Data can help providers assess and adjust to tackle cardiac care

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Heart disease is the No. 1 cause of death for men and women in both the U.S. as well as the Garden State. And according to the Centers for Disease Control and Prevention, cardiovascular diseases account for $216 billion in health care system costs. More than 877,500 Americans die of heart disease, stroke, or other cardiovascular diseases every year, according to the CDC, which adds up to $147 billion in lost job productivity from premature death. Harnessing data can help to turn that tide by allowing health care providers to keep track of their progress and make advances in how care is delivered.

In New Jersey, hospitals performing cardiac surgery are required to report data to the Department of Health on each patient that receives open heart surgery. Findings from that data collection are published in annual cardiac surgery reports. Utilizing the report is one way hospitals can work to improve the quality of care they deliver and outcomes for patients. According to the most recent assessment, covering 2019-2020 and published in August 2022, there has been a decline in the statewide risk-adjusted mortality rate for bypass surgery, which dropped by 43.3% to 2.45% in 2020.

NJDOH also collects data on open heart surgeries, diagnostic procedures, and elective and primary percutaneous coronary interventions – or PCI, a non-surgical technique for treating coronary artery disease – that are distributed quarterly. It’s that information that serves as the basis for the NJBIZ Cardiac Care Centers list (see page 20 in this week’s issue).

On this year’s ranking the top four hospitals from 2022 held onto their spots in the 2023 list, though each recorded a decline in the number of services provided over the prior year (see chart below).

Rounding out the top 5 in 2023, AtlantiCare Regional Medical Center Mainland Campus in Pomona jumped from its previous seventh-place spot with 161 more procedures recorded during the latest 12-month period. Last year’s No. 5, Virtua Our Lady of Lourdes Hospital in Camden, slipped to eighth in 2023, with 835 less procedures.

While most other rankings among the top 25 listed companies either held or shifted minimally, Capital Health Medical Center – Hopewell jumped 12 spots to secure the No. 21 rank on the 2023 list, and Inspira Medical Center Mullica Hill rose five to place at No. 24. Among significant drops, St. Francis Medical Center – now under Capital Health’s purview – fell seven spots to No. 23 in 2023, performing nearly 1,000 less total cardiac services with the most differentiation in diagnostics and elective PCI (631 and 341 less, respectively, according to the most-recent data).

Getting with the guidelines

To help providers improve upon patient outcomes in cardiovascular and stroke care, the American Heart Association offers its in-hospital Get With The Guidelines assessment. Beyond the effects that the program brings to the individual patient experience, AHA says the initiative offers other incentives, including the capability to increase the equitable delivery of care to patients and improve staff morale; opportunities for certification; accurate reimbursement; and a competitive edge and return on investment, through reduced readmission rates and lengths of stay.

According to AHA, GWTG hospitals show decreases in 30-day readmission rates compared to those that have not taken part in the program. The No. 1-listed NJBIZ Cardiac Care Center, Morristown Medical Center, for instance has received 10-Year Recognition from AHA for its at least decade-long participation and achievement of Gold Plus for Get With The Guidelines-Stroke and/or Get With The Guidelines-Heart Failure, in addition to Target: Stroke Honor Roll Elite Plus and Target: Type 2 Diabetes Honor Roll.

According to AHA, more than 2,600 hospitals in the U.S. participate in at least one of its Get With The Guidelines program—offering access to nearly 80% of the population. Through the initiative, participating facilities receive evidence-based frameworks and measurement tools to improve the care they offer in: Stroke, Heart Failure, Resuscitation, Atrial Fibrillation (AFIB) and Coronary Artery Disease in addition to health care certifications. Program participants qualify for Get With The Guidelines Awards by demonstrating their commitment to quality care.

Earlier this month, a number of New Jersey providers celebrated their Get With The Guidelines distinctions.

Eight Hackensack Meridian Health hospitals received Get With The Guidelines recognition in Heart Failure.

The ailment, the provider explained, means the heart is having a hard time pumping blood and oxygen throughout the body. There isn’t a cure for heart failure, but patients can keep up a quality life by working with health care professionals to maintain a plan that works for them, which may include medication, symptom monitoring or lifestyle changes.

Beyond the Get With The Guidelines designation, AHA recognizes the goal of treating patients with 85% or higher compliance to core standards of care over increasing lengths of time: Two consecutive calendar years results in a Gold Plus designation, while the Target: Heart Failure Honor Roll requires meeting specific criteria that improves medication adherence, provides early follow-up care and coordination, and enhances patient education; hospitals receiving Target: Type 2 Diabetes Honor Roll demonstrate that patients with Type 2 diabetes – who might be at higher risk for complications – receive the most up-to-date, evidence-based care when hospitalized due to heart disease.

HMH’s Get With The Guidelines – Heart Failure designees are:

Ocean University Medical Center in Brick, JFK University Medical Center in Edison, Riverview Medical Center in Red Bank and Palisades Medical Center in North Bergen, which each received Gold Plus Awards with Target: Heart Failure Honor Roll and Target: Type 2 Diabetes Honor Roll; Bayshore Medical Center in Holmdel, Gold Plus Award with Target: Heart Failure Honor Roll; Jersey Shore University Medical Center in Neptune and Southern Ocean Medical Center in Manahawkin, each earning Gold Plus Awards; and Hackensack University Medical Center in Hackensack, which received Silver Award with Target: Type 2 Diabetes Honor Roll.

