Customized Partnerships Strengthen Local Programs and Improve Patient Outcomes

Children and adults with congenital heart defects (CHDs) should have access to exceptional, multispecialty care regardless of where they live. At Cincinnati Children’s, we’re working toward that ambitious aim by partnering with heart centers regionally and as far away as the West Coast and the United Arab Emirates (UAE).

Each collaboration allows the heart centers to build a robust and reliable infrastructure and strengthen the care they provide to their community. The focus extends beyond surgery into the cardiac intensive care unit (CICU), anesthesiology and other specialties integral to caring for patients with complex heart conditions.

Michael Gaies, MD, MPH, Cardiology division director and executive co-director of the Heart Institute, explains.

Dr. Gaies, how would you describe these collaborations?

We customize each collaboration based on the participating institution’s needs, existing infrastructure and location. Our longest-standing integrated program collaboration is with University of Kentucky Children’s Hospital in Lexington, about 100 miles south of Cincinnati. This collaboration, which started in 2017, is the Joint Pediatric and Congenital Heart Program. The program is now jointly ranked among the top 5 in the country by U.S. News and World Report.

Kentucky Children’s initially enlisted Cincinnati Children’s through an RFP process to help rebuild their congenital heart surgery program.

Through this collaboration, we integrated our capabilities with weekly case conferences, surgical coverage, quality dashboards and joint participation in national registries and public surgical outcome reporting. The collaboration has also brought many improvements to heart patients in Kentucky. For example, in the last few years, Kentucky Children’s opened a dedicated cardiac operating room and pediatric CICU. Their team is proud to offer this level of specialty care in their community.

Kentucky Children’s now only transfers patients to Cincinnati for highly complex procedures and specialty care, such as ventricular assist device implantation.

Are collaborations like this part of a trend?

I hope so. Existing informal referral practices are not enough to ensure that people with a CHD are consistently receiving optimal care regardless of where they live.

Carl Backer, MD, a Cincinnati Children’s pediatric heart surgeon, was a leading architect of new, nationally supported recommendations to increase access to high-quality pediatric cardiac care. One of the recommendations was that comprehensive heart centers like ours partner with programs that offer some but not all CHD services. Our collaborations are in the spirit of those recommendations, and we hope more institutions will follow suit.

Q. What does a collaboration look like for other heart centers?

It varies. Our most recent collaboration is with Akron Children’s Hospital in Northeast Ohio, about 250 miles away. They have a very strong CHD surgical program, so their need for new infrastructure will be minimal. However, Cincinnati Children’s has helped jointly recruit and hire cardiothoracic surgeon Tara Karamlou, MD for the program, which will provide important continuity for the program. Some complex neonatal surgeries and advanced heart failure care will be referred from Akron to Cincinnati Children’s.

Cincinnati Children’s is also collaborating with Peyton Manning Children’s in Indianapolis to invigorate their congenital heart surgery program. We helped recruit and hire a renowned surgeon – Roosevelt Bryant III, MD – and are building a strong congenital heart surgery program infrastructure to allow heart patients to receive top heart surgery care closer to home.

Cincinnati Children’s is also expanding relationships globally. For the past 10 years, children with congenital heart disease in the UAE have received care from Cincinnati Children’s, both in the United States and in the UAE. As Cincinnati Children’s explores a broader partnership with the main children’s hospital in Abu Dhabi, the Heart Institute is prepared to extend consultative and in-country care for patients in the UAE.

What role do providers at partner institutions play?

Providers that are part of our joint heart programs, like Kentucky Children’s Hospital and Peyton Manning Children’s Hospital, are full-fledged members of the Heart Institute team. Our faculty values their expertise and works closely with them to ensure the care patients receive is effective and achieves excellent outcomes. To that end, the institute recently appointed pediatric cardiologist David Cooper, MD, MPH, to the new role of network officer. We established this role to help facilitate the implementation of best practices and ensure clinical operational excellence.

Taking on extra work while remaining laser-focused on maintaining the highest quality here in Greater Cincinnati is a lot of work. But it’s well worth it.

Do you have plans to expand your collaboration program?

We don’t actively seek out collaborations. But we welcome all inquiries from any heart center, whether they need a second opinion, a surgical consult or more robust collaboration. Our goal is to help as many patients as possible improve their health outcomes and quality of life, no matter where they live.

(Published December 2024)

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