A multidisciplinary team of physicians, nurses, pharmacists, and other providers with UHealth – University of Miami Health System was recently recognized for meeting the bronze level of an American Heart Association (AHA) challenge to assure optimal care for patients with heart failure.
Get With The Guidelines – Heart Failure awards range from the bronze award for a 90-day demonstration of tight guideline adherence to the silver for 12 months and gold for 24 months.
“We are well on our way to silver and don’t plan to stop there,” said advanced heart failure specialist Luanda Grazette, M.D., M.P.H., FACC, director of advanced heart failure, heart failure recovery, and therapeutic innovation at UHealth and medical director for heart failure quality at the University of Miami Miller School of Medicine.
Dr. Grazette joined the Miller School in November 2020 to lead the Division of Cardiovascular Medicine’s advanced heart failure program. She had previously led a quality team that achieved Get With The Guidelines Gold Plus status for the Keck Hospital of USC, contributing to the rise of its cardiovascular services from the 60s to No. 11 in U.S. News & World Report’s national rankings.
“This accomplishment is a great testament to the group’s transformational teamwork and coordination, and to Dr. Grazette’s leadership in putting UHealth on the map for heart failure recognition,” said Jeff Goldberger, M.D., M.B.A., chief of the Division of Cardiovascular Medicine and professor of medicine at the Miller School.
Better Treatments and Medicines
Heart failure, a condition characterized by compromised heart function, develops from a variety of etiologies. Over the past few decades, the treatment prospects for affected individuals have improved tremendously, enabling the vast majority of patients to lead active lives.
“The majority of heart failure patients do extremely well with new medicines like angiotensin receptor-neprilysin inhibitors (ARNIs)/Entresto and SGLT2 antagonists, or with implantable defibrillators or resynchronization devices,” Dr. Grazette said. “With this abundance of therapies and medical devices, the challenges to ensuring that patients get the appropriate care are mostly logistical.”
Recognizing this, in 2005, the AHA laid out goals that focus on achieving significant patient outcome improvements. Get With The Guidelines – Heart Failure is one of several AHA challenges that target heart disease and stroke.
“This is a voluntary, hospital-based quality improvement initiative, and the goal is to make sure that every patient who is admitted with heart failure leaves with the therapies that they should have, based on their symptoms and presentation and what is supported in the evidence to be beneficial and effective,” Dr. Grazette said.
Robust Quality Team
The initiative tasks the hospital system with putting into place systems of care with educational components and protocols for clinicians, pharmacists, and other staff to make sure that this happens.
Criteria include, “How many of those who need appropriate medication actually have it at discharge? How many have scheduled appointments at discharge? How many are referred for cardiac rehab, if appropriate, at discharge?” Dr. Grazette said.
Dr. Grazette says even though she came to the division at the height of COVID-19, the quality team she found in place was “very, very robust.”
“From the hospital administrator’s support to the multidisciplinary team and clinical staff, I have amazing partners working with me on this,” she said. “I don't think they could have been more enthusiastic about doing what is needed to take the best care of our patients.”