ECMO | Extracorporeal Membrane Oxygenation

ELSO Centers that wish to set themselves apart by being recognized as a program that has documented the use of the ELSO guidelines in creating their program, but do not yet have 5 years of experience with ECMO patients, average of 5 or more patients/year, or 3 years of membership in ELSO, should apply for the “Path to Excellence “ Award. This Silver Level ELSO Award is recognition for ECLS Programs that are based on established ELSO Guidelines. These programs are on the Path to Excellence but have not yet demonstrated the extraordinary achievement in all categories as required for the Center of Excellence Designation. These programs desire recognition for their adherence to the ELSO Guidelines in providing ECLS patient care and are working towards the requirements for designation as a Center of Excellence. An ECLS program must meet or exceed criteria in the following categories:

• Systems Focus

• Environmental Focus

• Workforce Focus

• Knowledge Management

The Center of Excellence in Life Support Award will be designated amongst the applications that are established and have the experience or volume. A minimum score must be achieved on the Excellence in Life Support application to be designated as a Center of Excellence. The minimum score is determined by statistical evaluation of all application scores, using a standardized Award Scoring Tool. Historically, some centers achieve significantly higher scores than others even within those designated as Centers of Excellence.

Centers who achieve the minimum passing score but less than the highest level will be recognized with the Gold Level Award for Excellence in Life Support. Those centers that achieve the highest scores will be recognized with the Platinum Level Award for Excellence in Life Support. These ECLS programs must meet or exceed criteria in the following categories:

• Systems Focus

• Environmental Focus

• Workforce Focus

• Knowledge Management

• Quality Focus

• Process Optimization

• Family Focus

ECMO Programs may apply for the Path to Excellence Award (Silver) if they are a member of ELSO and have established that they are on the Path to Excellence. Using the Center Evaluation and Improvement Tool will help in this endeavor.

ECMO Programs may apply for the Center of Excellence Award (Gold or Platinum) designation once they have been a member of ELSO for 3 years and have been providing ECMO therapy for 5 years. The ECMO program must have supported an average of 5 or more patients per year over the last 5 years. All ECMO patients from the applying institution MUST be entered into the ELSO Registry.

The application consists of 38 questions, some with multiple sub questions, organized into 7 categories. The application process is impartial, and the application is blinded to assure anonymity. The application must be completely de-identified – No staff names, no hospital names, states or countries, or individual program names should be used. “X” may be used in place of any identifier. Refer to the Application Instructions for specific directions regarding completion of the application.

Five specific supportive documents must be attached with the completed application:

• Overall course outline or plan for Basic ECMO Course

• Initial water drill checklist or simulation scenario

• Recent continuing education simulation scenario

• Orientation competency check-off documentation for ECMO Specialist

• Recent example of annual competency evaluation tool

All documents must be in PDF form to upload. The redaction tool in Adobe Acrobat may be used for PDFs that are in need of de-identification.

Additional documents may be included for some questions. All documents, figures, tables, charts, graphs, and photos that relate to that question must be in a single PDF file and attached to that question as an upload. Please reference the attachment within the answer (i.e., fig. 1). Figures, etc. may not be embedded within the answer field.

Videos are optional and will NOT impact your score and CANNOT be used in lieu of answers to questions. If you have a video, please include a link in your PDF.

Not all questions have an upload icon available. Not every question requires an attachment.

ECMO programs can evaluate their readiness for the award process by downloading the ELSO Award Path to Readiness Tool or the ELSO Award Center Evaluation Improvement Tool. These tools will help you decide if your program is meeting ELSO criteria and is ready to apply - or how to improve your existing program

The Application Award cycle begins October 15th and closes March 1st at 23:59 EST.

The Award Evaluation and Improvement Tool and the Application Worksheet are available October 15th for the current Award cycle. Online Application form for submission is available January 1st.

Applications submitted outside of these time periods will not be considered.

A center may apply at any time during the 3 year award designation period. A Path to Excellence Center may meet criteria for the Center of Excellence Award and decide to apply before their Path designation expires.

