Institute Criteria

Criteria for Institutional Recognition by ESOI

For any institute or hospitals to be accredited for the fellowship course should fulfil following minimum criteria.

• Institute must be a member of ESOI for at least 3 years.
• The Centre must have minimum 5 years of experience in conducting practising ECMO.
• The centre must be submitting all data registry forms for every patient supported with ECLS to ESOI for last 3 years.
• Minimum of 50 bedded Hospital/ Institute for Single speciality and 100 bedded hospital for Multispecialty.
• In one academic year, they should be having at least 20 cases of ECMO.
• Institutions should have one full time faculty, who are eligible, to be considered as teachers, as per ESOI guidelines for teachers.

Institute should provide facilities consistent with the all-round training including training in basic medical sciences, critical care, cardiac surgery, perfusion science and ECMO.

Infrastructure

• The Institute should have at least 10 bedded ICU for each super specialty of which 5 beds are for high dependency cases.
• The department shall have adequate number of all equipments including the latest one necessary for training as may be prescribed by the MCI.
• Dedicated Operating room fully equipped with Basic infrastructure and Instruments required for the cardiac surgery & the round the clock availability of surgical team.
• Catheterization Lab with facility to do cardiac & peripheral intervention.
• The institute shall have adequate laboratory facilities and shall provide all the investigative facilities required and regularly updated, keeping in view the advancement of knowledge and technology and research requirements for training of students.
• Radiology department has portable X ray, Ultra sound (including head & Doppler), CT Scan Facility.
• Blood Bank or blood storage unit (with adequate blood & blood products like platelets concentrates, Fresh frozen plasma & cryoprecipitate of different groups).
• At least 2 cubicle beds for ECMO inside the ICU. Each bed space is around 300 sq feet. It has 2 central oxygen line, 2 central compressor & 2 suction lines with multiple electrical points (~ 15 – 20) & bed side facility for haemodialysis.
• On the same floor ECMO stock & record room which should not be less than 200 sq feet.

Training facility

• A separate CME room with simulation which is around 400 Sq feet.
• Various simulators for skill development.
• Live relay OT facility.
• Auditorium with facility for Audio visual.
• The Institute should have excellent central library, departmental library, computer with internet facility and journals (National as well as International). The library services available to fellows should include electronic retrieval of information from medical databases.
• Conferences, including medical-surgical reviews, analyses of complications and deaths, seminars, and clinical and basic science instruction, must be regularly scheduled.

ECMO Department & Team

Each Institute aspiring for fellowship program should have a dedicated ECMO department & ECMO team.

ECMO Patron or Advisor

They should be either

• Head of the institute or should be head of department from the Institute.
• National or international faculty of ECMO.

Their role is to help in training the team, guidance in difficult cases, the counselling of the relatives & overall development of program in institute.

ECMO Director

He/ she should preferably intensivist or cardiologist or cardiovascular surgeon who is qualified to supervise and to educate fellows and must meet requirements stipulated by ESOI. The director must be recognized nationally or regionally by his or her peers as a leader in the area of the program’s focus.

• Qualifications of the program director – Program director must
  • Be certified by the Medical Council of India.
  • Be licensed to practice medicine in the state in which the sponsoring institution is located.
  • Be a member in good standing of at least one of the constituent societies.
  • Minimum 15 Years experience of Specific/specialized branch.
  • Demonstrated experience and/or expertise in teaching residents, fellows, or post graduates on a regional, national or international level.
• Responsibilities of the program director.

It is the responsibility of the program director to support the fellowship program by devoting his or her efforts to its management and administration. The director is also expected to be an active and recognized participant in the institution’s clinical and educational programs. Program director must be responsible for the fellowship program. They are responsible for –

• The entire ECMO set up in their centre.
• Selection of ECMO team, planning & execution of the general protocol for ECMO.
  • Planning & monitoring of the individual ECMO cases.
  • Maintain a cooperative working relationship with all other recognized ECMO training programs.
  • Organization and supervision of the research activities of fellows.
  • Implementation of fair procedures, as established by the sponsoring institution, regarding academic discipline complaints and grievances.
  • Selection of fellows for the program in accordance with institutional policies.
  • Selection and supervision of the teaching staff and other program personnel at each institution participating in the program.

