Heart Disease continues to be the leading cause of deaths in the United States and worldwide, despite a decline of nearly 50 percent over the last 30 years. Healthcare experts use the term heart disease to describe several conditions. The most common are: Arrhythmia, which is described as an irregular heartbeat. Atherosclerosis occurs when a buildup of plaque in the arteries causes hardening. Cardiomyopathy refers to a weakening of the heart muscle which causes difficulty in pumping blood. Congenital heart defects are the result of abnormal development in the womb, and Coronary Artery Disease is the result of Atherosclerosis.
The reasons why heart disease remains the leading cause of mortalities are varied. Smoking increases the risk of heart disease. The Centers for Disease Control report “In 2018, nearly 14 of every 100 U.S. adults aged 18 years or older (13.7%) or an estimated 34.2 million adults in the United States currently smoke cigarettes.” Obesity and a sedentary lifestyle also factor heavily in cardiovascular risk. Hereditary conditions and medical issues including hypertension, diabetes and cholesterol are contributory factors for heart disease. Additional risk factors include excessive alcohol consumption and a high fat diet.
The National Strategy for Quality Improvement in Healthcare was created as an extension of the Affordable Care Act to increase healthcare outcomes through targeted initiatives aimed at increasing patient safety, inviting patients to be active participants in their healthcare, communicating effectively, equipping patients with the necessary tools to prevent and treat heart disease, community outreach programs and providing quality healthcare to a greater population base.
My healthcare organization has a patient safety program designed to increase patient safety by offering hand sanitizers in all corridors and patient rooms to reduce the risk of infection. The risk of falls is avoided by placing call buttons in patient rooms and restrooms, and providing non-skid socks. Each time a healthcare professional interacts with a patient, the identity of the patient is cross referenced verbally with armband identification.
Patients are encouraged to be active participants in their healthcare. This can be achieved by setting healthcare goals to hold patients responsible for healthier outcomes, involving family members in patient centered care, and establishing a care team including the primary care physician and any specialty physicians the patient may need. My employer uses a patient portal, MyChart which is accessible at all times for patients to communicate with a physician, schedule an appointment, review test results and request refills. As cited by Harvard School of Public Health, “studies show that person-centered care reduces length of stay, lowers care and operating costs, enhances employee retention, and decreases adverse events.”
An essential tool of effective communication is speaking to patients in language they are able to understand. Healthcare professionals often use an abundance of medical terminology and acronyms which may be unfamiliar to their patients. These patients may be reluctant to ask questions for fear of appearing unintelligent.
Patients must be cognizant of suitable methods to prevent and treat heart disease. Patients can decrease the risk of heart disease by maintaining a healthy weight, exercising regularly for a minimum of 30 minutes, tracking blood pressure and choosing an eating regiment focused on fish, grains and fresh fruits and vegetables. Smokers should cease smoking to diminish the risk of developing heart disease.
These same lifestyle changes will treat heart disease as well, in addition to medications such as statins and surgical procedures.
Healthcare organizations sponsors community outreach programs to enhance outcomes in underserved communities by hosting health fairs for patients to received free medical and dental care, providing transportation to doctor appointments, distributing free smoke alarms and fans to senior citizens during the summer months. According to Harvard School of Public Health, “In 2015, the Centers for Disease Control invested nearly $300 million in state and community prevention programs targeting heart disease, obesity, diabetes, stroke, and health disparities through campaigns such as Million Hearts, Tips from Former Smokers, and Sodium Reduction in Communities.”
In efforts to provide quality healthcare to a greater segment of the population, several states have expanded Medicaid coverage to include those previously deemed ineligible, such as adults who are not disabled and do not have dependent children. The advent of Medicare Advantage plans offered through private insurers provide all the traditional Medicare benefits of hospital and medical coverage plus supplemental benefits including free or discounted health club memberships, dental and vision at nominal costs.
Despite the advancements in changing the face of death by reducing mortality rates, a great deal remains to be done. Disparities persist across racial and socio-economic classes and rising healthcare costs suggest affordability will continue to be an obstacle.
References
- https://www.cdc.gov/tobacco/data_statistics/fact_sheets/adult_data/cig_smoking/index.htm
- https://www.hsph.harvard.edu/ecpe/an-update-on-united-states-healthcare-quality-improvement-efforts/
