Rapid Care for Heart Attacks - Genesis Consistently Outperforms National Standards  (Posted 12/11/06) 

As a Vietnam veteran, Joe Chenoweth of Davenport knows the importance of teamwork, speed, and precision in combat. 

As a veteran of two heart attacks, he also knows the teamwork, speed and precision of the heart and emergency experts at Genesis Medical Center, Davenport. 

Last week when the nation's leading heart agencies called for faster response times for heart attack victims, Chenoweth read the news accounts with interest.  That's because the Genesis response time for his November 8 heart attacks was 65 minutes faster than the national standard of care. 

Less than a third of hospitals across the nation make the 90-minute standard of care set by the American College of Cardiology.

It only took 25 minutes from the time Chenoweth, 57, entered the Genesis Emergency Department and was treated by Ann Kandis, M.D., to the time that cardiologist Peter Sharis, M.D., opened his blocked artery.  That's called "door-to-dilation," and the median has improved impressively since Genesis instituted a heart attack alert system in June 2004.  

"Genesis has great heart care.  I should know after surviving two heart attacks and at least eight stents," Chenoweth said. 

"During my second heart attack, I remember my chest really hurting and hospital staff wheeling me out of the emergency room to the Cath Lab and cutting my clothes off as they were running.  I remember the needle sticking into my groin before the drugs that knocked me out took hold.  That's how quickly everyone responded." 

A National Leader
With 176 heart attack alerts under its belt, Genesis Medical Center, Davenport, has earned a median response time of 56 minutes, considerably faster than the national standard of care.  The Genesis record is 17 minutes, set on November 7 when a 68-year-old woman began having chest pains, and after several minutes, mustered the strength to call a relative for help. 

"I was in the Genesis emergency room for such a short time," said the woman, who asked that her name not be used.  "My husband said they literally ran me down the hall to the catheterization lab.  You see in on T.V. all the time, but I've never seen it done in real-life before." 

The 2004 creation of the Genesis alert coincided with aggressive national guidelines - issued by the American Heart Association and American College of Cardiology - for treating ST elevation myocardial infarction, or STEMI. 

"Every minute counts for this form of heart attack, and the Genesis alert is designed to facilitate faster treatment," said Cindy McGee, Nurse Manager of the Genesis Catheterization Lab in Davenport.  "Genesis is exceeding national benchmarks that most hospitals are not even approaching." 

Chenoweth not only credits Genesis staff but the emergency medical technicians (EMTs) in the field who responded first to his heart attack. 

How The Alert Works
Responding to a 911 call, EMTs from MEDIC Emergency Medical Services advise the hospital's Emergency Department of a potential heart attack alert whenever a 12-lead electrocardiogram shows a "ST-segment elevation."  such a reading indicates a heart attack in progress and an urgent need for emergency angioplasty. 

"The EMTs are our eyes and ears in the field," said Richard Vermeer, D.O., Medical Director of the Genesis Emergency Department.  "Their role is crucial, particularly because many times precious time is lost when people postpone calling 911 at the onset of heart attack symptoms."  

Genesis' M.I. Alert simultaneously the Emergency Department, Cath Lab and affected hospital departments, including Nursing, Lab, Pharmacy, Respiratory Care, Spiritual Care, and Security.  (M.I. stands for myocardial infarction, or heart attack.)  The hospital begins responding before the patient even arrives.  The Genesis Medical Center, Illini Campus instituted a heart attack alert process last summer. 

"With the M.I. Alert, the Cath Lab is aware much sooner that a patient is on the way," said McGee.  "Out timeline is to have the patient in the Cath Lab and have his or her artery open within the national standard of 90 minutes or less.  Since the M.I. Alert, we're pleased to see our median time has decreased to 56 minutes."

The best way a heart attack victim can improve his or her chances for survival and quality of life after a heart attack is clear, she says:  "Call 911 immediately when you notice symptoms.  Don't delay, and get to a hospital that has a Cardiac Cath Lab team and can open the arteries sooner and save heart muscle.  Genesis Medical Center, Davenport, is able to provide the highest level of care to a person having a heart attack." 

The Genesis Cardiac Catheterization Lab in Davenport is ranked among the largest interventional heart programs in the U.s. 

-- by Linda Barlow, Genesis 

Ahead of the Curve
Last week, the American Heart Association and the American College of Cardiology urged the nation's hospitals to implement six evidence-based strategies to speed heart attack response times.  Genesis has had these in place for more than two years: 

* Having emergency medicine physicians activate the catheterization (cath) lab
* Using a single call to activate the cath lab
* Having the cath lab team arrive and be ready within 20-30 minutes 
* Providing real-time data feedback in the emergency department and cath lab
* Having the commitment of senior management 
* Using a team-based approach spanning multiple departments 

Another optional recommendation, using pre-hospital EKGs to activate the process, is also part of the Genesis heart attack alert system. 

Genesis ranks in the 91st percentile nationally for heart attack response times, according to the American College of Cardiology.  Nationally, only 33 percent of patients have blockages cleared within the 90-minute standard.  At Genesis, 80 percent of patients have blockages cleared in less than 90 minutes.