Featured Research

from universities, journals, and other organizations

Coordinated system helps heart attack patients get treatment faster

Date:
June 28, 2011
Source:
American Heart Association
Summary:
A new report finds a U.S. statewide coordinated care system reduced transfer times between hospitals for heart attack patients needing emergency angioplasty to open blocked heart arteries. The researchers compared how long it took to transfer patients from smaller facilities without emergency angioplasty capabilities to hospitals with them, before and after a statewide patient transfer program was instituted. EMS crews had a particularly strong impact on improving coordination of patient care.

Coordinating care among emergency medical services (EMS) and hospital systems significantly reduced the time to transfer heart attack patients to hospitals providing emergency coronary angioplasty, according to research reported in Circulation: Cardiovascular Quality and Outcomes, an American Heart Association journal.

Researchers examined "door-in-door-out" times at North Carolina hospitals among 436 patients experiencing ST-elevation myocardial infarction (STEMI) ― the deadliest form of heart attack when the blood supply is blocked to a large area of the heart.

STEMI patients generally need coronary angioplasty, or percutaneous coronary intervention (PCI), to open blocked coronary arteries. PCI within 90 minutes of first medical contact can improve outcomes and is recommended by American Heart Association/American College of Cardiology guidelines.

The researchers compared how long it took to transfer patients from smaller facilities without the ability to perform emergency PCI to hospitals with such capabilities, before and after a statewide patient transfer program was instituted.

The study showed median door-in-door-out times decreased from 97 minutes before the program began to 58 minutes one year after the program was implemented. Emergency medical services (EMS), emergency departments and hospitals were all involved in the process and each helped reduce transfer times. However, care protocols implemented by EMS had the greatest impact ― a median time improvement from 138 minutes before to 44 minutes after.

"The work being done to coordinate what happens in hospitals and ambulances can make a big difference in getting people quicker treatment and saving more lives," said Seth Glickman, M.D., M.B.A., the study's lead researcher and assistant professor of emergency medicine at the University of North Carolina in Chapel Hill. "But with that said, more work is still needed to expand the integrated systems across the country and to further reduce time to treatment."

Every year in the United States, almost 250,000 patients suffer a STEMI. But only 25 percent of the country's hospitals are PCI-capable, meaning they have the facilities to perform emergency coronary angioplasty. During that surgical procedure, a balloon-tipped tube is threaded through an artery to the heart. The balloon is then inflated to widen the artery and restore blood flow.

For the study, researchers used data from the Reperfusion of Acute Myocardial Infarction in North Carolina Emergency Departments (RACE) program ― the only initiative aiming to optimize STEMI coordinated care procedures across an entire state.

Researchers surveyed 55 North Carolina hospitals without PCI capabilities, recording which of eight processes to improve efficiency were adopted as part of the statewide care coordination program. These improved processes included:

  • Administering an electrocardiogram (EKG) in the ambulance.
  • Training paramedics to recognize STEMI patients based on EKG results.
  • Having a single phone number to notify PCI-capable hospitals of an imminent patient transfer to their facility.
  • Having established protocols for treating and transferring STEMI patients.

Researchers determined associations between the number of timesaving processes adopted and how quickly patients were treated and transferred. Pre-hospital, emergency department and hospital processes were all independently associated with shorter door-in-door-out time for STEMI patients requiring transfer.

In 2007, the American Heart Association launched Mission: Lifeline to help develop integrated systems of care for STEMI patients across the nation. The association's guidelines recommend each community should develop a STEMI system of care that follows standards at least as stringent as those developed for Mission: Lifeline.

About 450 hospitals are part of Mission: Lifeline, designated as either "STEMI-referring" (those not PCI-capable) or "STEMI-receiving" facilities. In addition, more than 560 STEMI systems are registered with Mission: Lifeline, representing coverage of more than 57 percent of the U.S. population.

