Finding Answers with Wellstar’s Autonomic Program

Wellstar’s ongoing commitment to improving patients’ health and wellness was on full display when more than 100 cardiovascular healthcare providers gathered for the third annual Cardiovascular Quality Forum last spring. The forum, which was hosted at Wellstar Kennestone Regional Medical Center, serves as a way to share best practices across the Wellstar Center for Cardiovascular Care in order to enhance patient care systemwide.

“All of our Wellstar cardiovascular programs across the system are constantly working to improve clinical processes in order to improve patient outcomes, whether it be reducing mortalities, decreasing complications, reducing length of stay, etc.,” said Wellstar Quality Manager Dave Bloomquist. “Our annual Cardiovascular Quality Forum allows us to share the work being done at each individual hospital so all Wellstar hospitals can benefit from each other’s improvement efforts.”

The centerpiece of the forum is the poster competition, an idea borrowed from the American College of Cardiology’s annual Quality Summit. Each Wellstar hospital is encouraged to share its cardiovascular improvement successes in the form of a poster submission. Submissions can come from any stakeholder across the care continuum, including inpatient, outpatient, procedural, wellness and post-acute care areas. The posters are then judged by a panel of physicians using an objective scoring tool.

“After three years of holding this event, our physician leaders are still quite eager to devote the time necessary to score the ever-increasing number of posters,” Bloomquist said. “When we held the first Cardiovascular Quality Forum, we had 12 poster submissions. Last year we received 20 submissions, and this year we received 32 submissions.”

The posters represent the hard work from Wellstar teams to enhance and sustain a culture of high-level cardiovascular quality. This year, the top five posters belonged to Wellstar Kennestone, Wellstar MCG Health, Wellstar North Fulton, Wellstar Paulding and Wellstar West Georgia Medical Centers. Wellstar West Georgia earned the top overall score for its poster on decreasing telemetry calls, or the overuse of cardiac monitoring.

Additional highlights of the 2024 forum included a keynote address delivered by Mayo Clinic Cardiologist Dr. Abhishek Deshmukh and an awards presentation that honored Wellstar Cobb Medical Center with the overall cardiovascular quality award.

For the first time, the event also recognized outstanding provider leadership in quality. Wellstar Kennestone Cardiothoracic Surgery Physician Assistant Deleen Huff received the APP quality leader award, while Wellstar North Fulton Cardiologist Dr. Suresh Ramamurthy received the physician quality leader award. The awards are based on nominations, which may be submitted by any individual from any hospital.

“It was quite moving to read the nominations for physician quality leaders,” Bloomquist shared. “There was so much love and respect shown for our physicians by their clinical teams that it brought tears to my eyes as I read each nomination.”

Tears also flowed during the forum when a patient who survived a heart attack took the stage to share his testimonial alongside the Wellstar care team members who treated him.

“As we do each year, we invited a patient to join us to tell their story and recognize their Wellstar care team,” said Bloomquist. “There was not a dry eye in the room when the patient and his family told their journey at Wellstar—which ended with a left ventricular assist device (LVAD)—and thanked his care team for their love and care.”

As the Cardiovascular Quality Forum continues to grow, Wellstar patients will benefit greatly from care teams who are dedicated to improvement through collaboration. Bloomquist noted that the forum has been increasingly recognized by system leaders, including a number of hospital presidents who attend.

Looking ahead, Bloomquist said he is eager to see even more heart care leaders acknowledged for their contributions to the service line. “We will continue to grow the list of cardiovascular stakeholders that will be recognized for their improvement efforts to include inpatient nurses and EMS partners,” he shared.

The next Cardiovascular Quality Forum will be held March 2025.

Like most seniors, Ja’Quan Hart was very much looking forward to going off to college in the summer of 2023.

The Thomson, Ga., resident had just graduated high school and as a linebacker and tight end, helped lead his Thomson High School Bulldogs to win the Class AA State Championship.

“I had these big tackles, and I caught like an 89-yeard interception pass,” he said. “That was like my best game. We won state!”

Ja’Quan’s talent and skill on the football field—and his love of the game—earned him the opportunity to play for the University of Kansas with a full scholarship.

Unfortunately, life had other plans.

Amid packing for school and booking his flights, Ja’Quan learned from a routine sports physical that he had an irregularity in his heart that could be life-threatening.

That irregularity turned out to be a leaky aortic valve—and an abrupt end to his aspirations of a college football career.

“Blood was flowing back into my heart. It wasn’t going all the way through,” Ja’Quan explained.

In a healthy heart, leaflets between the left and right ventricles open to allow blood to flow through the heart one way and then close fully to keep blood from flowing back into the heart. In a condition like Ja’Quan’s, the leaflets do not close all the way and blood does leak back into the heart.

For most people the treatment for a leaky aortic valve involves a valve replacement. But a valve replacement now will often require another replacement surgery at some point in the future, and probably more than one, said Dr. Brian Bateson, a pediatric cardiothoracic surgeon and co-director of the adult congenital heart program at Wellstar MCG Health Medical Center. The younger the patient, the more potential surgeries the patient will need to have to replace the valves when they wear out.

