How an Ottawa cardiologist is transforming care for patients with incurable heart disease

December 2020

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In less than a year, amid the backdrop of a global pandemic, one Ottawa doctor creates a first-of-its-kind program for heart patients.

Dr. Caroline McGuinty is one of the newer faces around the University of Ottawa Heart Institute (UOHI). Thanks to an unrelenting coronavirus pandemic, the early-career cardiologist has yet to meet some of her colleagues in person. Despite these challenges, however, McGuinty is making strides. In the months since COVID came to town, she has worked tirelessly to identify and fill a significant gap in the care delivery for patients with serious and incurable heart conditions. What happens to patients with end-stage heart disease after all treatment options are exhausted? McGuinty has long pondered the question. And now, she has developed and launched an original program that speaks to heart of the matter.

Patients with end-stage heart disease have the same need for palliative care as do cancer patients, and we’ve created a one-of-a-kind program to deliver these services in a timely way.

- Dr. Caroline McGuinty

“We know palliative care is important for patients living with incurable illnesses. Often these patients don’t receive palliative care until late in their disease course, if at all,” explains Dr. Caroline McGuinty, medical director of the Cardiac Supportive and Palliative Care Program at the UOHI. The program is a specialized outpatient clinic for patients with advanced cardiac disease and their caregivers and family. “The goal is to bridge the gap so we can introduce palliative care to patients earlier in their disease course and provide this care within a cardiology practice. A program like this one hasn’t existed in eastern Ontario until now.”

Dr. Caroline McGuinty, University of Ottawa Heart Institute.

Get to know Dr. Caroline McGuinty: A transcript of this blog’s conversation with Dr. Caroline McGuinty is featured in The Beat Interviews, a new column we’ve started to introduce readers to the brilliant minds, steady hands, and compassionate hearts who work at the UOHI.

McGuinty is the clinic’s main consultant. She sees every patient referred to the program in her capacity as a cardiologist with expertise in palliative care. Dr. McGuinty completed her studies at the University of Ottawa and the University of Toronto where she completed fellowships in both heart failure and heart transplant, and advanced training in palliative care.

Palliative care is a subspecialty of medicine that improves the quality of life for patients facing life-threatening illnesses. Dr. McGuinty says it’s a more holistic and patient-centred approach to treat both the physical and psychosocial aspects of the disease and support the people who love and care for the patients who have one. Through the Local Health Integration Network, the clinic collaborates with community palliative care services across eastern Ontario. As patients progress through their disease, they’re bridged into palliative community services. Typically, a physician or nurse will visit a patient in the comfort of the patient’s home.

McGuinty and her team assist patients and their caregivers with everything from symptom management, goals of care discussion, and advanced care planning, to coordination and navigation of care resources that improve quality of life and prevent hospital admissions.

“This is what is unique and special about this program,” said McGuinty. “This specialized care isn’t available in the outpatient setting. Through our program, we can ease the burden of people facing complicated and life-limiting health issues and provide support services for their caregivers and families who are themselves experiencing a challenging period in their lives. Patients with end-stage heart disease have the same need for palliative care as do cancer patients, and we’ve created a one-of-a-kind program to deliver these services in a timely way.”

It has been less than one year since Dr. McGuinty moved her family from Toronto to the nation’s capital to begin her career at the UOHI. Despite an almost oppressive-like despair that seems to have settled in Ontario, she and her colleagues remain hopeful—optimistic even—about the future.

“The physicians and the administrators are enthusiastic about introducing palliative care for patients with advanced cardiac disease. The resources they were willing to invest to make this level of care possible warms my heart. We believe we’re creating a model that other centres will be able to replicate for the improved integration of palliative care services for cardiac patients in Canada and all over the world.”