Strengthening the leadership and nurses and allied professionals to support patients with valvular heart disease: Evidence to support the role of clinical valve coordinators

The central role of the Clinical Valve Coordinator (CVC) has been endorsed by international guidelines to provide unique expertise for programs that deliver comprehensive care to patients with valvular heart disease. Conventionally held by a nurse or allied professional, the CVC plays a pivotal role as a member of the Heart Team to promote a patient-centred approach, optimise patients’ journey of care and program efficiencies, and contribute to improved outcomes and experiences. Despite this guidance, the role of the CVC remains unevenly defined, implemented, and evaluated across regions, especially in Europe where the uptake is absent in multiple countries. We formed a clinical academic research collaborative to develop an evidence-based approach to accelerate the implementation of CVC roles across European programs. We report on the first two initiatives: (1) the development of a joint ACNAP/EAPCI clinical consensus statement, and (2) a pan-European descriptive study of the current state, facilitators and barriers of role implementation. In close collaboration with ACNAP and EAPCI, we engaged a multidisciplinary group of 20 nurses, allied professionals and cardiologists with representation from 10 countries who informed the development of consensus recommendations. These centred are (1) reporting evidence supporting the value add of the CVC for patients, the Heart Team and for hospitals, (2) outlining the unique responsibilities and competencies of the role, including clinical coordination, direct and indirect patient care, and programme leadership, aligned with the ESC/ACNAP Core Curriculum for Cardiovascular Nurses and Allied Professionals, and (3) requirements for infrastructure and organisational integration. We report on the preliminary findings of the environmental scan study; to date, 98 respondents (nursing and allied professionals: 68%; cardiologists: 32%, countries: N=9) have described (1) significant country-level variation in adherence to the consensus recommendations, (2) diverse patient, clinician and hospital-level variables that impact adoption or barriers to optimise the CVC role, and (3) absence of evaluation indicators and uneven impact across valvular heart disease patients’ journey of care. This initiative begins to address the pressing need for contemporary and local evidence to support the adoption of CVCs across valvular heart disease programs, and promote role clarity, unique competencies, and evaluation to meet the growing needs of patients, multidisciplinary teams and hospitals.