Destination therapy for advanced heart failure offers new hope
Scripps Memorial Hospital La Jolla has earned The Joint Commission’s Gold Seal of Approval as a hospital performing ventricular assist device (VAD) as a destination therapy. Destination therapy is permanent support for end stage heart failure by means of an implantable artificial heart pump.
Approval means the VAD program demonstrated compliance with The Joint Commission’s national standards for health care quality and safety in disease-specific care. The certification recognizes Scripps La Jolla’s dedication to continuous compliance with The Joint Commission’s state-of-the-art standards.
“This approval by The Joint Commission means that we can continue to implant mechanical hearts in patients with advanced heart failure. These pumps literally can mean the difference of life and death for the failing heart,” said James Heywood, MD, VAD medical director, Scripps Health.
Scripps La Jolla underwent a rigorous on-site survey by a team of The Joint Commission surveyors who evaluated the hospital’s VAD Program for compliance with standards of care specific to the needs of patients and families, including a review of policies, procedures, staff credentials, quality and outcome data, as well as conversations with patients and staff. The Joint Commission certification process aims to ensure safe, high quality care and services by identifying opportunities for improvement and implementing those improvements.
“This accreditation is the result of a true team effort by our physicians and staff,” said Gary G. Fybel, chief executive, Scripps La Jolla. "This demonstrates to our patients that they are in a quality program and that Scripps La Jolla provides the highest level of care for patients with advanced heart failure.”
What is a VAD?
Like the heart, the VAD is a pump that is placed inside a person’s chest, where it helps the heart pump oxygen-rich blood throughout the body. One end is inserted into the left ventricle – the chamber of the heart that pumps blood out of the lungs and into the body – and the other end is attached to the aorta, the body’s main artery. An electrical connection passes from the device through the skin to the control unit and batteries.
The pump and its connections are implanted during open-heart surgery. A computer controller, a power pack, and a reserve power pack are worn by the patient.
A VAD restores normal blood flow to a person whose heart has been weakened by heart disease.
First Scripps procedure done in June
Frank Andrews, 65, was the first recipient of a VAD at Scripps La Jolla on June 15. Diagnosed with congestive heart disease one year ago, the San Marcos resident was having difficulty with the most basic components of daily living, such as breathing and walking across a room. He had considered placing his name on the heart transplant list, however, his doctors informed him that it would take up to a year to get a heart and that he most likely did not have a year to live.
“I knew I was going downhill and I knew I needed to do something to fix it,” Andrews said.
What complicated the situation further for Andrews was that he and his wife were in the process of adopting their 6-year-old grandson when he made the decision to undergo the VAD procedure.
“The main thing that saved me is my grandson. I have to be here for him. I need to be here for at least another 10 years,” said Andrews.
Since the surgery, Andrews can always be found wearing a five-button black vest that houses the battery pack and the cords for the VAD – similar to what former Vice President Dick Cheney used to wear prior to his heart transplant surgery. Andrews admits that the adjustment to the VAD has been a challenge, but he is happy to be on the road to recovery and is looking forward to throwing a ball again with his grandson.
“I know this is going to work out for me. I’m one of the lucky ones,” he said.
This accreditation represents another milestone of Scripps’ leadership in heart care and research. Construction is currently under way on the $456 million Prebys Cardiovascular Institute, a center for innovation that will bring together top researchers, physicians and staff. The institute will incorporate leading-edge wireless technologies and individualized medicine for the best in patient care when it opens in 2015. Annually, more than 55,000 patients receive their cardiovascular care from Scripps, making it San Diego County’s largest heart care provider. Scripps is the region’s only cardiovascular program consistently recognized by U.S. News & World Report as one of the best in the country.
About the Joint Commission
The Joint Commission’s Disease-Specific Care Certification Program, launched in 2002, is designed to evaluate clinical programs across the continuum of care. Certification requirements address three core areas: compliance with consensus-based national standards; effective use of evidence-based clinical practice guidelines to manage and optimize care; and an organized approach to performance measurement and improvement activities. Founded in 1951, The Joint Commission seeks to continuously improve health care for the public, in collaboration with other stakeholders, by evaluating health care organizations and inspiring them to excel in providing safe and effective care of the highest quality and value. The Joint Commission evaluates and accredits more than 18,000 health care organizations and programs in the United States. The Joint Commission also provides certification of more than 1,700 disease-specific care programs, primary stroke centers, and health care staffing services. An independent, not-for-profit organization, The Joint Commission is the nation’s oldest and largest standards-setting and accrediting body in health care. Learn more about The Joint Commission at www.jointcommission.org or the certification.
About Scripps Health
Learn more about Scripps Health, a nonprofit integrated health system in San Diego, Calif.
Image reprinted with the permission of Thoratec Corporation.