Yale Project Aims to Improve Heart Attack Care at Billings Clinic through Organizational Culture

ZACH BENOIT zbenoit@billingsgazette.com

With the help of Yale University and nine other like-minded hospitals, Billings Clinic hopes that an ongoing research project will help improve care for heart attack patients across the country.

Called Leadership Saves Lives, the two-year project is run by Yale’s Global Health Leadership Institute and looks at the organizational culture and structure of Billings Clinic and nine other hospitals across the country and how it relates to and can affect acute myocardial infarction care.

“The way that we’re doing it is by promoting organizational culture,” said Erika Linnander, a senior technical officer with the GHLI. “It’s proactive engagement with emergency medical services. Really, a lot of this is concerning getting teams working better together.”

At Billings Clinic and the other hospitals that means examining and gathering feedback from every employee level that might work with a patient, from nurses and physician assistants to physicians, department heads and managers.

“We want all people to have their voice heard without having to worry about what level they’re on,” said Dr. Brian Rah, an interventional cardiologist helping to spearhead the clinic’s involvement. “This is a big deal. A lot of people are invested in this. All these levels are necessary to take care of the patient and the goal at the end is to take the best care of the patient we can.”

How it works

The idea is to look at each level that in some way interacts with a patient and get all of the medical staff involved on the same page before a heart attack even happens.

Dr. Clint Seger, the clinic’s regional chief medical officer, said that coordination of AMI care is especially important in Montana, which has a more rural population and where patients often aren’t close to the care they need in the event of a heart attack.

That means coordination and streamlining of care among everybody involved can play a vital role in getting patient’s the help they need in the most timely way possible.

“It’s important to look at how we can help to improve care across the region, how to improve and streamline the system,” he said. “What’s really going to drive that cultural change is if everybody involved is on the same page.”

The project is about a year into its two-year lifespan, beginning in June 2014, and Yale representatives have been visiting the participating hospitals every six months to gather information.

The Billings fit

In late May, they visited Billings Clinic to interview employees — about 20 staff members are championing the effort locally — and hold workshops for them.

“We want to look at everyone who touches a patient and at getting that guiding coalition to really work together as a team,” Linnander said.

Representatives from all 10 hospitals and Yale will gather in Arizona at the end of the month to further discuss findings and what to do moving forward in the project’s final year.

The hospitals — which span the U.S., from New Hampshire to Florida to Arizona — were selected for the program in part due to their inclusion Mayo Clinic Care Network and include teaching and non-teaching organizations.

Rah said that Billings Clinic takes the project very seriously and hopes that it will improve on its level of care. With that in mind, the core group of staff working on the project meet regularly to evaluate and discuss their thoughts.

That’s important, Rah said, because the wide range of expertise brings with it a wide range of views and solutions that might otherwise be left unexplored.

“We are already doing very well in AMI care but our goal has always been to be the best in the nation,” he said. “There’s a lot of buy-in. We chose a core team here for a reason.”

Seger noted that other organizations around Montana are interested in how the program turns out and see potential in its findings.

“You can sense the intense interest in this,” he said. “People are inquiring about Leadership Saves Lives.”

Billings Gazette