Evolving Metrics: Dr Richard Neville Explains How Quality Assessment in CLTI Care Is Being Re-Engineered
INOVA Schar Heart and Vascular in Falls Church, Virginia
Kicking off the first session of AMP on optimizing treatment of chronic limb-threatening ischemia (CLTI) on Wednesday morning, Richard Neville, MD, FACS, DFSVS, Associate Director at INOVA Schar Heart and Vascular in Falls Church, Virginia, outlined how CLTI programs are redefining “quality.” Drawing on his own data, Dr Neville said that the era of anecdotal morbidity and mortality reviews has given way to continuous, data-driven evaluation aligned with value-based care.
Dr Neville began by reminding the audience that preventable medical errors remain a pervasive problem in U.S. healthcare. Traditional grand rounds reviews often devolve into fault-finding rather than systemic improvement. His solution is a multidisciplinary, multi-institutional Vascular Operations Committee that integrates education programs, data analytics, quality analysis, peer review, credentialing, clinical guidelines, inventory management, and patient satisfaction. These elements, he said, transform “quality” from a retrospective judgment to a proactive management tool.
The committee meets at least monthly and supports a schedule of focused case conferences and journal clubs. The group’s carotid endarterectomy service set volume thresholds—10 or more cases per institution annually and 20 or more cases per surgeon over 24 months—before a provider’s results undergo formal VQI analysis and peer review. After implementing a standardized protocol, case volume rose by 26% without compromising outcomes.
Quality improvement also produced tangible savings: optimizing peripheral device inventory trimmed approximately $200,000 from annual costs. Dr Neville emphasized that financial stewardship is inseparable from clinical excellence and noted that system-wide patient-satisfaction metrics have already begun to reflect the new culture of accountability.
“Quality in CLTI is changing,” Dr Neville concluded, adding that success now demands a team dedicated to quality patient care and an unwavering commitment to data transparency.
