National Cardiovascular Center Harapan Kita – Gold Winner of the Excellence Award for Leadership and Management

National Cardiovascular Center Harapan Kita bagged the Gold title for the Excellence Award for Leadership and Management at the 2024 IHF Awards

Cardiovascular network fostering programme 

In Indonesia, cardiovascular diseases claim more than 650,000 lives every year. Based on data from the Institute for Health Metrics and Evaluation, this breakdown includes stroke deaths (331,349), coronary heart diseases (245,343), and hypertension-related heart diseases (50,620). Despite this, there is still a huge gap in cardiovascular services.  

In response, the National Cardiovascular Center (NCCHK) established a referral network for cardiovascular services across over 500 regional public hospitals. The initiative was meant to foster equalization and standardization of cardiovascular services quality across the country.  

To achieve this mission, NCCHK formed a cardiovascular support team to consistently improve the quality and quantity of cardiovascular services in Indonesia. The programme aimed to ensure that district and city hospitals should minimally be able to perform Primary Percutaneous Coronary Intervention (PPCI) and that each provincial general hospital could perform open-heart surgery, specifically coronary artery bypass grafting (CABG). By 2024, the goal was for 13 provinces to be able to extend CABG services. Finally, the long-term vision is making non-surgical interventions available in all cities. 

Beyond the NCCHK, different stakeholders were committed to the project, including the Ministry of Health, local governments, provincial health offices, and network hospitals. Throughout the country, the NCCHK conducted targeted visits to regional general hospitals to perform assessments regarding conditions for human resources, medical equipment, and infrastructure planning.  Local governments also signed memorandums of understanding and cooperation with regional general hospitals in support of the cause. Proctorships were also conducted for non-surgical procedures and open heart surgeries. 

Expanding cardiovascular services

The programme focused on strategic initiatives including the development of standard medical equipment planning and other cardiovascular service support. NCCHK worked towards a regional referral system, pharmacy supply chain, and an integrated patient verification system for patients with national insurance. Apart from this, NCCHK together with other stakeholders committed to carrying out education and training to support the implementation process.  

NCCHK ensured that processes were streamlined for easy monitoring and smooth flow with guidelines drafted for cardiovascular interventions. Budget availability was also monitored by local governments. The stakeholders established an integrated emergency response system and prioritized the readiness of ambulance transportation. Additionally, staff training was provided to familiarize doctors and nurses with reading clinical emergency signs for cardiovascular interventions. They also formalized allowing laboratory tests expedited through WhatsApp to speed up processes. 

The programme’s effectiveness was regularly evaluated through, periodic reports to the Ministry of Health. More hospitals became equipped to carry out the target services. Hospitals with catheterization facilities rose from 58 in 2021 to 118 in 2023. CABG services expanded from 16 in 2021 to 21 in 2023. Records showed that 76 regional general hospitals have the capability to carry out PPCI measures, from just 54 in 2021. Additionally, it was observed that the Non-Surgical Intervention fostering programme had a 100% survival rate and 0% mortality rate.  

The programme’s success eventually led the Ministry of Health to adopt it as a national initiative, promoting improvements in cardiovascular referral services and access to care for eight other priority diseases.