First Impressions - Memorial Hospital of South Bend

TakingTimetheMoving at the speed of safetyThe quicker a heart attack patient’sheart resumes normal blood flow, thebetter his or her chances for recovery.Therefore, Memorial Hospital hasdeveloped a precisely coordinatedplan to treat such patients, particularlythose with the most severe heartattacks, ST elevation myocardialinfarctions (STEMIs).The American Heart Association (AHA)gold standard for STEMI treatment is apercutaneous coronary intervention(PCI). This is the quick, effective clearingof arterial blockage with an angioplastyballoon and subsequent reinforcementof the artery with a stent.Members of Memorial’s code STEMI team prepare a patient for a PCI intervention.The AHA timeframe for PCI is 90minutes from the time a patiententers the hospital to inflation of theangioplasty balloon, which clears theblockage and enables blood flow. Inother words, 90 minutes from “doorto-balloon.”The entire process hingeson quick, effective identification of aSTEMI patient and coordination amonga goal-oriented team.laying groundworkThe moment a possible heart attackpatient enters Memorial, an EKG andother tests are administered. If thepatient has a STEMI, he is prepared andthe lab and cardiologist are activated.The earlier the team activates, thesooner treatment can begin.Memorial has steadily worked towardconsistently meeting the AHA goal.“We have been fine-tuning our processwith great success. Our mortality ratesare lower than national levels and ouraverage time is 78 minutes,” explainsCatherine Bringedahl, R.N., managerof Memorial Hospital’s cardiaccatheterization lab. But this successwas just the beginning.raising the barFour years ago, Memorial rewrote thedefinition of effective care, nowfocused on what Keith Sherry, M.D.,medical director for EMS andHelicopter Services, terms “call-toballoon”times. The clock starts themoment 911 is dialed and stops whenthe angioplasty balloon inflates.The key of call-to-balloon? Localadvanced life-support ambulancesperforming EKGs in the field, longbefore patients reach Memorial. IfSTEMI is confirmed, the teamactivates while the patient is in transit.These patients average an impressive53-minute door-to-balloon time.taking flightIn 2007, Memorial broadened theprogram to patients at outlyingreferral hospitals (those without PCIcapability) via MedFlight, Memorial’sair medical transport service,beginning with the CommunityHospital of Bremen. The result? CodeSTEMI, an intricately coordinatedprogram utilizing MedFlight’scapabilities.“We stress moving at the speedof safety, with trust in the expertiseof our colleagues and withoutduplication of efforts,” explainsMedFlight Program Manager RodneyLogan, R.N.“Achieving STEMI treatmenttimeframes within AHA standards, evenfor patients transferred from outlyinghospitals, is a real accomplishment. It’ssolid proof of what’s possible withexcellent integration of multiple teams,representing different hospitals inseveral communities, all for the benefitof our mutual patients,” says Dr. Sherry.Thus far, Memorial has conducted threeCode STEMIs with the CommunityHospital of Bremen, the most recentclocking in at 81 minutes from theirdoor to Memorial’s balloon. •SPRING / SUMMER 2010 › www.qualityoflife.org011