Shaping The Future Of ACHD
The Columbus Ohio Adult Congenital Heart Disease (COACH) Program is helping to shape the future of ACHD not only locally in Columbus, but throughout Ohio, the Midwest, and nationally. In Columbus, we have developed one of the most comprehensive service lines for ACHD in the US. Combining the nationally recognized faculty, world class diagnostic testing and therapies, and state of the art facilities at two US News and World Report leading institutions; Nationwide Children’s Hospital and The Ohio State University (OSU), the COACH Program is leading the way in ACHD clinical care, education, and research. By fully integrating our program into both hospital systems, we are able to provide ACHD care with a patient centered strategy. This approach allows individually tailored options for ACHD care driven by what is best for each particular patient as opposed to trying to fit the patient into a health care system not prepared for ACHD. This forward-thinking approach is utilized for each and every ACHD patient and is the basis for our outstanding ACHD outcomes.
In our Transition Education Program at Nationwide Children’s Hospital, our ACHD team along with the Pediatric Heart Center faculty, has developed a robust, broad-based education program for all CHD patients starting at age 15 and continuing until they transition to the COACH program. Our ACHD nurses meet with nearly 200 patients annually as they prepare to transfer from pediatric to ACHD cardiology care. Doing this, we develop a relationship with the patient and parents early in the spectrum of CHD care for eventual ACHD transition. The transition education program highlights aspects of life-long CHD care including insurance concerns, medication compliance, pregnancy and family planning, work-related considerations, and psychosocial needs. We feel this pre-meeting makes the process of active transition to ACHD care smoother, less traumatic, and helps mitigate the current national epidemic of the lost to care. The ACHD fellow will learn about transition and the education process as part of their ACHD training, a crucial component to their future career as an ACHD cardiologist.
Once patients transition to us, or enter care from outside referrals, our team is prepared to evaluate and provide care in one of our many ACHD clinics. We hold ACHD clinics each day of the week at either Nationwide Children's Hospital or Ohio State University Medical Center. ACHD fellows attend clinic with the ACHD team an average of 2-3 days per week depending on the rotation. With a clinic staffed by ACHD trained physicians, ACHD advanced practice nurses and RNs, as well as psychologists, social workers, and nutritionists/dieticians, the experience for the ACHD fellow is a true educational endeavor.
Once patients have transitioned to ACHD care, their care is individualized. In a patient population which requires frequent follow-up imaging and intermittent surgical or catheter-based intervention, we are able to offer state-of-the-art planning, interpretation, and execution of care plans. We have developed lesion specific protocols for ACHD advanced imaging (MRI/CT) and echocardiography and have faculty trained in ACHD to guide the examination and interpretation. With over 400 MRI/CT scans/year, and specific rotations for the ACHD fellow, comprehension and knowledge in ACHD MRI/CT will clearly improve with greater ability to understand protocols and interpret images. We individualize our approach to CHD interventional cardiac catheterization. Our Hybrid interventional catheterization laboratories at Nationwide Children's provide an opportunity for ACHD fellows to gain exposure to transcatheter valve therapy, device closure techniques, covered stent procedures and Hybrid approaches to complex patients This cath lab experience for the ACHD fellow both in the lab and through observation is essential for ACHD training and career development.
An essential part of our ACHD care involves expanding clinics to outlying communities to improve access to care for our ACHD population. In an ongoing and expanding effort, we have developed monthly outreach ACHD clinics at several Ohio locations, stretching West to Dayton, North to Mansfield and Lima, and Southeast to Portsmouth with plans for other locations in the near future. The ACHD fellow participates in outreach with the ACHD team and thus is able to experience real community-based ACHD care.
We are committed to the promotion of ACHD patient education. We have delivered educational lectures along with dinner to our patients on various general topics such as: Diet and Exercise, How to Manage Heart Failure at Home, Psychological Support for ACHD Patients, Social Service Needs for ACHD Patient, Electrical Issues Pacemakers and Arrhythmias, Interventional Cardiac Catheterization for ACHD and Pregnancy and Heart Disease; and also lesion specific lectures including Tetralogy of Fallot, Coarctation of the Aorta, Transposition of the Great Arteries, and Single Ventricle/Fontan. The ACHD fellow participates by helping to provide some of the lectures for this series.
COACH is leading the way in ACHD research. Our ACHD program has focused on developing and implementing important clinical research in several areas. The ACHD fellow is an integral part of the research team, participating in their own directed projects as well as projects initiated and performed by the ACHD team. Book chapters, peer review articles, review papers, local presentations, and national presentations are an expected part of the ACHD fellowship. We help provide the research support with dedicated ACHD research coordinators, IRB, and database personnel so the fellow can focus on the research. See the fellow page for research accomplishments of our ACHD fellows.
We are helping to shape the ACHD National Agenda. Members of the COACH team have initiated, developed and accomplished several goals within the National Agenda for US ACHD care.
In summary, the COACH program is working to provide the best care locally and to create an impact nationally for ACHD care. As an ACHD fellow with our program, you will have opportunities unlike anywhere else in the US to develop your ability to not only care for ACHD patients but also to understand how to run an ACHD program while engaging with our program on several levels with education, research and advocacy.