Carolyn Pullen, BScN, RN, PhD, was out for her morning run when she had an epiphany that may change the future of cardiovascular healthcare in Canada.
As CEO of the Canadian Cardiovascular Society (CCS), which represents cardiovascular healthcare professionals across the country, Pullen had been thinking about ways to support her members and to improve patient care.
“There are networks of specialized organizations advocating for children’s health and in the domain of cancer care, and they’ve all achieved remarkable things,” she said in a recent interview with The Beat. “But there has never been a Canadian network of Canada’s cardiovascular centres.”
Cardiovascular disease is a leading cause of morbidity and mortality, and yet, according to Pullen, it feels like it has fallen out of the public’s view more so than some other major chronic diseases.
High time to close the gap
Pullen placed a call to then CCS President Dr. Marc Ruel.
A world-renowned cardiac surgeon and former head of the Division of Cardiac Surgery at the University of Ottawa Heart Institute (UOHI), Dr. Ruel recognized an obvious opportunity for community building that the CCS could drive to support better cardiovascular care across the country.
“Heart centres with the ability to channel and use their resources efficiently to curtail cardiovascular diseases and develop programs that improve healthcare delivery and access have the responsibility to share their experiences, knowledge and expertise,” he said.
In fact, Dr. Ruel was already driving stronger alliances across jurisdictions through a key alliance between the UOHI and Eastern Health in Newfoundland. Working together to target gaps, the UOHI was able to contribute a range of supports that helped Eastern Health reduce waitlists for complex surgical cardiac procedures and share innovations that could be readily scaled in another province. They were already collaborating on education events and fellowship exchanges.
In the months since those early discussions, Carolyn Pullen, Dr. Ruel, and the CCS have completed much of the groundwork to get a national alliance up and running. They now say there is enough momentum and support for the initiative that a coalition of administrative leaders with influence over health policy are ready to gather formally to discuss next steps.
“We saw the benefits of engaging with administrative leaders and organization policy-setters who aren’t traditionally CCS members,” said Pullen. “Through significant consultation, it became apparent that the right people to engage were those who understand the system-level problems and have a voice in the system-level solutions.”
Influential voices like Dr. Thierry Mesana’s
Dr. Thierry Mesana is president and chief executive officer of the UOHI. He is renowned globally as the heart valve surgeon who revolutionized treatment of cardiovascular disease — Dr. Mesana wrote the book on advancing patient-centred cardiac care through the concept of heart teams.
Heart teams are multidisciplinary groups of medical experts who collaborate to provide individualized treatment for several complex cardiovascular problems.
Both Drs. Mesana and Ruel can attest to the power of interdisciplinary teamwork.
“Working in silos is a flawed concept in medicine and especially in cardiovascular care,” said Dr. Ruel. “When you centre everything around a specialty, your perspective is limited. However, when your thinking revolves around disease processes, and when you unite specialists with varying viewpoints and skill sets, the result is more informed patient-centred discussions about the best approach to treating each patient.”
It is thinking like this that sparked an agreement between the UOHI and Eastern Health. The visionary partnership brings Ottawa heart surgeons to Newfoundland and cardiac patients to Ottawa to help ease the backlog of heart surgeries in Newfoundland and Labrador. Surgeons from the UOHI also provide professional and academic sessions for Eastern Health cardiac-care staff.
“A champion will show others the way”
In a letter to Dr. Thierry Mesana, Pullen credited the UOHI-Eastern Health initiative as having inspired the CCS to speak with leaders across the country to galvanize them around the idea of forming a national alliance.
A vision from an inspiring leader, she wrote, “will show others the way.”
Dr. Mesana has agreed to be a champion for the alliance. On October 28 in Montréal, he led a kickoff workshop as part of the largest gathering of cardiovascular and allied health professionals in Canada. The objective of that meeting was to decide priorities around which to focus a two-year work plan.
“The vision is to establish a community of practice for administrative leaders from cardiovascular centres across Canada to address common challenges by sharing and pooling knowledge, experience, tools, and solutions, and to establish a common voice to policymakers on key issues,” said Dr. Mesana.
“It’s about building a structured, national forum to share information, spotlight innovative practices for quality improvement, develop solutions for persistent, common, and emerging problems that impede cardiac patient care and outcomes,” he elaborated. “The larger, well-resourced centres can support the small or community-based ones; the smaller, more nimble centres can share innovations that serve unique populations in strategic and efficient ways. The benefits are bi-directional.”
“I believe that an alliance of Canada’s cardiovascular centres has the power to accelerate the right changes, to amplify the voice of advocacy for cardiovascular care in Canada, and to bring the crisis of heart disease morbidity and mortality back into the public’s view.”
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