September 10, 2008

Carle Foundation Hospital Becomes First Accredited Chest Pain Center in Central Illinois

September 10, 2008

Carle Foundation Hospital has received accreditation as a Chest Pain Center from the Society of Chest Pain Centers - a non-profit, international society whose mission is to reduce heart-related fatalities. Carle is the only hospital in central Illinois to hold this official designation.

"This accreditation further assures our patients that they have access to the most advanced heart care services available in central Illinois," said John Snyder, executive vice president and chief operating officer of The Carle Foundation. "Chest pain centers have shown that they can reduce the time it takes for a potential heart attack patient to see a physician. That is important since treatment is most effective during the early stages of a cardiac episode."

Carle Foundation Hospital's accreditation as a Chest Pain Center goes above and beyond the required standards to include a PCI designation (Percutaneous Coronary Intervention), a procedure commonly known as angioplasty to treat narrowed arteries of the heart. Carle is one of only seven Illinois hospitals to have a PCI designation.

Chest pain centers allow physicians to better monitor patients through a specialized observation setting, and help to educate the community about the risks of heart disease, said Benjamin Davis, M.D., emergency department physician and medical director of Carle Foundation Hospital's Chest Pain Center.

"Through our emergency department last year, we saw approximately 3,700 patients with acute coronary syndrome (those with chest pains and related symptoms)," Dr. Davis added. "We want to do everything possible so that patients who come to us with chest pain have successful outcomes."

Emergency Department Protocols

To help assure successful outcomes, Carle's emergency department uses a multidisciplinary, "protocolized" approach for treating patients with chest pain, Dr. Davis said. This involves collaboration between emergency medical service (EMS) providers, nurses, emergency physicians, cardiologists and hospitalists.

EMS providers are trained to recognize a patient with acute coronary syndrome and administer proven therapies, explains Dr. Davis. They also communicate with the emergency department to facilitate rapid evaluation once the patient arrives at the hospital. In some cases, EMS providers may even transmit an electrocardiogram (EKG), which records electrical activity of the heart, prior to arriving at the hospital.

Once a patient with chest pain arrives in the emergency department, either by ambulance or walk-in, triage nurses activate the Rule Out Myocardial Infarction (ROMI) protocol. This protocol facilitates nurses arriving promptly at the patient's bedside to start IVs, draw blood and initiate therapy. At the same time, a page is sent to a technician who promptly performs an EKG that is immediately read by an emergency physician.

"If it is clearly a heart attack, the cardiologist will be notified by the emergency physician within minutes of the patient entering the emergency department," Dr. Davis said. "The emergency physician and nurse will initiate any treatments to stabilize the patient. The patient will then be transferred to the catheterization lab for intervention, or if the diagnosis is still uncertain, will remain in the emergency department for further evaluation."

PCI Benefit to Patients

Carle Foundation Hospital's PCI designation, which accompanies its Chest Pain Center accreditation, is especially beneficial to patients, said Matthew Gibb, M.D., Carle Clinic division head of cardiology and medical director of the cardiac catheterization lab at Carle Foundation Hospital. PCI procedures are performed in a cardiac catheterization lab.

"As an interventional cardiologist, I have seen first hand the value of having a catheterization lab in terms of the procedures that can be done to save lives," Dr. Gibb said.

A more positive outcome for the patient is realized when the timeframe is short between when a heart attack is diagnosed and the time the patient is brought to the catheterization lab, Dr. Gibb added.

"Minutes can make a difference," he said. "There is 24-hour, seven-day-a-week coordination with the emergency department to bring patients to the catheterization lab in a short period of time. We're consistently at 60 minutes or less from the time a patient enters the emergency department to the time a procedure is performed in the catheterization lab."

An interventional cardiology team is on call 24-hours a day, seven days a week and can respond to cardiac emergencies within 20 minutes of notification, Dr. Gibb said. A 12-lead EKG system inside Arrow ambulances that allows EMS personnel to diagnose and communicate heart conditions in the field, allows the cardiology team to be notified before the ambulance even arrives at the hospital.

A Leader in Cardiac Care

Snyder said Carle's Chest Pain Center accreditation further complements the hospital's national recognition as a leader in providing superior cardiovascular services. The hospital has received five-star ratings for clinical excellence in the treatment of heart failure and atrial fibrillation from HealthGrades, the nation's leading healthcare ratings company. In addition to its five-star ratings, Carle Foundation Hospital is ranked among the top 10% of hospitals in the nation for cardiology services.

To become an accredited Chest Pain Center, Carle Foundation Hospital had to demonstrate excellence in several key areas. This accreditation shows that Carle has:

• Strong patient care outcomes.
• An Emergency Department that offers a full-spectrum of emergency cardiac care, including rapid diagnosis and fast-track treatment that often prevents a severe heart attack from occurring.
• Standardized care (or a common set of guidelines) for patients entering with chest pain.
• Cooperative relationships between cardiologists and Emergency Department physicians.
• An integrated relationship with local emergency medical services that links care processes for patients with symptoms of possible acute coronary syndrome.
• An emergency department program that minimizes delays in therapy treatments for patients with acute coronary syndrome.
• A program that monitors and evaluates low-risk patients to avoid the inadvertent release home of heart attack patients or those with unstable angina (chest pain or discomfort).
• A facility that is optimally designed to evaluate chest pain.
• A community outreach program that educates the public to promptly seek medical care if they have symptoms of a heart attack.

Carle Foundation Hospital, a 305-bed regional care hospital located in Urbana, Ill., offers a higher level of clinical service and technology than any area hospital, and serves as the area's only Level I Trauma Center and Co-Perinatal Center. With more than twenty-five departments including surgical, cardiovascular and neonatal ICUs, Carle Foundation Hospital joins with the Carle Clinic Association to provide services through the Carle Heart Center, Mills Breast Cancer Institute, and Carle Cancer Center. A full range of health-related organizations complete the Hospital system. Carle Foundation Hospital also places an emphasis on education and medical research with the goal of translating laboratory research into breakthroughs in patient care.