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This is where health care leadership comes together.

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Becker's sixteenth annual meeting brings more than 3,500

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hospital and health system executives and nearly 800

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speakers to Chicago

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April.

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This year's event includes keynote conversations with Dallas

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Cowboys legend Troy Aikman and former president George

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w Bush. For the agenda and event details,

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visit beckershospitalreview.com

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and click on the events tab in the

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upper right. We're looking forward to hosting you

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in Chicago.

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Welcome to the Becker's Healthcare podcast. I'm Mariah

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Taylor, assistant editor, and I'm thrilled to interview

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Suzette Graham Hill, lead of cardio obstetrics program

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at NYC Health and Hospitals, Kings County.

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Suzette, thank you so much for joining me

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today. I'm so excited to learn more about

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how hospitals are addressing cardiovascular

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disease in pregnant patients. But before we dive

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in, I'd love to hear just a little

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bit more about you and your background.

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Well, a physician specialist here at Kings County

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Hospital

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taking care of adult patients,

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in particularly

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pregnant women who are referred from the obstetrics

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department

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where we see them in our heart health

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center, and we evaluate them, especially if they

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have preeclampsia

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or chronic hypertension.

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We evaluate them, with a physical exam as

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well as set up an echocardiogram

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as well as blood work to prevent any

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cardiovascular

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complications.

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So, I do that as well

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as read echocardiograms

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and perform transesophageal,

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echocardiograms.

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So I do a whole host of things

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to take care of adult patients.

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Excellent.

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And as probably many of our listeners know,

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cardiovascular

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disease is the leading cause of pregnancy related

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deaths right now. Can you tell us a

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little bit more about the scale of this

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problem and why hospital leaders are taking notice?

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Well, as you said, cardiovascular

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disease is the leading cause of pregnancy related

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deaths in The United States. And these deaths

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we are noticing

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are happening after delivery, and they are and

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they are preventative

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with better screening and follow-up.

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We've noticed that most of the deaths are

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related to cardiomyopathy

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and hypertensive,

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disorders.

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So we in at Kings County Hospital, we

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are trying to,

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stop or trying to,

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do the workup so that we could prevent

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cardiovascular

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complications

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because we recognize that most of the deaths

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are occurring

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one year postpartum.

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And we also noted that black women are

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disproportionately

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affected

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that are are significantly affected by hypertensive

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heart disease, and they're having early mortality.

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So the hospital leaders

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are taking notice to all of these

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causes of, morbidity and mortality

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because these outcomes

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can largely be preventable

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with earlier screening,

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better follow-up,

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and stronger coordination

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between the obstetrics department and cardiology.

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Hospital leaders have noted that this is no

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longer a clinical issue.

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It is a systems and quality issue that

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we're all working together to forestall.

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I love that. And let's dive into that

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just a little bit deeper. What are hospitals

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doing in care and operations to kind of

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meet this demand?

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Well, this shift means that the hospitals

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have they must move beyond

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traditional

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six weeks, the postpartum model. Maternal health care

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had now requires coordination

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between the obstetrics department,

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cardiology, and primary care. The traditional models of

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that six weeks is no longer effective. So

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cardiovascular

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risk is continuing

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to rise post six weeks after a woman

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has their baby.

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So the hospitals

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must build systems

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that integrate

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cardiology,

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maternal fetal medicine,

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nursing, and primary care. And it also

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requires an investment in blood pressure monitoring for

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the moms,

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patient education,

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and smoother discharge

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planning.

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So from an operational

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perspective,

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it shifts maternal care from a short term

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event to a long term

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population health strategies.

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Leaders in our hospital

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view maternal cardiovascular

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health as part of a quality improvement

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and a risk management

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effort to take care of our patients.

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Amazing. And I know you guys are doing

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an amazing job of really improving

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your rates and the access to care for

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these patients. So can you give us a

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little bit more details about what kind of

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initiatives or programs are showing success?

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Well, we have formed a cardio obstetric team,

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which involves obstetrics and cardiology.

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We also are working with the maternal health

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team to,

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have remote blood pressure monitoring,

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And we're also working with the obstetrics team

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to have automatic

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cardiology

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referrals for those women with preeclampsia.

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When hospitals standardized

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follow-up

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and extend postpartum care, we recognize

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outcomes improve.

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The American Heart Association

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has issued a guidance

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sub supporting

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cardio anesthetic teams, which brings the cardiologist

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and the obstetrics teams together

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for those high risk patients

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identified in the OBGYN

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department.

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So what we're doing, we're we're implementing

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remote blood pressure monitoring

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and programs

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that to reduce the postpartum

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complication

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by identifying

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high blood pressure early. Some of the hospitals

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schedule cardiology

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follow-up appointments before discharge,

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which improves our continuity of care.

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States are expanding Medicaid coverage to twelve months

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postpartum

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and also improving follow-up access.

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These interventions

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have been shown that structured systems

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can

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significantly

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reduce

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preventable deaths.

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Amazing.

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And now for all of our listeners out

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there who are hearing you and your passion

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and thinking, I wanna do better at our

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hospital. I wanna make something happen. What is

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your recommendation

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for an area in heart care or patient

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experience that they can make the biggest difference?

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Well, hospitals can make the biggest difference by

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improving

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early risk

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identification

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and postpartum follow-up.

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We we're standardizing our cardiovascular

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screening

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during pregnancy

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to help identify

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those high risk women sooner.

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We're implementing

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automatic referrals to cardiology

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for those women with preeclampsia

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or severe hypertension

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to prevent long term complications.

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Clear communication

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at discharge

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we've identified is the key, including scheduling follow-up

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visits before the patients leave the hospital.

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Also, it will improve the patient's outcomes.

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Finally,

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we're trying to address the social barriers

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such as transportation,

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insurance

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gaps, and health care literacy

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that because we recognize that this can dramatically

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improve continuity

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of care. The greatest opportunity

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lies in coordinating

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patient centered systems

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rather than isolated

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interventions.

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Incredible.

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Well, this has been a really informative discussion,

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and I just love hearing all the passion

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that you bring to this. So thank you

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for joining me and sharing everything on the

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podcast today.

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Thank you.