Peter Kane, MD, and John Rommel MD, from Novant Health New Hanover Regional Medical Center in Wilmington, NC, discuss heart team collaboration and the impact and economic benefits of implementing a cardiogenic shock protocol in their smaller nonacademic system. Dr. Rommel, who is the director of heart failure, explains that the impetus for implementing protocols and the heart team approach was recognizing that “we were providing great individualized care, but we were providing very bad systems of care.” After implementation, Dr. Rommel reports that it has been “refreshing” to follow patients throughout the course of their care. Erin Romano, MHA, CPC, CPB, from Abiomed, discusses steps to take for program sustainability and Dr. Kane, a cardiothoracic surgeon, reinforces the importance of documentation for reimbursement, emphasizing “potential miscodes cost millions of dollars.” Dr. Kane acknowledges that there is often resistance from administration when setting up a collaborative heart team program, but explains, “If you do some homework, you can break down that resistance and have a successful program.”