Center of Excellence (Gold or Platinum)

• $3,500 fee USD

• Valid for a 3 year Award Period

Or

Center on the Path to Excellence (Silver)

• $2,000 fee USD

• Valid for a 3 year Award Period

The fee may be paid by check or credit card. Please refer to the Payment Section for details

Application fees must be received in full by the Application submission deadline, March 1st, for the Application to be accepted. Individual accommodations may be made by contacting ELSO

The Center of Excellence in Life Support and the Center on the Path to Excellence designations covers a 3 year period which begins January 1^st and ends December 31^st.

The center contact will Validate and Submit the application and will receive a notice that is was accepted. It is submitted electronically and received by ELSO. After the application is verified, it is assigned to a panel of expert reviewers trained in the award criteria. Anonymity and confidentiality of the application is maintained throughout the application and review process. ECMO program contacts listed in the application will be notified of their application results by July 15 ^th

Your center must meet a wide variety of criteria in order to receive the ELSO Award for Excellence in Life Support. The panel of reviewers scores each application. If an application scores insufficiently, the application is denied. The Center will be notified by the Committee. Applications that do not meet criteria will not be allowed to revise and resubmit within the same Award cycle. The decisions of the Committee are final.

The Committee scoring process is such that any application that does not achieve minimum score is automatically reviewed by additional reviewers and the decisions are final. Please see ELSO COE Policy and Procedures.

Centers do not apply for Platinum designation; they apply for the Award of Excellence in Life Support. Centers that achieve the highest scores will be recognized with the Platinum Level designation.

• Having a comprehensive quality program

• Maintain and continuously improve upon existing processes

• Complete the application thoroughly and describe processes and policies in detail

• Review and learn from previous application scores, and determine areas of weakness by comparing your scores in categories with other centers

• Use the ELSO Award Center Evaluation and Improvement Tool

Each Application is blinded by ELSO administration. The Committee does not know center identity at the time of review. Each center has the responsibility to ensure that their application is de-identified. The Center of Excellence Committee is multi-disciplinary and has years of extracorporeal life support experience. Every reviewer completes a training session to learn to review applications. Interrater reliability is measured yearly, to ensure standardized evaluation of every application. A standardized scoring rubric is used for each application question and total points are compiled. A minimum score is required to receive the Center of Excellence in Life Support Award.

A reference guide has been created to help centers.

The application is a lengthy one. The application process may take several months and highest performing centers begin planning several years in advance. It is recommended that centers involve members of their institution Quality department and leadership teams in the application process.

The Scoring Tool is proprietary information and publication could bias center answers.

You must meet the application criteria as listed for the Award of Excellence. Once you meet these criteria you may apply during any Award application period.

You must be a member of ELSO and current on your dues for three years. Dues may be paid in arrears. Center of Excellence designation will be automatically forfeited if ELSO dues are delinquent during the designated Award period.

If your Centers’ average patient numbers for five years equal 5 or more, you are still eligible to apply.

Late applications may be considered on a case by case basis. A significant late fee will be imposed

The Application process includes a verification of patients submitted into the ELSO Registry and compares those numbers to the Application. Discrepancies must be reconciled. Please assure that your patient submissions are up to date when you submit.

Yes, as long as the Center has staff that is fulfilling the job duties associated with the Coordinator, describe that person. It may be the Medical Director or other team member completing these duties.

All centers consent for a site visit by submitting the Award Application. Any center refusing the site visit will be ineligible for Center of Excellence designation.

A percentage of applying Centers will receive a site visit for the purpose of validating the application. Reviewers will not evaluate outcomes or any patient specific data. Scores are subject to revision upon findings from the site visit.

Site visits will be conducted by teams of 2 COE committee members. Site visits will be conducted between April 1^st and June 30^th based on dates selected on the Application. Centers selected will be notified approximately two weeks prior to the visit with specific instructions

Most challenges related to these issues are due in part to the individual Center’s data security or firewall. Please contact your Centers IT department for support.

You will not be able to download your current application until after the application cycle has been closed and you have been notified of your Award status. Previous applications will be available. Please refer to the Award website under ‘Application’.

Please contact the ELSO Office Support@elso,org for assistance.