BlueStem Cardiology/Jane Phillips Hospital Excel at Acute Heart Attack Care

The first few minutes of care of an acute heart attack are the most important. A heart attack is caused by one of the blood vessels, coronary arteries, that supply the heart becoming occluded or blocked. When the coronary artery becomes plugged off the heart muscle that is supplied by that artery starts to under go damage. If the artery can be opened quickly enough, the damage is minimized. The best way to achieve this result is to take a patient with an acute heart attack as soon as possible to the cardiac cath lab and open the artery with a balloon and stent.

A national initiative begun by The American College of Cardiology one year ago, is termed “Door to Balloon” with acronym of D2B. The goal for Cardiologists a few years ago was to try to open the artery within two hours or 120 minutes. The new D2B initiative set a more aggressive goal of 90 minutes from the time the patient arrived in the emergency room until the time the artery is opened in the cath lab. To get this to happen, the EMS crews on the ambulances, the Emergency Room Physicians, the Cath Lab personnel and Cardiologists have all had to work closely together.

BlueStem Cardiology and Jane Phillips Hospital enrolled in the D2B program when it launched last year. Our results have been excellent. The first four months of 2009 have seen 13 people arrive in the emergency room that fit the criteria of an acute heart attack according to the D2B protocol. The average door to balloon time has been well below the 90 minute target and in fact has been 56 minutes. The longest door to balloon time was still well within the 90 minute national goal at 72 minutes. 

Jane Phillips Hospital and BlueStem Cardiology have participated in the NCDR (National Cath Lab Registry) data since they have been collecting data 10 years ago. Jane Phillips was involved in the initial study comparing the smaller hospitals to the larger city hospitals. A somewhat surprising result was noted at the end of the study last year, in that the smaller hospitals actually had a better outcome primarily driven by the fact that the time it took to get a patient through the emergency room into the cath lab was shorter in the smaller, well run hospitals like Jane Phillips.

Improving the quality of care for acute heart attacks is an ongoing process at Jane Phillips Hospital and involves our ambulance crews, emergency room physicians, emergency nurses, Cath lab personnel and BlueStem Cardiologists. We are committed to continue to have excellent results and even improve wherever possible.  The next step in this process is to improve the time that it takes for the patients to get from home to the cath lab. This is actually a joint effort between the American College of Cardiology and American Heart Association called “Mission Lifeline.” Stay tuned for results.

DeFehr Attends Health Care Reform Conference

May 2009 -- Washington DC

Dr. Stan DeFehr of BlueStem Cardiology recently attended the first of three upcoming conferences focused on the issues facing medicine in today's climate. As the American College of Cardiology Governor, DeFehr attended a recent conference on health care reform in Washington DC, and will also be attending an ACC legislative session also on health care reform in September, as well as the National ACC Scientific Session at the end of March.