Heart Failure (HF), a potentially life-threatening condition, occurs when the heart is not pumping as well as it should to deliver oxygen and nutrient-rich blood to the human body. Each side of the heart is composed of two chambers: the atrium, or upper chamber, and the ventricle, or lower chamber. The atrium receives blood into the heart, while the ventricle pumps it out. Heart failure occurs when any of the four chambers ---atriums or ventricles --- lose their ability to keep pace with the amount of blood flow that should normally flow through the circulation. The result of this failure is fatigue, shortness of breath, and fluid overload that can lead to a downward spiral and loss of functional capacity.
According to the American Heart Association, today, more than 6 million people in the United States suffer from heart failure, and each year almost half a million new patients are stricken with the condition. In particular, older people are at risk, as evidenced by the fact that heart failure is the leading culprit underlying the hospitalization of people over the age of 65. Among the broad range of cardiovascular-related diseases, heart failure is the only one on the rise, and its predominance is at the root of the approximately 35 billion in associated costs that are spent each year to treat patients who suffer from heart failure.
There are many issues that combine to create these escalating costs. Heart failure is often associated with the long lengths of stay in the hospital, largely because it can lead to or occur in conjunction with multiple co-morbidities --- cases where two diseases co-exist in a patient. These co-morbidities can include such conditions as diabetes, hypertension, renal insufficiency, chronic obstructive pulmonary disease (COPD) and anemia, to name just a few. In addition, heart failure is also unfortunately characterized by high rates of recidivism (readmission to the hospital), much of it due to an inability among patients to adhere to their low-sodium diets, recognize the symptoms of an impending failure, or otherwise properly manage their conditions while at home. High variability, high volumes and high mortality rates also play prominent roles in the disease’s profile.
In spite of these daunting obstacles, there is good reason for optimism. That’s because, although heart failure typically cannot be cured permanently, a person suffering from it can still lead a long, active and enjoyable life by getting the treatment and paying active attention to his or her lifestyle. Clearly, a great deal of progress has been made in recent years in understanding and treating the disease.
The Heart Failure Program at Hackensack University Medical Center is an award winning program utilizing the multidisciplinary approach which has developed innovative ways to improve outcomes for heart failure patients. The program includes an in-hospital component (a dedicated inpatient heart failure unit) while also providing in-hospital consultative services. It has developed definitive clinical pathways, multidisciplinary rounds aimed at reducing lengths of stay, and preventing readmissions.
The outpatient component of the program includes a heart failure center which provides initial consultation with state of the art diagnostic methods, as well as providing ongoing care both at the center and at home (utilizing nurse case managers and heart failure home care nurses). An adjunct to these programs has been the development of a telephone follow-up program which has focused on patients with high readmission rates. Together these measures have ensured that more patients with heart failure are being treated optimally without being admitted to the hospital.
The Heart Failure Program has a well-developed research program which facilitates both inpatient and outpatient therapies with new FDA research approved investigational treatment modalities not otherwise available. Research findings are published in prestigious journals in the field of heart failure and cardiology.
The multidisciplinary approach includes a team directed by a physician heart failure expert who is a clinician, researcher, and has administrative responsibilities for the program. Other members of the team include nurses with extensive experience in the management of heart failure patients including an advanced practice nurse. The team approach involves social services, dietary counseling, physical rehabilitation, educational programs, and support groups.
Many patients referred to the program have advanced heart failure. In this case, the program is able to provide cutting edge treatments both pharmacologic and mechanical while also providing transplant evaluation and bridge to transplant when indicated.
Additionally, the staff of the Heart Failure Program have considerable expertise in the diagnosis and treatment of Pulmonary Hypertension (PH) which is one of two centers on New Jersey.
The Heart Failure Program was founded in 2000 by Dr. Robert Berkowitz, who received his medical degree from Yale University Medical School and his Ph.D. in cellular-molecular biology from the University of California at Davis. The program, under the direction, of Dr. Berkowitz, is Joint Commission certified. HackensackUMC has had the lowest HF mortality in the nation for the past 10 years and therefore, has become the gold standard to which all other hospitals/HF programs are compared.
From the moment a patient is referred by their physician, a comprehensive individualized treatment plan is established throughout every stage of Heart Failure and Pulmonary Hypertension. This includes, but is not limited to:
Cardiac/Pulmonary Rehabilitation Services
Ventricular Assist Devices
Heart and Lung Bridge To Transplant
Palliative Care and Pain Management
MEET OUR STAFF
Robert L. Berkowitz, MD; PhD; FACC – Program Medical Director
Bernard Kim, MD – Associate Medical Director
Marites Welch, MA.Ed, BSN, RN, CCRN – Administrative Manager
Nancy Elmann, MSN, CCRN, APN-C – Nurse Practitioner
Maureen Gramble, BSN, RN, CHFN – Staff Nurse
Melanie Wedlick, BSN, RN – Staff Nurse
Lisa Lupetti, BSN, RN – Staff Nurse
Deborah Babino, BSN, RN-BC – Staff Nurse
Sheila Scollo, BSN, RN – Staff Nurse
Michelle Browning, BSN, RN, HNB-BC – Telemonitoring Staff Nurse
Tami Azouri, BSN, RN, HNB-BC – Telemonitoring Staff Nurse
Diana Cuttingham – Administrative Assistant
Tarah Nodar – Coordinator
Patricia Delannoy-Moustafa – Coordinator
The Services We Offer:
Heart Failure Tele-Monitoring Program
20 Prospect Ave. Suite 201
Hackensack, NJ 07601
Monday through Thursday, 9:00 am to 5:00 pm
Friday 9:00 am to 4:00p