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A federal reporting agency is recognizing ThedaCare
for consistently being one of the best health care systems in the United States
for quickly getting patients who are experiencing a heart attack through the
emergency department and into surgery.
"Patients who arrive at a ThedaCare hospital, or one
of our rural partner hospitals, have a better chance of getting the fastest
treatment for a heart attack versus 98 percent of all hospitals in the country!"
said Dr. Peter Ackell, cardiologist with Appleton Cardiology Associates. "‘Time
is muscle’ in the battle to survive heart attacks. People in the Fox Cities, and
Northeast Wisconsin, should be reassured that they live in an area that gets
high marks for cardiac care, and gets patients the cardiac treatment they need
faster than anybody in the area."
In early 2006, the American College of Cardiologists
endorsed a new 90-minute standard for door-to-balloon time – the time it takes
to treat a heart attack patient from his or her arrival in the emergency
department to surgery in the cardiac catheterization lab. This new timetable
provides patients, particularly those experiencing a ST segment elevation
myocardial infarction or STEMI heart attack, with the best chance for effective
treatment and recovery.
To better meet this updated standard, ThedaCare drew
on its quality improvement expertise and implemented a new process for cardiac
patients called Code STEMI. Utilizing Code STEMI, ThedaCare has restored blood
flow through a patient’s blocked artery in as little as 17 minutes, and
consistently performs the life-saving procedure well within the national
benchmark of 90 minutes.
These outcomes are now being recognized by the
National Cardiovascular Data Registry (NCDR), which measures cardiac-related
quality data. ThedaCare currently ranks in the 98th percentile of
hospitals nationwide, meaning it achieves outcomes matched by only 2 percent of
facilities across the country. Over the last full year, since the first quarter
of 2007, ThedaCare’s average percentile ranking has been 97.5. According to
NCDR, outcome data that meets or exceeds the 90th percentile are
recognized as "leading scores representing best practices."
ThedaCare also is listed 28th out of the
824 hospitals in the NCDR database. According to the NCDR, 96.2 percent of STEMI
patients at ThedaCare experience door-to-balloon times less than 90 minutes. The
Code STEMI process is resulting in improved outcomes, fewer complications, and
higher survival rates for heart attack patients.
"This is a testament to the doctors, nurses,
managers, and other staff, along with the area’s first responders and the
leaders of many rural hospitals," said Kathryn Correia, president of Appleton
Medical Center (AMC) and Theda Clark Medical Center (Theda Clark), and senior
vice president of ThedaCare.
"Our care was good before, but we did not have the
coordination we have now," said Cyril Walsh, MD, medical director of the
emergency department at AMC. "Because of that improved communication and
planning, our door-to-balloon times have improved dramatically."
When a patient arrives at a ThedaCare facility and is
experiencing chest pain, the Code STEMI process begins – quickly and
efficiently. ThedaCare also is working with area first responders, ThedaStar and
rural hospitals to ensure that the 90-minute door-to-balloon time is achieved
not only for patients at ThedaCare hospitals, but also those at other local
hospitals. Those other hospitals include ThedaCare’s New London Family Medical
Center and Riverside Medical Center, in addition to Shawano Medical Center, Wild
Rose Community Memorial Hospital and Berlin Medical Center.
"The Code Stemi program at ThedaCare has looked at
every aspect of care and how to speed up the process," said Dan Perrault, MD,
Emergency Room physician at Berlin Memorial Hospital. "We have easily cut our
times in half in our transfer of critical cardiac patients. I wish all of our
inter-facility transfers worked this well."
Over the Sept. 5 weekend, a patient arrived at
Shawano Medical Center, was flown by ThedaStar to Appleton Medical Center and
was in surgery at the cath lab in 63 minutes. Another patient arrived at
Riverside Medical Center in Waupaca and was in surgery at AMC 75 minutes later.
Both incidents surpassed national standards – even though they also included
medical transport.
This example details the story of one patient, who
arrived at New London Family Medical Center (NLFMC) and was flown by ThedaStar
to Appleton Medical Center (AMC), where there are state-of-the-art heart
catheterization labs. (Theda Clark Medical Center also has a state-of-the-art
heart catheterization lab.)
Event Elapsed Time
- Patient arrives at NLFMC 0 minutes
- Patient receives electrocardiogram (EKG) 3 minutes
- Physician reads EKG and diagnoses STEMI 7 minutes
- Code STEMI activated and ThedaStar helicopter 14
minutes
departs Theda Clark
- Helicopter arrives at NLFMC 26 minutes
- Patient transferred to helicopter and departs 38 minutes
- Helicopter arrives at Appleton Medical Center 46 minutes
- Patient prepped in catheterization laboratory 58 minutes
- Patient receives angioplasty treatment of blocked artery 77
minutes
"Many of our patients live outside of Appleton and Neenah, where
we have catheterization labs," Dr. Ackell said. "Yet these rural patients also
have access to this best care, through our partnerships with many outlying
hospitals and first responders." | 
