Surviving a heart attack: It matters where you go for treatment

When you think you are having a heart attack, you need to make quick decisions. Your chances of surviving may depend on where you go for treatment, says a study published in the Annals of Internal Medicine. Researchers at Yale University found there are five factors that the most successful hospitals implement when treating heart attack patients:

Having cardiologists in the emergency department 24/7.
Holding regular monthly meetings between physicians and paramedics to review acute myocardial infarction (AMI) cases.
An emphasis on teamwork between physicians and nurses.
Staff who are encouraged to be creative in problem-solving.
Nurses who have specialized duties.

Hospitals that followed these five strategies doubled the 30-day survival rate for heart attack patients. The study also determined that only 10% of the 500-plus hospitals surveyed maintained even four of these five standards.

Piedmont's accreditations and outcomes

William Ballard, M.D., an interventional cardiologist and director of the Cardiac Network at Piedmont Heart Institute, says Piedmont implements all five of these strategies and has earned accreditations in chest pain and heart failure, both of which indicate a hospital’s success in treating heart-related conditions.

Piedmont Augusta, Piedmont Fayette, Piedmont Newnan and Piedmont Mountainside hospitals also have chest pain accreditation. Dr. Ballard attributes the successful accreditation to the hard work of an extensive team. “These accreditations are so important because they standardize our approach, allow us to share outcomes and help us achieve the best result for the patient,” Dr. Ballard says. “We are also extending our network to more hospitals to improve the level of care and patient outcomes,” Dr. Ballard explains.

“We are already reaching out to hospitals that regularly send heart attack patients to us to help improve the transfer process.” Piedmont takes a “home to home,” approach, ensuring the best, most efficient care from the time a patient leaves his or her home with chest pain, arrives at the hospital for treatment and then returns home after treatment. This process includes a cardiac rehab plan for a comprehensive approach to patient wellness.

How a team prepares while you’re in the ambulance

While the patient is in the ambulance, EMS personnel can utilize electrocardiography (EKG) equipment and send results to the hospital while they are on their way. A nurse then reads the results and can activate Piedmont’s emergency cath lab so the team and an operating table is ready when the patient arrives. “This approach leads to better and more prompt care,” Dr. Ballard says.

Currently, the national standard is a 90-minute window from the time a patient arrives at the hospital with chest pain to the time a physician performs necessary procedures. Piedmont Atlanta consistently exceeds this goal with an average window of 50 minutes.

Piedmont’s commitment to teamwork

“We work with paramedics at local fire stations and have conducted EKG training,” Dr. Ballard says. “We go over our program in general so they can begin to interpret EKGs, and let our team at the hospital know what they see when the patient is in the ambulance.”

Piedmont’s emergency department physicians, cardiologists, nursing directors and EMS personnel meet monthly to review every heart attack case. “We work to think outside the box on approaches to speed up our processes and make them more efficient,” he says. “We want to more rapidly get to a diagnosis and more efficiently move the patient through care.”

An institutional approach

The key to the best outcomes for heart attack patients is a team approach. “Every single person is involved,” Dr. Ballard says. “Accreditation mandates that the entire institution, from the highest level administrators to the bedside care team to lab, transport, and patient education, just to name a few, are fully involved and invested in the best outcomes.

"It is this institutional commitment and our multidisciplinary team that make it work.” For more information on heart attack treatment, visit Piedmont Heart Institute.

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