International Standards for Centers of Excellence in Heart Failure and Heart Transplantation
International Standards for Centers of Excellence in Heart Failure and Heart Transplantation
Adaptation of AHA/ACC, ESC, Canadian, NICE/UK, and Australian & New Zealand Frameworks for Future Accreditation of Jordanian Hospitals. Based on Major Guidelines: AHA/ACC/HFSA 2022, ESC 2021, CCS 2022, NICE/UK, ANZHF
Including Focused Updates: ESC 2023, NICE 2025 Draft
Keynotes :
1. Guideline-Directed Medical Therapy (GDMT)
• Monitoring of prescription rates and implementation of up-titration protocols to reach target doses of cornerstone therapies (ARNI, ACEI/ARB, beta-blockers, MRA, SGLT2 inhibitors).
• Outcome tracking: early follow-up visits within 30 days (multiple reviews if needed), along with long-term outcomes including 1-year and 5-year survival and quality of life.
2. Advanced Heart Failure & Device Therapies
• • Availability of advanced options: LVAD, ICD/CRT, pulmonary pressure monitoring (as feasible), and clear referral pathways for transplant.
• Regular outcome review: mortality, readmissions, and quality-of-life measures (scores when feasible).
3. Heart Transplantation Standards
• Multidisciplinary Transplant Team: cardiologists, cardiac surgeons, anesthesiologists, intensivists, infectious disease specialists, clinical pharmacists, specialized nursing, psychology, and social work.
• Infrastructure for donor evaluation, recipient selection, and post-transplant immunosuppression monitoring.
• Long-term registry participation to benchmark outcomes (1-year, 5-year survival).
4. Multidisciplinary Team (MDT) & Care Coordination
• Continuous staff training and accredited CME activities.
5. Care Continuum & Patient Transitions
• Structured discharge protocols.
• Early post-discharge follow-up (within 7–14 days).
• Home-based monitoring and telemedicine integration(as feasible).
6. Quality Measurement & Registries
• Mandatory participation in international/national registries (AHA GWTG-HF, ESC EORP-HF, CCS-HF, ANZHF).
• Continuous data collection: admissions, length of stay, readmissions, mortality, functional status, device use.
7. Research & Innovation
• Active participation in clinical trials and digital health initiatives.
• Strong partnership with academic centers for translational research.
8. Network & Accreditation Model
• Hospitals recognized as CoE hubs, linked to referral hospitals in a national network.
• Tiered certification: Primary HF Center → Advanced HF Center → HF + Transplant CoE.
• Accreditation based on periodic review (every 3–5 years) with international benchmarking.
9. Community & Public Health Impact
• Collaboration with EMS and primary care for early referral and patient triage.
10. Governance, Safety & Sustainability
• Strict compliance with safety, quality, and infection-control standards.
Conclusion:
This framework unifies AHA/ACC International Certification, ESC/EORP benchmarks, Canadian CCS criteria, and NICE/ANZ standards. It provides a stepwise pathway to progress from guideline-based HF care to fully accredited Centers of Excellence in Heart Failure and Heart Transplantation.
