MedStar physicians continually look for ways to provide better access to care across the entire region.
“We take our role as stewards in promoting population health very seriously,” says George Ruiz, MD, chief of Cardiology at MedStar Union Memorial Hospital and MedStar Good Samaritan Hospital.
Recently the cardiac team began leveraging system-wide expertise to benefit advanced heart failure (AHF) patients. These patients might receive screening and diagnosis of AHF in one of the northern (Baltimore area) hospitals, such as MedStar Union Memorial or MedStar Franklin Square Medical Center. Then a team comprised of cardiac experts from various hospitals evaluates and determines treatment—and within a day, patients can be transferred to MedStar Washington Hospital Center for consideration of ventricular assist device (VAD) therapy, among other options.
“We are focusing on having the most advanced therapies and the best resources readily available to all our patients, regardless of their geographic location,” says Dr. Ruiz.
Cardiologist Sandeep Jani, MD, associate director of Advanced Heart Failure and Population Health for the Baltimore region, agrees. “Our system encompasses a broad region and population, and each hospital provides specialized options,” he says. “Patients are seamlessly provided access to a wide variety of services.”
Jane Lashley, CRNP, helps coordinate patient care and services between the northern and southern hospitals as the new program develops. “The entire team—physicians, nurse practitioners, VAD and transplant coordinators, palliative care specialists, social workers among many others—all have the attitude that we will figure out, as a team, the details to make this work and do what is right for each patient,” she says. “Our patients are telling us that, from being virtually bedridden, they are now able to walk without losing their breath and can’t wait to go home. We all believe we are transforming these people’s lives.” Dr. Ruiz adds that the team’s involvement spans the range of patient needs. “In addition to technologies and advanced therapies, we also work together to deliver the palliative care options. System-wide, our approach is aggressive but thoughtful. Our entire AHF team is integrated and tightly connected—which allows us to build these bridges across regions to deliver the care that fits with each patient’s individual goals. If the treatment exists, we will find a way to deliver it.”
Indicators of Advanced Heart Failure
(I NEED HELP)
- I Needs inotropes
- N NTProBNP, NYHA III/IV
- E End organ dysfunction
- E EF < 20%
- D Defibrillator shocks
- H More than 1 hospital in last 12 months
- E Persistant Edema/ Escalating diuretics
- L Low BP < 100mmHg
- P Prognostic meds— inablity to uptitrate ACE/Arbs, etc.