Contributor – Thomas Hinneh
Nursing, at its core, is a discipline of response to human need, suffering, inequity, and the evolving realities of health and illness. Today, the growing burden of heart disease requires more than response; it demands urgent leadership and innovation in our approach to care. It calls for a reimagining of how care is delivered, how knowledge is generated, and how nurses position themselves within the increasingly complex health systems and the growing burden of diseases. This moment is unmistakably a clarion call.
Heart disease remains the leading cause of mortality globally, with one person dying from cardiovascular disease approximately every 34 seconds in the U.S., yet its burden is not evenly distributed. Communities already experiencing structural and social inequities, such as limited access to care and socioeconomic disadvantage, coupled with fragmented health systems, carry the heaviest burden. In these spaces, the traditional, physician-centered model of care is inadeamatient and their needs. It is time for nurses to take the reins in implementing team-based cardiovascular and chronic care.
Nursing must transcend task-based coordination and assert its leadership in designing and advancing holistic, person-centered care that meets the complex realities of patients and communities.
As a care model and as a philosophical shift, team-based care is uniquely positioned to support cardiovascular and chronic diseases. It reflects an understanding that improved health is co-produced through relationships built among providers, patients, families, and their communities. However, the role of nurses in health care teams is often under-leveraged, typically positioned as support rather than as leadership. This raises an important epistemic question: What do nurses know, what should they know, and how can their knowledge and expertise be fully leveraged in a team-based approach for heart disease management?
Nursing knowledge has always extended beyond simply following tasks and protocols. There is empirical knowledge, but also personal, ethical, aesthetic, and emancipatory ways of understanding health and human experience. Applied to heart disease management and prevention, this means recognizing patient outcomes (i.e., blood pressure control, glucose control, and prevention of fatal outcomes) as both clinical outcomes and daily experiences that are often influenced by culture, access, trust, and daily realities. Nurses, through their proximity to patients, their families and communities, are uniquely positioned to bring all these dimensions into care delivery, both in practice and in the community.
Team-based innovations, when led by nurses, can be transformative. In community settings, nurses may bridge the gap between health systems and everyday life, which is critical to translating clinical guidance into culturally meaningful practices, supporting self-management, and addressing barriers that extend beyond the clinic walls. In practice settings, nurses coordinate care, foster continuity, and ensure that patients are not reduced to numbers or diagnoses but are engaged as persons within their social contexts. Every aspect of these engagements in the care continuum has a significant impact on patient outcomes and experiences.
“No single health care provider, regardless of expertise, can fully address the complex needs of patients living with chronic diseases. Nurse-led team-based care models are therefore essential to address health worker shortage and optimize care.”
Importantly, this clarion call is not emerging in isolation. The Community Preventive Services Task Force (CPSTF), the U.S. Surgeon General, the American Academy of Nursing, and more recently the 2025 AHA/ACC Hypertension Guideline have all emphasized the importance of team-based care in improving cardiovascular outcomes and reducing disparities. The American Academy of Nursing’s 2026 report, Transforming Health and Healthcare, further highlights the critical role of nursing leadership in advancing nurse-led team-based models of care across U.S. health systems. Yet, despite these longstanding recommendations, nurses who remain central to care coordination across the country continue to be underrepresented in efforts to improve heart health. This moment therefore presents an important opportunity for nurses not only to lead team-based models of care, but also to address interconnected cardiometabolic conditions such as hypertension, diabetes, and dyslipidemia, whose combined effects substantially increase the burden of heart disease.
Drawing on Boykin and Schoenhofer’s Nursing as Caring, we recognize that people are inherently caring, and nursing is the commitment to nurture that caring in moments of vulnerability. Watson’s Theory of Human Caring further invites nurses to create transpersonal caring moments amid alarms, serving medications, and managing discharge planning. Bringing these philosophical paradigms into care is only possible through a team-based approach, given its potential to inspire transdisciplinarity into care and unite multiple perspectives in the service of the patient.
Yet, often, the role of nurses is limited to participation rather than leading. Therefore, these theories suggest that, to achieve intentional nurse leadership in care spaces, we must transform care environments and address structural constraints, including scope-of-practice regulations, institutional restrictions, and policies that limit the full expression of caring. Nurses must be recognized not just as implementers of care, but as designers of care models, not just contributors, but leaders in research, and not just participants in teams, but shapers of how teams function. This shift is not about hierarchy; it is about alignment, reorganizing care to make use of nursing’s holistic, person-centered perspective and fit the needs of a health system grappling with the complexity of chronic disease.
There is also a moral dimension to this call. When systems prioritize efficiency over connection, throughput over presence, and metrics over meaning, the risk is not only poor outcomes, but the erosion of care itself. Nurse-led team-based care models counterbalances this within heart disease management. It supports the paradigm that quality of care is not only measured in patient outcomes, but in whether individuals feel seen, supported, and empowered in managing their health.
The integration of community and practice is particularly critical in this moment. Too often, these domains exist in parallel rather than in partnership. Community-based interventions are often positioned as supplementary, while clinical care is treated as central to healthcare delivery, given its immediate impact on patient outcomes. Nursing disrupts this divide. Nurses work across these spaces, create continuity to ensure that what is taught in clinics is lived in communities, and that what is experienced in communities informs clinical decision-making. This bidirectional flow is the foundation of sustainable care for patients with chronic conditions.
To answer this clarion call, nursing must also invest in knowledge generation. Research on a team-based approach to care must reflect the realities of diverse populations, incorporating cultural, social, and structural determinants of health. Nurses must lead research that asks not only what works, but for whom, in what context, and why, on the journey to equitable healthcare.
The heart disease crisis is not solely a clinical challenge; it is a test of how the discipline of nursing understands itself. It is a test of how healthcare workers can convene and leverage shared expertise for the common good of the populations we serve!
A moment to reimagine team-based care not as a redistribution of tasks, but as a transformation of provider-patient relationships and roles. A moment to center nursing knowledge as essential to addressing one of the most pressing health challenges of our time.
About Thomas Hinneh
Thomas Hinneh is an early-career cardiovascular nurse scientist from Ghana, where his lived experiences shaped his commitment to addressing the growing burden of cardiovascular disease.
He began his career in nursing in 2013, graduating with a Bachelor’s degree in Nursing at the Kwame Nkrumah University of Science and Technology. After working for over 5 years, Thomas was awarded multiple prestigious global scholarship including the Chevening scholarship. Australia Africa Award, Commonwealth Shared Scholarship, and German Exchange program for development-related postgraduate programs (DAAD). He received an advanced master’s degree in International Health in Germany from Heidelberg University and a master’s degree in Nursing in the United Kingdom from Dundee University. He later completed a PhD in Nursing at Johns Hopkins University.
Throughout his career, Dr. Hinneh has led several nurse-led hypertension programs, managing patient care and coordinating clinical teams to improve cardiovascular outcomes. In 2021, he received funding from Pharmacists Without Borders in Germany to lead a health systems–level cardiovascular risk management program in primary healthcare facilities in Ghana. He has trained more than 100 healthcare providers in hypertension management and team-based care.
During his service with the Ghana Health Service, he held multiple leadership roles, including Deputy Nurse Manager, Quality Improvement Lead, Head of the Outpatient Department, Chairman of the District Nurses and Midwives Association, and Head of Public Health Services. He is also the co-founder of the HI Foundation, a nonprofit organization focused on community awareness and prevention of cardiovascular diseases.
Dr. Hinneh has received several awards, including recognition from the American Heart Association and the Preventive Cardiovascular Nurses Association. His work is centered on advancing cardiometabolic risk prevention through community-based initiatives and health systems strengthening.