A Journey through System Level Accreditation - 2025 Quality Summit Presentation (Non-CE)-A Journey through System Level Accreditation

Video Transcription

Video Summary

This presentation featured three large healthcare systems—Memorial Hermann Health System, Common Spirit Health, and Indiana University Health—sharing their journeys toward system-level accreditation with the American College of Cardiology (ACC). Memorial Hermann detailed their phased approach, starting with their academic medical center, leveraging chest pain MI registries, and emphasizing collaboration among chest pain coordinators across 11 hospitals. They focused on improving cardiac rehab referrals, optimizing order sets, and enhancing real-time data tracking, aiming for system-wide accreditation by 2026.<br /><br />Common Spirit Health described pursuing multifacility accreditation across 21 hospitals in the Mountain Region. They emphasized financial incentives, centralizing agreements, shared quality improvement projects, and leveraging a designated program coordinator model, enabling sites to support each other and standardize processes. Despite initial challenges with legal approvals and budgeting, they successfully activated most sites in early 2025 and fostered teamwork to ease the workload.<br /><br />Indiana University Health shared their well-established accreditation history, involving multiple accreditations and process improvements such as reducing post-PCI bleeds and kidney injury. Emphasizing culture and system-level quality governance, they leverage registry data and clinical effectiveness councils to drive evidence-based care. They are still evolving system-wide integration but prioritize quality and safety over cost.<br /><br />Overall, the panel highlighted the importance of communication, utilizing registry data, collaborative leadership, shared resources, and overcoming challenges like budget approval and IT delays to successfully pursue ACC accreditation at the system level.

Keywords

intravascular imaging

percutaneous coronary intervention

PCI

IVUS

OCT

cardiovascular care

coronary CT angiography

CTFFR

interventional cardiology

American College of Cardiology accreditation

Memorial Hermann Health System

Common Spirit Health

Indiana University Health

system-level healthcare accreditation

cardiac care quality improvement

multi-hospital collaboration