After making a $2.5 million investment in Cleveland-based University Hospitals Harrington Heart & Vascular Institute at the UH Portage Medical Center, which included establishing a catheterization lab and implementing preventive screening programs in 2016, the surrounding region saw a significant decrease in cardiovascular disease-associated mortality.
The crude death rate for ischemic heart disease in the Portage County region between 2016 and 2019 decreased by 36% among individuals ages 65-74, 28% among individuals 85 and older, and 21% among individuals ages 75-84.
Interventional cardiologist Anjan Gupta, MD, directs cardiac catheterization services at the University Hospitals Portage Medical Center. He spoke to Becker’s about the care strategies that contributed to these outcomes, and what achievement the system is aiming for next.
Editor’s note: Responses have been lightly edited for clarity and length.
Question: What do you believe were the most critical factors behind this improvement in patient outcomes?
Dr. Anjan Gupta: The most critical factor was having 24/7 availability for the cardiac cath lab out, with the presence of interventional cardiology, because that’s what was lacking before. Local patients used to get transferred to Akron or Cleveland, which are both about 45 minutes to an hour away.
The other important piece was teamwork. It was a collective effort of all the nurses, the technicians, the hospital administrators, everybody together being dedicated to improving the heart health of the community — that’s what I think led to our success story.
Q: How did your team strategically balance resources and personnel to ensure both interventional procedures and prevention efforts received adequate focus and support?
AG: In the cath lab itself, we had a team of very enthusiastic people. We have a team of nurses and techs who we actually trained to cover both the cath lab and the interventional radiology lab, which helped us optimize our resources.
We also increased our critical care beds, as well as hired more nurses to cover critical care and step-down units, because we knew that once we opened the 24/7 catheterization lab, we’d be facing more patients. That helped us face the increased number of patients that we started seeing.
When Harrington Heart and Vascular Institute, University Hospital recruited me to start this program, I realized there was a lack of understanding around cardiovascular disease in the community.
I began to organize a multiprong effort. I started doing educational events for the firemen and the EMS teams, educating and empowering them with the knowledge of what cardiovascular disease is, what things to look for, and what they could educate patients about. They did a great job with that.
Additionally, if they brought a patient to the cath lab, we would invite them to stay and see what’s going on, educate them on what we do and how the timeliness of the intervention helps save lives.
The second thing we started doing were patient education events. We met with the community on Saturday mornings, giving talks about heart attacks, heart failure, and prevention. Then, at the same venue, we offered free cholesterol and blood pressure screening. I would also visit industrial factories and talk to the workers about cardiovascular risk factors. We also have a retired cath lab nurse who volunteers and attends local community events to help educate the community.
We also enroll our heart patients in cardiac rehab, where the nurses not only help patients exercise, they talk about nutrition and knowing the signs and symptoms of heart attack.
Lastly, we started the Food For Life program, which allows patients who need assistance to get free healthy groceries from the hospital.
All of these initiatives together, intervening at the right time to provide treatment, and also educating the community on how to prevent heart disease, helped us achieve those good results.
Q: What are the next steps for University Hospitals Harrington Heart & Vascular Institute in building on this success and continuing to improve cardiovascular health outcomes in underserved regions?
AG: A new initiative that we are starting is focused on peripheral vascular disease. Peripheral vascular disease goes hand in hand with coronary artery disease. We are trying to do more aggressive outreach for peripheral arterial disease prevention and treatment.
