GPHC advancing cardiac care through GPACC initiative

Mar 26, 2017 News

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By Sharmain Grainger
Heart disease is a chronic condition that cannot simply be addressed and forgotten. Instead effectively tackling heart conditions requires a great deal of attention and considerable investment.

It was with this in mind that that the Guyana Programme to Advance Cardiac Care (GPACC) was introduced at the Georgetown Public Hospital Corporation (GPHC). Although the programme has being ongoing for the past five years, it was formalised just two years ago.
Currently at the helm of this programme are Doctors Wayne Warnica and his wife Debra Isaac of the Calgary University’s Libin Cardiovascular Institute in Alberta, Canada.
The two, along with other experts in the field of cardiology, have been taking months out of the year to be here in Guyana help advance the aim of GPACC, which is to advance cardiac care for both adults and children. The GPACC service Dr. Isaac assured, during a recent interview, does not discriminate.
This, she noted, means that patients receiving both in-patient and out-patient services can all receive cardiac care at absolutely no cost at the GPHC.
Based on her observation, Dr. Isaac has been able to deduce that Guyana has an alarming heart disease situation found in both adults and children. While the majority of children requiring attention suffer from congenital heart conditions, Dr. Isaac explained that those found in adults are called coronary heart diseases. These can manifest in blockages to the arteries which can lead to dysfunction or decrease function of parts of the heart, high blood pressure and other heart muscle diseases that cause heart failure where the heart just can’t pump blood.
The latter development means that one of the patient’s arteries is blocked and that part of the heart muscle applied by that artery can essentially die.
“When that part of the heart muscle dies that damage is permanent and can lead to heart failure or death,” Dr Isaac noted. She, however, noted that the GPHC now has the opportunity through GPACC and its partnership with Dr. Mahendra Carpen [a member of GPACC], who also serves as Cardiologist at the Caribbean Heart Institute, to help prevent heart failures from

advancing.
“If people come in and are having an acute heart attack we have the option to open up that blood vessel before the damage is done, but we can’t do it after a certain number of hours,” Dr. Isaac asserted. She made it clear, “if people come in eight hours after their chest pain it could be too late for us to do that treatment. We always use the term ‘time is muscle’…as the time goes on the muscle is lost.”
As such any person who develops a chest pain, especially if they are predisposed to heart disease, are known to suffer from shortness of breath, “they need to come in to GPHC and come in right away. They shouldn’t go to their local clinics, because if they go to other places they can waste time…we can make the diagnosis right away,” Dr. Isaac asserted as she alluded to an ECG programme that is in place at the GPHC.
Through the GPACC programme patients can benefit from the right diagnosis, the right treatment, the right surgery, if surgery is indicated, and the right follow-up care.
“That is what GPACC is all about,” Dr. Isaac emphasised.
But since this strategic programme is built on a platform of education, she pointed out that “our goal is not just to come here and do things all the time, our goals is to actually work with the local health care team and increase their skills to allow sustainability of this programme.”
In fact, Dr. Isaac anticipates that at some point “persons will say to us ‘you don’t have to actually come and work here anymore, we can do this on our own; come and visit but we don’t need you to do the work’.”
But according to Dr. Isaac, despite continued training, the GPHC has not yet gotten to the point where it doesn’t need the support of visiting experts. However, she did reveal that “we have gotten to the point where the ECHO lab, the Treadmill lab and the Cardiac ICU are actually still continuing to work when we are not here. We are here frequently to provide support and to provide increased education, to provide increased service and we are always available and in contact online, but they [local staff] are actually really running the service on their own.”
As part of the education support being offered, a nursing professor, a nursing educator and a senior nurse clinician are currently at the GPHC sharing their expertise with local nurses, even as they manage the cardiac intensive nursing care programme.
It has been one year since the latter mentioned programme has been going full throttle with the view of training the GPHC nurses to become cardiac heart failure nurse specialists. Once training is completed these nurses, according to Dr. Isaac, will be expected to manage the out-patient clinics and conduct education sessions for patients.
Added to this, she revealed that GPACC is currently about to commence its sixth ultrasound and echocardiography training for physicians and technologists. She, however, noted that while there are currently full-time personnel who are able to perform and review echocardiograms, “because of the system that we have developed we can do real time review…even when I am not here and I’m back home at the University of Calgary, every day I can download the studies that are done here, I can look at them, review them and view the interpretations that were done by the local staff and make revisions as necessary.”
Revisions, according to Dr. Isaac, are intended to help to provide patients with better care, while at the same time providing feedback and learning for the people tasked with doing the echocardiograms, so that their skills can improve.
The GPACC initiative is one that is interlinked with the hospital’s collaboration with the Baby Heart Foundation that has been offering crucial paediatric cardiac care.
Just last week, the Foundation completed eight paediatric cardiac procedures, and there are plans for a few more to be completed this week by a team of experts currently lending their support at the GPHC. The team is being led by the Foundation’s Chief Executive Officer of Clinical Operations, Dr. Rodrigo Soto.

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