Because Ja’Quan had not yet reached 20 years of age at the time of his care, a valve replacement would mean multiple surgeries over the course of his life.

The solution is a new device called the HAART ring that is affixed to the support structure of the aortic valve. This stabilizes the valve and allows for further repair of the leaflets themselves, meaning the valve can close properly and prevent leakage.

“If you’re using Ja’Quan’s own valve, keeping it in place and it functions, potentially he wouldn’t need another procedure again in his life because it’s still his own tissue. It’s not going to break down. Any prosthetic valve, whether it’s mechanical, bio-prosthetic will fail over time,” Dr. Bateson said. “Nothing’s better than what you’re born with.”

The HAART device is ideal for a young patient like Ja’Quan, but would also be a good treatment option for any person—pediatric or adult—with the same condition.

Ja’Quan spent three days in the hospital recovering from his surgery. Since, he has been slowly increasing his cardiovascular activity, such as walking, and following up with Dr. Bateson for regular checkups, who said he has been recovering very well.

Ja’Quan said he plans to continue to play sports, but will need to be more selective about the sports he can play.

“I play basketball. I just won’t be playing contact sports (like football),” he said.

Though he said it was disappointing to have to change direction as far as playing college football is concerned, Ja’Quan hasn’t let it dampen his spirit. Instead of college football, he is now exploring the possibility of driving trucks with the intention of going into business for himself—as long as it isn’t too strenuous for his heart.

“I’m not going to give up. I’m going to regroup and keep going and find another path to being successful in life,” he said.

The road to recovery after a stroke can be long and difficult. By following exercise recommendations from Wellstar’s rehabilitation care team, you can take an active role in the process and help shorten your journey.

According to the National Institutes of Health, falling can lead to delays in recovery for stroke survivors. Muscle stiffness and loss of balance are two common issues that contribute to increased fall risks. The expert providers at Wellstar work with patients and family members to develop individualized care plans that improve steadiness and flexibility. For added benefit, they also recommend you do the following exercises on your own.

Standing up and sitting down
Begin by sitting on a chair with a firm seat. Stand up fully and then slowly take a seat. Repeat as many times as you can tolerate initially. If necessary, use your hands to push into the standing position. Gradually progress to standing without the added assistance and completing more repetitions.

Step-ups
Begin by holding on to a stair rail. Step up onto the first step and then back down to the floor. Repeat as many times as you can tolerate initially. Step up with your stronger leg and lead with the weaker leg going down. Gradually progress to not holding on to the rail and increasing the number of repetitions.

Calf raises
Using a chair or countertop for balance, raise up onto your toes, lifting your heels completely off the floor. Slowly lower your heels back to the floor. Repeat as many times as you can tolerate initially. Gradually progress to not holding on and completing more repetitions.

Marching in place
Begin using a chair or countertop for balance and march in place for as many seconds as you can tolerate initially. Gradually progress to not holding on and marching in place for longer periods of time.

Shoulder flexion
Start with your arms at your side. With your palms facing each other, raise your arms in front of you as far as you can. Return to the starting position, then repeat.

Shoulder extension
Start with your arms at your side. With your palms facing each other, raise your arms behind you as far as you can. Return to the starting position, then repeat.

Shoulder abduction/adduction (lateral shoulder arm raises)
Extend your arms out to the side. Slowly raise your arms above your head. Return to the starting position, then repeat.

Elbow extension and flexion
Start with your arms at your sides, with your palms facing forward. Bend at your elbow so that your palm touches your shoulder. Return to the starting position, then repeat.

Wrist extension and flexion
Place your arms on a supported surface such as a table or desk, leaving your wrists free to move. Turn your palms up toward the ceiling and bend your wrists up and down.

Finger flexing and extending
Place your forearms on a surface such as a table or your lap with your palms facing up. Make a tight fist then open your hand and extend your fingers out until they are straight.

Get the most out of your exercise regimen

Establishing a regular exercise routine outside of your scheduled therapy appointments is important for your recovery. Perhaps equally important is completing the routine in a safe manner to avoid falling and to maximize your results. The experts at Wellstar suggest following these tips to maintain your safety.

• Dress comfortably. Your clothes should not limit your movements. Wear a hospital gown, pajamas or athletic clothing.
• Move slowly through all the movements.
• Do not hold your breath while doing any of these exercises. Breathe deeply. Count out loud during the exercises to keep your breaths evenly paced and remind you to breathe.
• Try to do the exercises while standing or sitting at the edge of your bed. If you do them this way, make sure another adult is around. This will help to make sure you are safe and reduce your risk of falling.
• Stop any exercise that causes you pain or discomfort and tell your doctor, occupational or physical therapist. Continue to do the other exercises that do not cause pain.

 If you have any questions, talk with your doctor, physical therapist or occupational therapist. Learn more about the expert care from Wellstar’s inpatient rehabilitation program.

For more information on Wellstar Roosevelt’s specialty rehabilitation services, visit rooseveltrecovery.com.