"This study provides further evidence of the importance of coordinated systems of care for quickly and appropriately treating heart attack patients," said Gray Ellrodt, M.D., vice-chair of the American Heart Association's Mission: Lifeline steering committee and chairman of the Department of Medicine at Berkshire Medical Center in Pittsfield, Mass.

"Of particular note is the important role of the EMS system ― their fast recognition and response to STEMI patients is crucial. It's one of the main reasons we urge anyone who thinks they may be having a heart attack to call 9-1-1 immediately, because getting them into the system of care quickly through EMS can literally mean the difference between life and death."

Co-authors are Barbara L. Lytle, M.S.; Fang-Shu Ou, M.S.; Greg Mears, M.D.; Sean O'Brien, Ph.D.; Charles B. Cairns, M.D.; J. Lee Garvey, M.D.; David J. Bohle, M.D.; Eric D. Peterson, M.D., M.P.H; James G. Jollis, M.D.; and Christopher B. Granger, M.D. Author disclosures are on the manuscript.

This study was supported by an award from the American Heart Association Pharmaceutical Roundtable. The RACE program was funded in part by Blue Cross and Blue Shield of North Carolina, Genentech and Sanofi Aventis.


Story Source:

The above story is based on materials provided by American Heart Association. Note: Materials may be edited for content and length.


Journal Reference:

  1. Seth W. Glickman, Barbara L. Lytle, Fang-Shu Ou, Greg Mears, Sean O'brien, Charles B. Cairns, J. Lee Garvey, David J. Bohle, Eric D. Peterson, James G. Jollis, Christopher B. Granger. Care Processes Associated With Quicker Door-In–Door-Out Times for Patients With ST-Elevation–Myocardial Infarction Requiring Transfer: Results From a Statewide Regionalization Program. Circulation: Cardiovascular Quality and Outcomes, 2011; DOI: 10.1161/CIRCOUTCOMES.110.959643

Cite This Page:

American Heart Association. "Coordinated system helps heart attack patients get treatment faster." ScienceDaily. ScienceDaily, 28 June 2011. <www.sciencedaily.com/releases/2011/06/110628163317.htm>.
American Heart Association. (2011, June 28). Coordinated system helps heart attack patients get treatment faster. ScienceDaily. Retrieved October 1, 2014 from www.sciencedaily.com/releases/2011/06/110628163317.htm
American Heart Association. "Coordinated system helps heart attack patients get treatment faster." ScienceDaily. www.sciencedaily.com/releases/2011/06/110628163317.htm (accessed October 1, 2014).

Share This



More Health & Medicine News

Wednesday, October 1, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Ebola Cases Keep Coming for Monrovia's Island Hospital

Ebola Cases Keep Coming for Monrovia's Island Hospital

AFP (Oct. 1, 2014) A look inside Monrovia's Island Hospital, a key treatment centre in the fight against Ebola in Liberia's capital city. Duration: 00:34 Video provided by AFP
Powered by NewsLook.com
Ebola Puts Stress on Liberian Health Workers

Ebola Puts Stress on Liberian Health Workers

AP (Oct. 1, 2014) The Ebola outbreak is putting stress on first responders in Liberia. Ambulance drivers say they are struggling with chronic shortages of safety equipment and patients who don't want to go to the hospital. (Oct. 1) Video provided by AP
Powered by NewsLook.com
Doctors Reassure Public Ebola Patient Won't Cause Outbreak

Doctors Reassure Public Ebola Patient Won't Cause Outbreak

Newsy (Sep. 30, 2014) After the announcement that the first U.S. patient had been diagnosed with Ebola, doctors were quick to say a U.S. outbreak is highly unlikely. Video provided by Newsy
Powered by NewsLook.com
TX Hospital Confirms Patient Admitted With Ebola

TX Hospital Confirms Patient Admitted With Ebola

AP (Sep. 30, 2014) Medical officials from Texas Health Presbyterian Hospital confirm they are treating a patient with the Ebola virus, the first case found in the US. (Sept. 30 Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins