Director Discusses Detailed Orchestration of Ramp Up for MitraClip Procedure
by TIM CRAIG
When Winter Haven Hospital begins its innovative MitraClip procedure later this year, it will come at the end of a months-long communitywide campaign guided by the office of Hollie Hill, the Structural Heart and Valve Program Director.
“There are so many different moving parts when you’re ramping up a new procedure like this, it’s not as simple as you think,” Hill says.
The procedure helps reverse a condition called mitral regurgitation, which is leakage of the mitral valve each time the ventricle contracts. Since the valve doesn’t close tightly, the blood flows backward into the ventricle, causing, among other things, shortness of breath, a rapid heartbeat and, if severe enough, congestion. Previous treatments were either through medication, which did nothing to fix the root cause regurgitation, or invasive heart surgery. The new procedure is minimally invasive and patients, on average, are able to go home within two days.
The procedure could be a benefit to 10 to 15 percent of the 65 and over population within the hospital’s three-county coverage area, according to Hill. However, in order to reach those potential patients, there have been a lot of steps and months of work behind the scenes to get things ready, Hill explains.
“The first thing we did was get our physician team to go out for specific training,” Hill says. “The physicians also had some opportunity to go over to Morton Plant Hospital in Clearwater and observe some cases over there. We were also able to go to the Fort Myers facility and observe.”
James Fuentes was one of the people who got to attend some of the sessions at Morton Plant. Fuentes, the charge nurse for the open heart surgical unit at Winter Haven Hospital, was excited for the opportunity.
“I have always been interested in the heart and was excited to learn more about the procedure,” says Fuentes. “Being able to be there at Morton Plant to see the procedure as well as the device with some hands-on experience helped out a lot.
“At the end of the day, it’s challenging but it’s something new,” says Fuentes. “These procedures are changing everything and as it continues to grow, it will be better for the patient.”
As the charge nurse, new procedures like this emphasize his role as coordinator for the surgical team.
“It takes a lot of teamwork between the physicians and the operating room team,” he says. “There’s a lot of meetings, first between the cardiologist and the surgeon, then there are lab tests, physical strength and stability tests, all that needs to be done before the surgery date.”
While Fuentes and the surgical doctors did their training, Program Director Hill worked to get other interested groups involved in the procedural rollout.
“We had an education symposium with the nursing staff,” Hill says. “The group sat through a one-hour circuit to learn more about the device.”
The group rotated through three stations, says Hill. The first station provided general information about the device, while a second station took the staff through the different nursing considerations when it came to the device and the patients. The third station focused on the procedure itself and the nurses were able to touch and see the device.
In early June, Abbott Laboratories, which makes the device, hosted a luncheon with the hospital staff and spent 30-45 minutes giving basic information and handing out brochures.
“The procedure is really exciting and has the possibility of helping a lot of people in our area,” Hill says. “So we try to provide people who are interested with information and teach them about the procedure.”
Hosting these different physician, nursing, and staff events to educate about the device also helps everyone speak with the same language when talking about the procedure with the public. It also helps people in the areas like inventory and billing see how the new procedure will impact what they do as well.
“The basic hurdle is to make sure the team members are trained properly, and bringing the right people together,” Hill says. “It is very difficult to get five physicians together at the same time because they all operate on different busy schedules. The same goes for the ICU nurses.”
For people who are unable to meet with the group, Hill and her staff find the time to get them the training and information they need. It is difficult and can be frustrating, she says, but it’s all worth it.
While much of the initial focus is aimed at groups within the hospital, Hill and her team also focused their attention on two key audiences outside of the facility.
“The first group is the referring physicians,” Hill says. “The second group is the people who live in the community and may be potentially eligible for the procedure.”
Doctors David Dodd and Andrew Murray meet with local physicians face-to-face or virtually to talk about the relative advantages of the procedure and what types of patients would be eligible. In a month or two, says Hill, the hospital will host a community symposium and invite people who could be eligible for the procedure to come and find out more about it.
With all the parts moving at different speeds and different times, it can be difficult for one group to connect the dots. But that’s where Hill’s expertise comes in.
“There is a lot involved in this campaign, but at the end of the day, it’s worth it because it’s what is best for the patients,” Hill says. “Procedures like this improve the quality of life of our community, and that’s what we are here for.