 capable cardiac cath lab with primary PCI capability? (Required.)

7. Does your institution provide destination advanced heart failure services? (Required.)

8. Please choose the category which would best describe your institution’s shock classification in a regionalized shock network: (Required.)

9. Which of the following best describes your practice with regards to utilizing pulmonary arterial catheters to diagnose cardiogenic shock? (Required.)

10. Which of the following best describes your practice with utilizing pulmonary arterial catheters to manage cardiogenic shock patients with mechanical circulatory support? (Required.)

11. Does your institution use any risk scores or staging systems in the stratification of patients with cardiogenic shock? (Required.)