The Heart Institute at Cincinnati Children’s Hospital Medical Center has been named the first accredited Pediatric Heart Failure Institute in the United States.
The Healthcare Accreditation Colloquium’s designation recognized the Cincinnati Children’s Heart Institute for seeking “pre-eminence in heart care.”
“The work being done at Cincinnati Children’s will set the tone for a new collaborative paradigm melding the worlds of pediatric and adult heart failure and will profoundly affect the way we view and treat heart failure in the not too distant future,” says Frank Smart, MD, chairperson of the Colloquium. “We are delighted that Cincinnati Children’s is our first accredited pediatric heart failure institute and will soon invite other forward thinking organizations to join in this groundbreaking effort.”
The Heart Institute was founded in 2008 to transform pediatric cardiovascular medicine with clinical programs driven by scientific discovery. The infrastructure now in place includes the innovative Advance Cardiomyopathy/Heart Failure Service, which includes a large inpatient and outpatient program. The Advanced Cardiomyopathy/Heart Failure Clinic is one of the largest in the nation, with a highly specialized, multidisciplinary team serving more than 600 patients with cardiomyopathies (heart muscle disease) a year.
What sets the clinic apart from others is its combination of cardiovascular genetics and cardiovascular genetic counseling, working in tandem to diagnose and treat cardiomyopathy and complex forms of heart muscle disease. Families of children are counseled regarding the underlying genetic basis of their disease and associated inheritance patterns. Patients also receive diagnostic genetic screening. The team includes five pediatric cardiologists, two clinical cardiovascular geneticists, three cardiovascular genetic counselors, an electrophysiologist and a diagnostics laboratory that analyzes underlying genetic causes of disease and viruses in the heart to detect and treat myocarditis (heart inflammation).
“Cincinnati Children’s is one of the few places in the world that offers state-of-the-art viral PCR (polymerase chain reaction) analysis and genetic testing for cardiac disease, combined with expert clinical insight and patient management,” says John Lynn Jefferies, MD, director of the Cardiomyopathy/Heart Failure Service. “The diagnostic lab is also a key part of our ‘soup-to-nuts’ approach to pediatric cardiovascular disease management. The integration leads to rapid new advances in therapies and care protocols.”
“Because of this marriage,” adds Jeffrey Robbins, PhD, co-director of the Heart Institute, we now have the ability to know the exact gene – the exact mutation – that’s causing disease, and we have the doctors who can stratify the risk and, at some point in the future, cure it.”
More than 800,000 Americans are diagnosed with heart failure each year. It is the number one reason for hospital admissions for individuals over the age of 65. Studies have shown that the largest heart failure burden comes from children born with congenital malformations. It has been estimated that 15 to 25 percent of children who have structural heart disease develop heart failure. Although cardiomyopathy is relatively rare, approximately 40 percent of patients who experience cardiomyopathy develop heart failure of such severity that it leads to transplantation or death.
The Healthcare Accreditation Colloquium’s rigorous accreditation process is modeled after process improvement methods and includes a study of current practices, a gap analysis (a technique to get to a desired future state), in-depth interviews, clinical process mapping, an onsite review and a comprehensive milestone report with specific action steps.
• an integration of care from early diagnosis to advanced care
• streamlined processes across the entire continuum of care
• enabling caregivers to provide greater care at home and less hospitalization
• collaboration with other Colloquium member hospitals across the country.
“When we started the process of establishing the Heart Institute, the leadership at Cincinnati Children’s asked us to shake the trees, shoot for the moon – which turned out to be a watch-what-you-wish-for scenario, because we do,” says Jeffrey Towbin, MD, chief of cardiology and co-director of the Heart Institute, along with with Dr. Robbins. “The Colloquium likewise approaches accreditation as an opportunity for improvement. Shooting for the moon can be uncomfortable, but we have to challenge the paradigms, no matter what they are.”