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 September 22, 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 September 22, 2014).

Share This



More Health & Medicine News

Monday, September 22, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Liberia Pleads for Help to Fight Ebola

Liberia Pleads for Help to Fight Ebola

AP (Sep. 22, 2014) Liberia's finance minister is urging the international community to quickly follow through on pledges of cash to battle Ebola. Bodies are piling up in the capital Monrovia as the nation awaits more help. (Sept. 22) Video provided by AP
Powered by NewsLook.com
Ebola Doctor Says Border Controls Critical

Ebola Doctor Says Border Controls Critical

AP (Sep. 22, 2014) A Florida doctor who helped fight the expanding Ebola outbreak in West Africa says the disease can be stopped, but only if nations quickly step up their response and make border control a priority. (Sept. 22) Video provided by AP
Powered by NewsLook.com
Global Ebola Aid Increasing But Critics Say It's Late

Global Ebola Aid Increasing But Critics Say It's Late

Newsy (Sep. 21, 2014) More than 100 tons of medical supplies were sent to West Africa on Saturday, but aid workers say the global response is still sluggish. Video provided by Newsy
Powered by NewsLook.com
Sierra Leone in Lockdown to Control Ebola

Sierra Leone in Lockdown to Control Ebola

AP (Sep. 21, 2014) Sierra Leone residents remained in lockdown on Saturday as part of a massive effort to confine millions of people to their homes in a bid to stem the biggest Ebola outbreak in history. (Sept. 20) 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