But to do it consistently for three consecutive years is unheard of. Until now.
Thanks to an innovative treatment protocol and teamwork between the staff at LDS Hospital, Alta View Hospital, Riverton Hospital, Park City Medical Center, several departments at Intermountain Medical Center, and emergency medical service responders, a medical milestone has been achieved: Every heart attack patient transported to and treated in the past three years at Intermountain Medical Center has received life-saving balloon therapy within 90 minutes. Most recently, a patient’s door-to-balloon time was 28 minutes.
What is a STEMI and how is it treated?
A STEMI heart attack is a high-risk medical emergency that’s caused by partial or complete blockage of a coronary artery, which supplies blood to the heart muscle. It requires rapid diagnosis and treatment because it has a higher risk of mortality and heart failure. Details on the treatment:
- A primary PCI, or percutaneous coronary intervention, is performed by opening the blocked artery and inflating a balloon in the artery.
- Time is crucial during this procedure because the sooner an artery can be opened, the less damage to the heart.
- The clock starts ticking once a patient presents to the emergency department at Intermountain Medical Center or any of its transfer hospitals (Jess, is that the right term? “Transfer hospitals” sounds odd. In stroke we say sister hospitals) in the region: Alta View Hospital, Riverton Hospital, LDS Hospital, and Park City Medical Center.
- Once admitted, the patient is assessed, prepped, and transferred to the catheterization lab at the Intermountain Medical Center Heart Institute. Doctors determine which artery is blocked and put a special wire down the artery to inflate a balloon that enables blood to flow again.
The average “door-to-balloon” time for STEMI patients at Intermountain Medical Center is 55 minutes, well below the national standard of 90 minutes. The fastest time recorded was 11 minutes.
“The system is so efficient that from the time a patient passes through the emergency department doors of any Intermountain hospital in the region and is transferred to Intermountain Medical Center and taken to the cath lab, 100 percent of those patients have had their artery opened in less than 90 minutes,” says Kent Meredith, MD, a cardiologist in the Intermountain Heart Institute. “The time is about the same as if they’d come to Intermountain Medical Center directly.”
The national average for patients who are transferred from another hospital is 145 minutes.
The success is due to the centralization of care at one center in the system, the education and experience of the region’s clinical and non-clinical staff, and the STEMI team’s dedication to excellence.
In the Intermountain Central Region, every hospital sends their patients to one catheterization lab, located at Intermountain Medical Center Heart Institute. “This allows the heart team with the best equipment, the most experience, and the most consistent approach to provide the best care,” says Don Lappé, MD, Chief of Cardiology at the Intermountain Heart Institute
“Our STEMI team is a multidisciplinary committee that includes doctors, nurses, cath lab techs, paramedics, hospital operators, administrators, and even non-medical people; we all play a role in this,” says Dr. Meredith. “We come together and look at every detail in the process. If we see a problem, we solve the problem. We streamline everything and get everyone involved.”
How do patients benefit from faster STEMI care?
Faster treatment of a heart attack reduces the incidence of heart failure, complications, and longer length of stay at the hospital. The results: Patients are able to resume their normal lives faster. “This is a complicated process to replicate 24/7, so doing it three years in a row among five hospitals is incredible,” says Dr. Lappé. “I know of no other process within a healthcare system that is as perfect as this process.”
He adds: “These results reflect the excellence of care delivered by the Intermountain Heart Institute not just for STEMI patients, but for any patients with heart problems. Only an efficient, effective, and collaborative team delivers this level of service. Our committed culture of excellence assures every patient at any Intermountain hospital is treated with excellent clinical care and service.”
EMS agencies that participate in the Intermountain STEMI protocol include Gold Cross Ambulance, Murray City Fire, Park City Fire, Salt Lake City Fire, Sandy Fire, and Unified Fire Authority. Members of those teams — and Intermountain’s STEMI team — were recently honored at a ceremony to recognize their three years of unprecedented excellence.
“Thank you for all you’re doing to provide excellent care to our patients and for helping us be a model of how care should be delivered,” said David Grauer, Intermountain Medical Center’s Administrator, at the ceremony. “Our 100 percent treatment rate is a remarkable achievement. I’m not aware of it happening at any other facility in the country on such a consistent basis for three consecutive years.”