perfusion education in europe - icebp · croatia, france, germany, greece, switzerland basic...

DHZBag/ xy/2006 ICEBP Montreal 2007

Perfusion Education in Europe

Frank Merkle, Heinz Weitkemper

European Board of Cardiovascular Perfusion


Challenges in Perfusionists‘ Daily Work

• Specialisation of hospitals and departments

• Diversification of perfusionist related tasks

• Increasing demand for interdisciplinary work

• Intraclinical entrepreneurship

• Changing clinical demands (patient related)

• Building up professional recognition and ethos


Challenges in Perfusion Increasing demand for clinical competent perfusionists

Europe 2002: 1 Open Heart Procedure in 1449 inhabitants (Total est. 521.752.000)

Bruckenberger 2004

Germany 2003: 1 Open Heart Procedure in 871 inhabitants GSTCVS 2004

U.S.A 2003: 1 Open Heart Procedure in 824 inhabitants (Total est. 290.850.005)

US Dept Health 2006


Trends in Germany

0 10000 20000 30000 40000 50000 60000 70000 80000 90000

100000

1978 1985 1995 1999 2001 2003 2005

Open Heart Operations with CPB

Kalmár et al, Gummert et al 20002006


Category with ECC without ECC Total

Valve 19.203 0 19.203

Coronary 62.023 5.313 67.336

Congenital 4.054 1.580 5.634

Miscellaneous 6.687 48.651 55.338

Total 91.967 55.544 147.511

Data from Germany 2005

Gummert et al 2006


European Perfusion Community 2001

number of perfusionists 1806

number of students approx. 140

number of heart centres 429

number of CPB per year approx. 320.000


Course Structures in Europe Onthejob training

Croatia, France, Germany, Greece, Switzerland

Basic University degree course

Italy, Germany

Postgraduate course (academic and nonacademic level)

Austria, Belgium, Denmark, Finland (M.D.), France, Germany, Great Britain, Ireland, Malta, Netherlands, Norway, Poland, Portugal, Spain, Sweden, Switzerland

Merkle Perfusion 2006


European Perfusion Education 20 countries

• academic in 10 countries (planned in B)

• nonacademic in 9 countries

• both academic and nonacademic in 1 country (D)

large variations • entry requirements

• educational systems

• cultural heritage

• language


Course Entry Requirements

cardiac anesthesiologist

engineer (bio, electronical, biomedical etc.)

physician

B.Sc.

B.Sc.N.

nurse

nurse with specialization in intensive care / anesthesiology

laboratory assistant

radiology technologists/assistants

medical technician

other qualifications

Academic NonAcademic


no certificate

Certificate

Diploma

Baccalaureate degree (B.Sc.)

Master degree (M.Sc.)

Perfusion Education Graduates


Problematic Perfusion Education in Europe

• Inhomogeneity in structure of education systems

• Wide variability of academic levels

• Absence of licensing / titling in many countries

• Cultural differences (language)

Necessity of professional body overseeing

competency of clinical perfusionists


European Perfusion Education

♦ 1991 the European Board of Cardiovascular Perfusion was founded

♦ Delegates are dispatched from the European Perfusion Societies

♦ Supported by European Association for CardioThoracic Surgery (EACTS) European Society for Cardiovascular Surgery (ESCS) European Association for Cardiothoracic Anaesthesiologists (EACTA)

♦ Accreditation of Perfusion Education Programmes AfK accredited since 1996



• Establish, monitor and maintain equality of standards in education and training

• Set out Essentials and Guidelines for training programmes

• Develop an advanced level of education and training programme to train the trainers in perfusion

• Establish a common perfusionists certification programme in Europe

• Issue a European Certificate of competence in Perfusion

• Liaise with the European commission

Main Goals


• Certification Registry

• CE Product Complaint Process

• EBCP Checklist

• Perfusion Education and Training Conference

• Support of National Professional Societies

Other Activities



EBCP Structure

Chairman General Secretary

Treasurer

Secretary Chair Accreditation Sub Committee

Chair Recertification Committee EACTS Representative EACTA Representative

Accreditation Sub Committee

Recertification Sub Committee

EBCP National Delegates

EBCP Trustees Academic Committee


EBCP Member Countries


Profession officially recognized

Austria

Denmark

Italy

Malta

Netherlands

Norway

Poland

United Kingdom


Benchmarking

is the search for solutions, based on the best methods

and procedures in the industry the 'Best Practices'

that lead companies to their top performance.

(Camp 1994)

http://www.benchmarking.fhg.de


• Regularly comparing aspects of performance with best practitioners

• Identifying gaps in performance

• Seeking fresh approaches to bring about improvements in performance

• Following through with implementing improvements

• Following up by monitoring progress and reviewing the benefits

http://www.benchmarking.gov.uk

Benchmarking


Institute of Medicine Health Care Quality

„... the degree to which health services...increase

the likelihood of desired health outcomes and are

consistent with current professional knowledge“

Pairolero, Ann Thorac Surg 2005;80:38795


Institute of Medicine Health Care Quality

Medical societies should:

• make improvements in quality and safety by

setting own performance standards

• incorporate standards into educational programs

Pairolero, Ann Thorac Surg 2005;80:38795


Benchmarking in Medicine

• Education and Training

• Certification and ReCertification

• Evidence Based Medicine

• Evaluation of Procedures

• Establishing Guidelines / Best Practice Methods


Benchmarking in Medicine

American Board of Thoracic Surgery (ABTS) –

Maintenance of Certification Process:

„Program documenting participation in a valid process

of assessment and improvement in quality of

care...against evidence based standards“

Gay, Ann Thorac Surg 2005;80:12


Professional Standing

Ø current license to practice

Lifelong Learning and SelfAssessment

Ø continuous medical education (CME)

Cognitive Expertise

Ø written examination at regular intervals

Evaluation of Performance in Practice

Ø references, peer evaluation, outcome data

Maintencance of Certification

Gay, Ann Thorac Surg 2005;80:12


European level: European Organizations

National level: National Societies

Unit level: Hospitals and departments

Insurance companies and Government

Graves, Perfusion 2005; 20:209215

Recommendations for Increased Safety in Perfusion


Daily Student Activity Log and Assessment


Procedure Scoring Sheet


Laboratory Simulation


Continuing Perfusion

Education Log


• Set minimum standards for training programmes

• Accreditation of training programmes

• Certification and recertification of perfusionists

• Support monitoring of product deficiencies

• Facilitation of communication between professional groups

• Encourage international collaboration



European level


• Monitor events

• Develop voluntary reporting systems

• Report incidents

• Evaluate methods

• Establish protocols and guidelines

• Start with recertification and continuing education



Unit level


Conclusion

• Need for raising safety standards in Europe will increase

• European Guidelines for Perfusion need to be established

• Research on Best Practices in Perfusion is mandatory

• Increased efforts for upgrading Perfusion Education are necessary

• Recertification of European Perfusionists should be encouraged

• National Perfusion Societies need to be supported


Future Requirements

♦ Efforts for recognition of the profession need to be supported

♦ Harmonization of curricula in Europe

♦ Multilateral recognition of certificates/diplomas

♦ Exchange of students between countries

♦ Ongoing education and training of certified perfusionists

♦ New clinical tasks for perfusionists

♦ New fields of application for CPB and perfusion technique

perfusion education in europe - icebp · croatia, france, germany, greece, switzerland basic...

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