According to HMH, approximately 6 million U.S. adults live with heart failure—and that figure is expected to surpass 8 million by 2030.

“Hackensack Meridian Health is committed to improving patient care by adhering to the latest treatment guidelines,” said Elizabeth Maiorana, vice president, Cardiovascular Care Transformation Services, HMH. “Get With The Guidelines makes it easier for our teams to put proven knowledge and guidelines to work on a daily basis, which studies show can help patients recover better. The end goal is to ensure more people in New Jersey experience longer, healthier lives.”

In Newark, University Hospital was also recognized with the Get With The Guidelines – Heart Failure Gold Plus award.

“It’s a distinct honor to be recognized once again by the American Heart Association for our work in maximizing survival and recovery after cardiovascular events,” said Ed Jimenez, president and CEO of University Hospital. “This esteemed recognition validates the incredible work of the physician faculty of Rutgers New Jersey Medical School and the staff at University Hospital who collaborate daily to provide outstanding cardiovascular care.”

In addition to being the only New Jersey-certified Level 1 Trauma Center in North Jersey, University Hospital is the principal affiliate of the Rutgers New Jersey Medical School.

The hospital said it was also recognized on the American Heart Association’s Target: Heart Failure Honor Roll and the Mission: Lifeline EMS Gold with Target: Heart Attack Honor Roll.

According to UH, the goal of the Target: Heart Failure Honor Roll is to further reduce hospital readmissions and help patients improve their quality of life in managing the chronic condition. The Mission: Lifeline EMS celebrates medical services programs that offer rapid and research-based care to people experiencing the most severe form of heart attack and stroke. The program helps to reduce barriers to timely treatment and facilitates coordination between the individual prehospital providers and health care systems.

UH also received the Target: Type 2 Diabetes Honor Roll award.

“Newark residents deserve a premium level of care, and the state of New Jersey demands it from our hospital,“ Jimenez said. “I am proud to observe our talented faculty and staff deliver it each and every day.”

RWJBarnabas Health’s Jersey City Medical Center, Robert Wood Johnson University Hospital Somerset and Robert Wood Johnson University Hospital were awarded the Get With The Guidelines-Stroke Gold Award; Cooperman Barnabas Medical Center was awarded the Get With The Guidelines-Stroke Silver Plus Award; and Clara Maass Medical Center was awarded the Get With The Guidelines-Stroke Silver Award, the system announced.

According to RWJBarnabas, stroke – considered a cardiovascular disease – is the fifth-leading cause of death and a leading cause of disability in the U.S. It occurs when a blood vessel to the brain is either blocked by a clot or bursts. As a result, part of the brain cannot get the blood and oxygen it needs, causing cells there to die. Early detection and treatment are imperative to improving survival, minimizing disability and accelerating recovery times.

“These recognitions from the American Heart Association are a testament to the hard work and dedication of our stroke care teams across RWJBarnabas Health,” Dr. Suhayl Dhib-Jalbut, chair of neurology at Rutgers Medical School and co-leader of the RWJBarnabas Health neuroscience services. “The framework developed to achieve the Get With The Guidelines-Stroke awards allows us to track and measure quality, exceed evidenced-based clinical guidelines, and provide superior outcomes to stroke patients across New Jersey.”

Englewood Health also announced it was getting with the guidelines this summer, earning a Get With The Guidelines – Stroke Gold Plus; Get With The Guidelines – Resuscitation Silver quality achievement award, recognizing the provider’s commitment to treating in-hospital cardiac arrest patients with best practices; the AHA’s Target: StrokeSM Elite award, meeting specific criteria that reduce the time between an eligible patient’s arrival at the hospital and treatment with clot-busting medications; and the Target: Type 2 Diabetes Honor Roll award.

“At Englewood Health, we know that adhering to the most current, evidence-based guidelines improve patient care and help save the lives of patients who experience cardiac arrest and stroke,” said Dr. Erik Chu, chief of emergency medicine at Englewood Health.

Added Tina Bloemer, vice president for quality at Englewood Health, “The American Heart Association’s Get With The Guidelines program makes it easier for our teams to engage in continuous quality improvement measures, with the end goal of ensuring those in our community live longer, healthier lives.”

Jefferson Health – New Jersey’s hospitals in Cherry Hill, Stratford and Washington Township each received the American Heart Association’s Get With The Guidelines – Stroke Gold Plus achievement in addition to the Target Stroke Honor Roll award and the Target: Type 2 Honor Roll award.

“Jefferson Health is committed to improving patient care by adhering to the latest treatment guidelines,” said Helene Burns, senior vice president & regional chief nursing officer for Jefferson Health – New Jersey. “Get With The Guidelines makes it easier for our teams to put proven knowledge and guidelines to work on a daily basis, which studies show can help patients recover better. The end goal is to ensure more people in South Jersey can experience longer, healthier lives.”

The Get With The Guidelines program includes a registry tool that collects data from participating hospitals. According to AHA, more than 13 million patient records have been entered since the program started, allowing providers and researchers access to explore trends and more.

Get With The Guidelines affords participating hospitals the opportunity to use guideline-directed treatments, industry-standard goals, and peer benchmarks to compare their performance and measure the impact of their efforts. To improve quality, participating hospitals and health systems also work with a program consultant to implement changes, interpret data and identify areas for improvement, according to AHA.