St. E, Yale target inpatient heart attack deaths

Photo: Provided
D.P. Suresh, Community Recorder guest columnist

St. Elizabeth Healthcare is fortunate to be part of a groundbreaking study looking at how to reduce inpatient heart attack deaths by influencing organizational culture. For this study, inpatient heart attack deaths means someone dies while in the hospital following a heart attack.

Leadership Saves Lives is a two-year project involving health systems across the country sponsored by Yale Global Health Leadership Institute. St. Elizabeth is joined in this venture by nine other Mayo Clinic Care Network members.

St. Elizabeth is the only health system in the region participating in this study, the first of its kind to look at how organizational culture affects patient outcomes. It’s unique because of its use of quantitative and qualitative data – which is uncommon in medical studies.

Kentucky ranked 43rd worst among U.S. states for cardiovascular deaths from 1990-2014, according to America’s Health Rankings. Ohio was No. 40 and Indiana No. 39. That same organization recently released its annual report that rated Kentucky 44th worst in healthy behaviors, determinants and outcomes. Ohio is No. 39 and Indiana No. 41.

Heart disease is, of course, the leading cause of death in the United States for men and women.

The Yale study’s goal is to learn how patients, family members, emergency medical technicians, emergency room personnel, physicians, nurses, pharmacists, health care administrators and others can collaborate to provide the best care and best outcomes possible.

Community education is a key component.

One example: If you experience heart attack symptoms, it is important you know you should call 911 immediately. We can’t stress enough the positive benefits of that.

According to a St. Elizabeth timeline evaluation, more than 50 percent of heart attack patients do not call 911 and arrive by car rather than by life squad, and they are waiting an average of nine hours before they seek care (either calling 911 or driving themselves to the emergency room). Making that 911 call – and making it sooner – can be a life-saving decision.

The Yale study, co-sponsored by The Medicines Company, will likely be completed next summer. But we’ve already learned why organizational culture is so important. As Dr. Victor Schmelzer, my colleague and medical director of the St. Elizabeth Healthcare Heart and Vascular Institute, says: It starts with a committed administration that supports innovation and fosters a collaborative environment.

Some examples of what’s ahead:

• St. Elizabeth Healthcare will work with community EMS providers to improve information received from emergency medical services prior to arrival at the hospital. St. Elizabeth is securing a grant to purchase software to support Pulsara, new technology that will enhance EKGs transmitted from EMS personnel to hospitals prior to patient arrival.

• EMS and St. Elizabeth staff will meet regularly to review processes of care, seeking opportunities for continued improvement.

• We will increase community education initiatives, including an enhanced focus on the importance of timely response to symptoms and the importance of calling 911.

• We will increase pharmacy involvement in care of heart attack patients.

• We will continue to identify and implement new technology. One example is the recent implementation of PulsePoint, a bystander CPR activation app.

St. Elizabeth has established a goal of reducing heart-related deaths by 25 percent in Northern Kentucky within 10 years of opening the Heart & Vascular Institute last spring.

Participating in this study and developing actionable items is just one of many ways in which we will continue to improve the health of our community today and in the future.

Dr. D.P. Suresh is medical director of St. Elizabeth Physicians Heart & Vascular

Cincinnati Enquirer