Clinical confidence and efficiency in structural heart disease: an administrator’s perspective

In a rapidly changing healthcare environment, Ms. Nierenberg steers the cardiovascular service line at Hackensack to navigate challenges and manage growth. As more patients of younger age and lower risk are referred for SHD procedures, managing these patients has become a key growth driver for Hackensack’s cardiovascular service line. This means that transcatheter procedures for SHD are helping to drive surgical volume and overall profitability.

She notes, “Structural heart disease care has been so innovative as we’ve moved away from open heart procedures to wire-based minimally invasive procedures. The development continues to be amazing as we look at other valves and other structural heart options. I think the general community is still not as aware as they could be that structural heart procedures can be percutaneous, rather than an open procedure.”

A multidisciplinary team approach to SHD cases is critically important. Ms. Nierenberg notes that Hackensack established the Structural and Congenital Heart Center to create a specialty-neutral, patient-focused approach that could bring together multiple specialties in a structured way. She states, “We’ve created a center of excellence that is really very encompassing in the way it brings providers together, and the collaboration is incredible.” 

One of the keys to growth has been Hackensack’s hybrid ORs, one of which features the Philips Azurion with FlexArm Image Guided Therapy System. The Azurion FlexArm is a Ceiling Mounted system that gives teams the freedom to position staff and equipment to allow optimal patient access—supporting complex cases and new procedures.

In the hybrid OR, the Philips Azurion Image Guided Therapy System is integrated with the Philips EPIQ cardiovascular ultrasound with 3D transesophageal imaging to provide live fusion imaging guidance for structural heart procedures—while the interventionalist has complete access to images, patient monitoring and reports at tableside. The care team can access a comprehensive patient view that helps improve teamwork and reduce errors. 

Beyond the capabilities of the Philips hybrid OR, Ms. Nierenberg notes, “Ongoing support and easy access to the Philips team has been hugely beneficial. We don’t have barriers to access, which is incredibly valuable to the clinical team. It does seem like a partnership.”

One of the ways that Ms. Nierenberg and Philips are working together to improve the future of cardiovascular care is through their participation in the Philips-sponsored CV TRIAD, a unique framework created to effectively tackle key challenges in cardiovascular care and drive transformation. 

The CV TRIAD brings together physician leaders, administrators, and industry to create a community of thought leaders committed to reinventing cardiovascular care. It’s based on the premise that different groups tackle problems differently. They can learn from one another and progress if they are brought together in a dynamic joint leadership team under shared accountability.

As Ms. Nierenberg observes, “There are very rich relationships that physicians have with their preferred vendor, but through my experience as an administrator, it became very obvious that we can all benefit from a much more collaborative and engaging approach. Philips had a similar vision, and over the years we’ve had an opportunity to work with physician leaders, administrators and industry together.” 

“We’re having conversations we don’t typically have. The CV TRIAD offers us the opportunity to see a different perspective. It’s a very professionally rewarding and creative environment.”