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NUMC’s Level I program sees outstanding outcomesWhen a heart attack patient calls 911 and is taken to the emergency department there are many things that need to happen in quick succession to increase that person’s chance of a long-term successful outcome with minimal heart damage and being able to resume a good quality of life. In the fourth quarter of 2006, New Ulm Medical Center did all those things exactly right for every patient. Since late 2003, NUMC has participated in the Level I program, which is a set of protocols for treating patients experiencing a certain kind of heart attack that focuses on getting them to the cardiac catheter lab at Abbott Northwestern Hospital in the timeliest manner possible. “The goal of the program is to open up and restore circulation through the blocked vessel(s) within 120 minutes of an individual’s arrival to the emergency department,” said NUMC Emergency Department Manager Julie Halvorson, RN. There are 33 hospitals in the state that are part of this program, in cooperation with Abbott Northwestern Hospital (ANW) in Minneapolis and the Minneapolis Heart Institute. “The clock for a Level I patient starts when they arrive at our emergency department,” explained NUMC President Lori Wightman. “The clock stops when that vessel has been opened up at Abbott.” The participating hospitals are broken into “zones” based on their distance from ANW. New Ulm Medical Center is in Zone 2, which means it is 60 to 200 miles away from ANW. The average time for Zone 2 hospitals in fourth quarter 2006 from “door to balloon” was 118 minutes, Halvorson said. “For New Ulm Medical Center, our average time was 105 minutes,” Halvorson said. “Our quickest time overall has been 80 minutes.” The median time for Zone 1 hospitals – those within 60 miles – is 95.5 minutes. “So that’s telling you that even in out state Minnesota if you go to a hospital who is participating in the Level I program you’ll receive the same care in about the same amount of time as you would if you were in the Twin Cities when you had your heart attack,” Halvorson said. Wightman marveled at the teamwork that has to occur in order for this kind of quick action to take place. “This doesn’t happen magically – it starts with the ambulance crew and continues with the emergency room physicians, nurses and technicians, lab and radiology departments, our plant operations staff, the helicopter crew and the medical specialists up at Abbott Northwestern,” Wightman said. “What these numbers say to me is that if you are a person having chest pain and you come to our emergency department immediately, you will be given world class treatment,” Wightman said. Another piece of Level I program that is tracked is how often heart attack patients are given the right medications when they arrive at the emergency department with a heart attack. “Abbott Northwestern and the Minneapolis Heart Institute have devised a specific protocol for the medication that is to be given to a heart attack patient,” explained ER physician Mark Rorem, MD. “This protocol is based on what we know is the very best treatment being delivered across the country.” The protocol calls for three steps that must be done immediately to help improve the patient’s outcome. The first thing is to thin the patient’s blood in two ways: by administering anti-platelet medicines (aspirin or plavex), and medications that decrease the amount of blood clotting proteins. The second step is to control the heart beat with a beta blocker. The third step is to open the artery as quickly as possible with either blood clot-dissolving medications, which can be administered at NUMC, or through angioplasty (performed at the catherization lab at ANW) or both. Best of practice supports these measures. For the fourth quarter of 2006, NUMC statistics showed that 100% of the heart attack patients in the emergency department received the recommended medications every time. “That was the best score in either zone for fourth quarter,” Wightman said. Since the start of the program, NUMC has cared for a total of 25 Level I patients; eight of those were in fourth quarter of 2006. |
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New Ulm Medical Center
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