Lisa Kohler, MD - AkronCantonMDNews

and nursing staff in contact with patients with symptoms
of ACS have certain core competencies and training.
Leadership and management may require additional core
competencies and training.
Process Improvement Orientation. CPU management
structure is based on continuous quality improvement
program principles to ensure quality patient care and
proper utilization of ED resources.
Organizational Structure and Commitment. The facility’s
administration, medical staff, and multidisciplinary
committee must make a commitment to the establishment
and support of a Chest Pain Center.
Community Outreach Program. An ED- or hospitalbased
community outreach program educates the public
to promptly seek medical care if they have symptoms of
an AMI, such as chest pain, chest discomfort, shortness of
breath, diaphoresis, syncope, and risk factors for coronary
artery disease, particularly smoking.
“The Society of Chest Pain Centers carefully evaluated
all of these things over a period of several months,” said Dr.
Litman. “In 2004 we received our initial accreditation. In
2007 we were re-accredited with a new designation as a chest
pain center with PCI (percutaneous intervention). This means
that Akron General is capable of acute interventions, such as
angioplasty and surgery, to open blocked arteries in patients
experiencing heart attacks.
Unlike traditional compliance-based models, the Chest Pain
Center accreditation process is based on a process improvement
methodology. The Society gives healthcare facilities the tools
to understand what their care processes are, to measure them,
to communicate about them across departments, and to make
strategic plans for their improvement.
“We constantly try to improve our process to improve
our treatment time,” said Thomas Lloyd, DO, medical
director of Akron General’s Chest Pain Center. “The goal
recommendations, from the American Heart Association
and from the American College of Cardiology, are to
effectively treat the heart attack in 90 minutes or less from
the time the patient comes through our door. We call this
‘door-to-balloon’ (D2B) time.”
Dr. Lloyd explained that only 35% of hospitals nationwide
have been able to achieve a D2B time of 90 minutes patients
presenting with AMI. In the past 6 months, however,
Akron General’s average has been 71 minutes. We are now
routinely treating many patients in less than 40 minutes.
“Every minute saved is heart muscle saved, and that makes
a difference in the patient’s quality of life,” he said. “If all
hospitals met these guidelines it would save an additional
1000 heart attack patients a year”.
Thomas Lloyd, DO, medical director of Akron General’s Chest
Pain Center
Both Dr. Litman and Dr. Lloyd credit teamwork and a
collaborative spirit for these impressive statistics.
“It takes a big team effort from the Emergency Department
which must be keyed into patients with chest pain, a
paramedic rescue service that works with the hospital,
interventional cardiologists and a cath lab team all of which
are willing to be on call and available within 20-30 minutes
of being called, technologists, nursing personnel . . . all are
important in making this work,” said Dr. Litman.
“We have really made great strides,” said Dr. Lloyd.
“Initially, I thought the 90-minute guideline was excessive
and too difficult to meet. But now that we’ve exceeded that,
I think that the guidelines can be reduced further. If you put
a system in effect to challenge that, you will meet it.”
For more information about the Society of Chest Pain
Centers and its accreditation process, visit the Society’s
website at www.scpcp.org. For more information about
Akron General Medical Center’s Chest Pain Center, call
1-800-362-2462 or visit www.akrongeneral.org.
GREATER AKRON/CANTON M.D. NEWS JANUARY-FEBRUARY 2008 | 39