Cardiovascular Rounds

The biggest challenges ACHD programs face—and what you can do to overcome them

by Ben Wheeler

Advances in early detection and treatment of congenital heart defects allow up to 90% of patients to survive well into adulthood, meaning the prevalence of adult congenital heart disease (ACHD) is on the rise.

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While these trends are a testament to advances in pediatric cardiology, providers and hospital systems are struggling to meet the complex needs of adult patients. As a result, hospitals have increasingly turned to specialized programs to care for these patients. If your hospital is considering starting a specialized ACHD program, focus on these three keys to success.

1. Hardwire opportunities for multidisciplinary collaboration

Just to keep up with care needs, one ACHD patient may need to routinely see multiple providers, such as an ACHD specialist, an EP, and an interventional cardiologist, in addition to any other necessary specialists—a level of collaboration that requires a combination of program infrastructure and clear protocols.

To foster this kind of teamwork, hospitals can establish multidisciplinary case conferences. These conferences create a dedicated space for specialists to come together and create a coordinated care plan for the patient. Moreover, the opportunity for direct contact between providers helps build trust and accountability. The case conferences themselves can occur on a flexible schedule to maximize participation, but full attendance by all relevant care providers is integral to success.

2. Partner with a pediatric hospital to build a patient base and enable a seamless care transition

This partnership allows for the smooth transition of care for pediatric patients who survive into adulthood. In turn, this care transition helps establish a consistent patient base, improve patient experience, and build relationships between the providers at each institution. Partnering with pediatric facilities also allows pediatric cardiologists to participate in case conferences for adult patients and share their expertise.

3. Prioritize community outreach for growth

ACHD patients don't always come from pediatric hospitals; patients are often discovered as adults with undiagnosed defects. Finding these patients requires extensive community outreach and education with referring providers.
For example, a small, dedicated outreach clinic can work with local providers in the community to do screenings and evaluations for potential ACHD patients. These outreach clinics allow the hospital to identify ACHD patients and steer them into their program, as well as educate the surrounding area about the program and its capabilities.

By creating a culture of collaboration and multi-disciplinary care—and by partnering with the right stakeholders—systems can build a strong foundation for sustainable program development.

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For years, the CV service line has been considered the growth engine for many hospitals. But maintaining progress is increasingly difficult as programs face greater competition, pressure to bend the cost curve, and uncertainty in demand in a market emphasizing population health.

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