Center of Excellence in Heart Failure – Simplified Summary (Task Force Edition)
Center of Excellence in Heart Failure – Simplified Summary (Task Force Edition)
Source: Prof. Nazih N. Kadri, MD FACC FHRS – Heart Failure & Electrophysiology Task Force, Jordan Cardiac Society (JCS)
Keynotes:
1. Vision and Mission
• Goal: Unify Heart Failure (HF) and Electrophysiology (EP) care for Jordan and the region.
• Focus: Turn global evidence into a locally adapted, unified system that ensures equal access and consistent quality of care.
2. Rationale
• Traditional reliance on foreign guidelines often missed local realities.
• The new Center of Excellence (CoE) adapts these standards into Jordan’s clinical context, balancing global rigor with local relevance.
3. Seven Pillars of Excellence
1. Unified Clinical Standards: Common diagnostic and treatment pathways across hospitals.
2. Integration of EP in HF: Combine rhythm management and device therapy (CRT/ICD) into HF care.
3. Training & Capacity Building: Continuous education and expansion of HF units nationwide.
4. Research & Registry: Creation of a national HF registry including rhythm and device data.
5. Technology & Innovation: Practical digital tools (e.g., ECG optimization, remote follow-up) without extra costs.
6. Quality & Accreditation: Regular audits and alignment with ESC/AHA benchmarks and JCI standards(Concerned with generating research, not granting certifications).
7. Regional Collaboration: Strengthen Jordan’s role as a regional hub for integrated HF and EP care.
4. Multidisciplinary Team (MDT)
• Core Members:
• Heart Failure cardiologist
• Cardiac surgeon (LVAD/MCS input)
• Electrophysiologist (ICD/CRT management)
• Imaging specialist (Echo/MRI/CT)
• Pharmacist (medication optimization)
• Primary care link and ancillary staff
• Model: Weekly MDT meetings + shared EMR notes + decision algorithms based on guidelines (Figures 17–22).
5. Guideline-Structured Functions
1. Diagnosis & Risk Stratification: Echo, MRI, biomarkers (NT-proBNP), functional tests (NYHA, 6MWT, CPET).
2. Pharmacologic Optimization: Full GDMT (ARNI, β-blocker, MRA, SGLT2i) with protocolized titration.
3. Device Therapy: MDT-based ICD/CRT decisions and conduction system pacing.
4. Advanced Therapies: LVAD, ECMO, heart transplant (ISHLT criteria).
5. Comorbidities: Diabetes, CKD, COPD, iron deficiency (IV iron per ESC 2021).
6. Palliative Care: Early symptom control and advance planning (KCCQ tracking).
7. Follow-Up & Telemonitoring: Early post-discharge visits (7–14 days) and remote monitoring (Class IIa ESC 2021).
Remote monitoring (tele-monitoring: automatic electronic transfer of patient data — such as weight, blood pressure, symptoms — or device data — such as heart rhythm and ICD/CRT function — from home to the medical team for early detectio
8. Quality Metrics: GDMT adherence and readmission rates as key benchmarks.
6. Workflow and Data Integration
• Weekly MDT rounds for complex cases and advanced therapies.
• Shared EMR visibility ensures real-time team coordination.
• Decision algorithms align with ESC and AHA HF guidelines — GDMT → devices → advanced options.
7. Core Message
The Center of Excellence is not a building — it’s a system of people, data, and protocols working together to improve outcomes for heart failure patients in Jordan and beyond
Additional Comments, Source: insights and comments received by the JCS Task Force during and after the conference discussions (outside Dr. Nazih’s presentation):
• ACC → CoE / ICOE: institutional accreditation for full hospitals — system-based, data-driven, and outcome-focused. The International Centers of Excellence (ICOE) model was introduced outside the USA in 2024, with Cleveland Clinic Abu Dhabi being the first and currently only accredited center in the region.
• AHA → Certified Units: pathway-based recognition for specific clinical units (e.g., Chest Pain, HF, Stroke) built around guideline adherence rather than full hospital systems. In Jordan, two hospitals currently hold AHA-certified Chest Pain Units, reflecting strong compliance with international protocols.
• ESC → Certification Programme: an equivalent European model granting accredited centers (HF, EP, Imaging, Cath Labs) that emphasize clinical quality, education, and professional training, rather than institutional infrastructure or system-wide data integration.
Another Note (outside the main article):
CRI (Cardiovascular Research Institute):
A scientific research body that conducts, coordinates, and publishes cardiovascular studies — often in collaboration with universities, hospitals, or national cardiac societies.
It is usually commissioned or funded by academic institutions, health authorities, or industry partners to generate clinical evidence and advance cardiovascular research.
(It produces and publishes research, not accreditations.)