On an almost weekly basis, Mandeep R. Mehra, MD, medical director of BWH’s Heart and Vascular Center, can count on receiving a certain type of email in his inbox. It contains a photo shared by a smiling patient who is now enjoying life after receiving a ventricular assist device (VAD) at BWH to treat end-stage heart failure.
Celebrating the success of these patients, some of whom previously relied on support for mobility due to a weak heart, is just one example of the commitment to patient-centered care in BWH’s VAD Program. That culture, as well as excellence in safety and quality of care, earned the program a recertification of accreditation from The Joint Commission (TJC) last month – the 30th successful review since 2009.
“What I’m most proud of is the absolute diligence to patient-centered care by our team,” Mehra said.
During its most recent review, TJC surveyors referred to BWH’s VAD Program as “a poster child” in the field. Surveyors applauded the program’s comprehensive clinical and nonclinical services, supported by the highest-quality specialists for each role.
“It is obvious this is very much a vested team whose actions speak louder than words,” according to one TJC surveyor. “Your patients and families speak very highly of you all.”
While Amy Prince, 42, of Maine, was recently recovering from surgery after receiving a VAD implant, the seamless coordination among her providers and their compassionate care left a lasting impression on her and her parents, Don and Jeanne Prince. Seeing Amy’s nurses stay after their shift ended to ensure a safe handoff as the next nurse came on duty was one of many acts that made the family feel more at ease during a stressful time, Don said.
“The way they orchestrated each team was amazing to see,” Jeanne said. “There was a willingness of everyone to help no matter what the task was, and people just stepped up. I didn’t perceive it as them just doing their job.”
Amy agreed, recalling that her care providers made her feel empowered to ask questions or address concerns.
“That was huge. They were always happy, friendly and knowledgeable,” Amy said. “Everyone here genuinely cares.”
Multidisciplinary teamwork among the program’s clinical and nonclinical staff – the latter of which includes roles such as financial counselors and equipment managers – is vital to improving the lives of VAD patients, said Michael M. Givertz, MD, medical director of BWH’s Heart Transplant and Mechanical Circulatory Support Program.
“Patients with end-stage heart failure have different challenges, so their care is often highly individualized,” Givertz said. “That requires a team with the capability of providing a high level of care while also being able to focus on a patient’s specific needs – whether those are medical, surgical, psycho-social, nursing-related or nutritional.”
Taking a holistic approach to caring for VAD patients is essential, agreed Lara Coakley, FNP, an outpatient nurse practitioner. That means not only monitoring a patient’s recovery from surgery, but also providing education on self-care and checking in on their home life, sleeping habits and exercise routines.
“We look for ways we can make improvements in their total care – not just their cardiac care,” said Coakley, who sees patients at BWH’s Watkins Cardiovascular Clinic, as well as at Spaulding Rehabilitation Hospital and remotely via video conferencing.
Looking ahead, the program aims to reduce morbidity, shorten patients’ length of stay and serve more patients, Givertz said. Improved quality of life and functional capacity are also key to optimizing VAD care, he added.
“With our new surgical director, Dr. Steve Singh, there’s growing excitement about the outcomes we’ve been able to achieve and, given the size of this team, the bandwidth we have to offer this type of therapy to greater numbers of patients,” Givertz said. “In addition, the Brigham remains at the forefront of innovation in VAD technology, which will continue to drive the field forward.”