Transcatheter aortic valve replacement (TAVR)

A Structural Heart Disease Clinic Focused on the Patient Experience

Greta Robb, BSN, RN, CCRC, Structural Heart Disease Program Coordinator, OhioHealth Advanced Heart and Vascular Center, McConnell Heart Hospital, Riverside Methodist Hospital, Columbus, Ohio

Greta Robb, BSN, RN, CCRC, Structural Heart Disease Program Coordinator, OhioHealth Advanced Heart and Vascular Center, McConnell Heart Hospital, Riverside Methodist Hospital, Columbus, Ohio

Greta Robb, BSN, RN, CCRC, can be contacted at greta.robb@ohiohealth.com.

Helping patients navigate the complex world of structural heart disease is at the core of the OhioHealth Advanced Heart and Vascular Center at the Riverside Methodist Hospital in Columbus, Ohio. The center is designed to provide one location where patients with valve disease and other structural heart defects can obtain the complex evaluations and care they need, including transcatheter aortic valve replacement (TAVR). Our patients have multiple issues that previously required them to see different specialists on separate days, in addition to undergoing various procedures. Dealing with the disease process, various specialties, and treatment options is often overwhelming for patients and their families. 

At the OhioHealth Advanced Heart and Vascular Center, we bring all these clinicians and imaging capabilities together under one roof so that our physicians are able to work together to determine the best treatment option. This has resulted in providing more efficient care with a significant decrease in time and distance for patient navigation. For instance, patients once traveled up to a mile within the hospital on the same day to obtain all necessary consults and testing. Today, the center now makes patient care delivery faster and less complicated by offering comprehensive, multidisciplinary care, and access to leading-edge clinical trials through the OhioHealth Research and Innovation Institute — all in one location. 

Developing the OhioHealth Advanced Heart and Vascular Center

The OhioHealth Advanced Heart and Vascular Center started with a vision. In the rapidly evolving field of structural heart disease and transcatheter aortic valve replacement (TAVR), great emphasis has been placed on the “heart team” and the TAVR procedure. We focused on why we developed the heart team in the first place: to offer advanced treatment options to our patients.  “We want care to be seamless for the patient, so we’ve structured the OhioHealth heart and vascular program around them. Our physicians and staff work in a collaborative, coordinated manner to create smooth transitions for patients and achieve the highest possible outcomes,” said Teresa Caulin-Glaser, MD, System Vice President, OhioHealth Heart and Vascular Services. The Center opened in May 2012. The goal was “to create a first-class patient experience,” says Mark Ohl, BSN, RN Administrative Manager and project lead of the center’s development.

 According to Mark, “So often in healthcare, the emphasis is on speed of patient throughput. That wasn’t our goal, so we had to benchmark other industries known for high levels of customer satisfaction, like consumer-focused businesses, entertainment, and hospitality. As a result, our inspiration came from well-known companies like Verizon, The Walt Disney Company, and the Four Seasons Hotels and Resorts. We started with a blank canvas. We knew we wanted an optimal patient experience, but we didn’t know exactly what that would look like. So we put together a cross-functional steering committee and conducted a series of ‘imagineering’ meetings. Our task was to imagine and brainstorm what a world-class patient experience would look like.”

The center’s planning committee consisted of members from every aspect of the patient care experience, from administrative staff and volunteers, nursing, referring physicians and cardiologists, to lean Six Sigma black belts. The team analyzed every point of the care continuum, from registration to follow-up, to ensure they all aligned for optimal patient-centered care.

Ultimately, the center was designed to provide a “concierge” experience where patients could have all of their testing completed in one day, with minimal wait times. This was accomplished with a highly engaged and flexible team. We focused on streamlining communications, registration, scheduling, and testing, all of which have led to high patient satisfaction scores.  

The patient concierge is the first and last person who sees patients during their comprehensive visit to the center. We use a mobile laptop and TeleTracking system software that allows the concierge to go directly to patients to activate them in the system, which then helps to navigate their care throughout their visit. According to patient concierge Craig Cassell, his job is to create a meaningful patient experience. “I’m the one person they see multiple times throughout their day, and I want them to know they can rely on me. We want them to have a great experience because we will likely see these patients many times,” says Craig. 

Our TAVR patients are often surprised that the nurse, nurse practitioner, cardiologist, surgeon, and research staff works together to educate them and help make decisions about their care. The center’s opening was well timed, coinciding with the rapid growth of the Structural Heart Clinic, the hub of our TAVR program. “Ordinarily, we would see patients in terms of a complex tertiary review. But the new process is perfect because we can review and think about every aspect of cases in advance of our patient consultation,” says cardiothoracic surgeon Dr. Dan Watson. 

As with anything complex, the basic structure evolves over time. The process of care is continually reviewed to ensure the patient comes first. “We believe OhioHealth has a great approach for getting these patients referred, comprehensively assessed, and treated quickly. As our Structural Heart Disease Program continues to grow, so does our belief that our patients deserve the best possible care. Our intent is to become a TAVR destination clinic, and we hope to make this happen by providing expert multidisciplinary care centered around the patient experience,” says interventional cardiologist Dr. Steve Yakubov.  

OhioHealth

Background

OhioHealth is a family of not-for-profit, faith-based hospitals and healthcare organizations. We have been serving patients in Central Ohio since 1891. Today we operate with 15,000 associates, 2,300 physicians and 5,500 volunteers. As we grow, so does our belief that people come first—that all patients, regardless of who they are and which of our hospitals or healthcare services they choose, deserve the best care available. We make this happen by providing expert, individualized care and by sharing the latest knowledge and innovations across the entire OhioHealth system.

OhioHealth Riverside Methodist Hospital:

  • Located in Columbus, Ohio
  • 12 member hospitals
  • Truven Health 100 Top Hospitals® list in the “Teaching Hospitals” category for the 11th time.
  •  9,000 cardiac and endovascular procedures annually
  • >800 cardiothoracic surgeries per year
  • 1 Hybrid OR
  • 1 Hybrid Cath Lab in construction
  • Advanced Heart & Vascular Center is home to 8 integrated clinics seeing 45-60 patients per day.
  • Specialty clinics include: Structural Heart Disease, Advanced Heart Failure/DVAD, Critical Limb and Wound Care, Hyperbarics, Vein, Hypertension, EECP and Cardiac Genetics.

Structural Heart Disease Program Leadership

Steven J. Yakubov, MD, FACC, FSCAI, Interventional Cardiology

System Chief, Structural Heart Disease, Medical Director, OhioHealth Research & Innovation Institute

John H. McConnell Endowed Chair for Advanced Structural Heart Disease

Daniel R. Watson, MD, Cardiothoracic Surgery, Medical Director, Endovascular Medicine

Greta Robb, BSN, RN, CCRC, Structural Heart Disease Program Coordinator