ECMO Coordinator

There can be –

• An experienced neonatal, paediatric, or adult intensive care registered nurse or
• Registered respiratory therapist with a strong ICU background (minimum of 1 year of ICU experience), or
• A certified clinical perfusionist with ECMO experience
• Person from administrative department

Their role is to look after –

• The data registry of the various cases.
• The ECMO stocks & purchases.
• Organising training of technical staff either inside the hospital or in other ECMO training centres.
• Organize regular meeting of the ECMO team members & if require interdepartmental meeting.
• Organization and supervision of fellows’ participation in conferences and other educational activities, and oversight of implementation of the fellowship curriculum.
• Notification in writing to Accreditation Committees of MUHS if there is change in the faculty complement for the fellowship.

ECMO Specialist

The qualification required is

• Perfusionist, respiratory therapist, registered nurse or even doctor from any faculty & should have following skills.
  • Technically adept
  • Able to work in stressful situations
  • Good communicator
  • Sound critical thinking skills
  • Team player
  • Flexible
  • Committed – 24 X 7, 365 days/ year
  • Patience
• They should have strong ICU or ICCU background at least 2 years of experience in critical care or should have at least 2 years of experience of perfusion technology

They are responsible for –

• Priming & circuit maintenance.
• The stock & machine maintenance.
• Solely responsible for Individual patient care & coordinating with different consultant & departments for their patient

ECMO Nurse

They are registered staff nurse, respiratory therapist with good ICU & ICCU experience.

Their primary role is

• To look after the general nursing care of the patient
• Maintaining the data of individual patient
• Monitoring circuit parameters & informing to ECMO specialist & ECMO fellows
• They should also get trained in priming & circuit maintenance
• They should assist the doctor for cannulation & decannulation

ECMO Physician

They should be either Intensivist (adult, Paediatric or neonatal), cardiologist, cardiac anaesthetist or cardiac surgeon. They should have at least 5 years of critical care experience. Their role is –

• They are available for all cases of ECMO round the clock to manage any complications either patient related or machine related.
• They take 6 hourly rounds & have thorough knowledge of ECMO & circuit.
• They are the overall in charge of the patient & are responsible for all decision making.
• They take the opinion from other branch colleague as & when required.
• Oversight of accurate tabulation and recording of operative logs by surgical fellows in the Fellowship case log system

Admission Norms

The number of students to be admitted shall be depend on the number of Annual ECMO run & number of teacher in the institute.

• Two student per year per recognised post graduate teacher in a department having a minimum of 3 faculty members (one professor, one associate professor / reader, and one assistant professor / lecturer).
• One student from regular course & 3 students from alternative route for Institute having annual 10 ECMO runs. The centres which has got ECMO runs of more than 20 for 2 consecutive years is eligible for 2 regular students provided they have two eligible teachers.
• Number of students may be increased proportionately but not more than two in a unit per year in any circumstances.

Application for Accreditation of Hospital / Institute

• Application for hospital recognition & teacher recognition are to be filled online and the required fee has to be paid online, through the ESOI website www.ecmosocietyofindia.com.
• The institute and teachers applications will be scrutinised by the academic wing of ESOI and the Program Assessment Authority.
• These Two teacher candidates have to apply along with the institute for recognition as ESOI fellowship teacher.
• The institute applying for the accreditation must give an undertaking in addition to having one eligible teachers that:
  • In case a teacher leaves the institute they will continue to provide training to the trainee
  • All facilities in the institute will be provided to the trainee during his period of training in the institute.
• Institutions should apply for accreditation along with teacher’s accreditation. Both the Teacher & Institute Form will be scrutinized simultaneously for accreditation purpose.
• If found eligible, Program Assessment Authority will appoint 2 inspectors who will make an on-site inspection visit of the institute.
• The travel & stay of the inspectors shall be looked after by the Institute desirous of recognition.
• The inspection report will be tabled at the next ESOI academic committee Board meeting and the decision of academic committee board will be ratified by EC.
• Once recognition is granted, institutes may start taking candidates from the same academic year if the process is completed before the last date of registration to the courses, or the next academic session if the process is completed later.
• In case institutes do not meet the criteria, they will have to reapply after fulfilling all criteria, which will be followed by a re-inspection.
• All appeals regarding the inspection report or recognition will be put up at the academic committee Board and ESOI executive committee.
• The decision of the Academic committee of ESOI will be final and binding in all respects.
• Institutions that do not enrol candidates for three consecutive years will automatically lose accreditation and will need to apply for re-inspection afresh, through the formal process.

How to apply

• The institution will apply on a preformed Performa available on ESOI web site to the ESOI secretariat (annexure II).
• Each application has to be accompanied with inspection fees decided from time to time by EC of the society.

Duration of Completion of Process of Accreditation

The whole process preferably should be completed within a quarter (3 months) from the date of receipt of the application.

Institute Accreditation Fees

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