Issue link: https://viewer.e-digitaledition.com/i/470290
are not on one. When we applied the Get with the Guidelines program at MetroHealth, we achieved in excess of 90 percent of patients who received blood thinners who actually needed them." "It's all about evidence-based measures and putting processes in place, and educating everyone — the doctors and nurses and staff and the patients them- selves — to make sure you meet those measures," says Robert Schweikert, MD, Chief of Cardiology at Akron General Medical Center. Akron General is home to Summit County's first accredited chest pain center. It also recently received Joint Commission recertification for heart failure. Over the past three years, since the Joint Commission surveyors' last visit, Akron General's mortality rate for heart failure patients has significantly dropped below the national average. "Our chief quality officer actually put it in terms of additional lives saved — we saved 17 more lives," says Dr. Schweikert. In addition to the protocols and pro- cesses, he attributes this to the efforts to educate patients — about their condition and ways they can combat it — through Akron General's stand-alone heart failure clinic. The clinic is led by a heart-failure- certified physician assistant and staffed by nurses who work with referring physi- cians to educate patients and keep them out of the hospital. "Like our mortality rates, our readmis- sion rates for heart failure patients are also better than the national average," Dr. Schweikert points out. "But when we specifically look at the people that make it into our heart failure clinic, the readmission rates are twice as good. The only challenge is getting physicians to refer and getting patients to comply. Our nurses in the clinic have done a good job of both." " W h en w e s e t a s t a n d a rd , w e s t r i v e f o r i m p r o v e m e n t . I f w e can't find anyone else to challenge u s, we ch a l lenge ou rselves," say s Ahmed El Ghamry Sabe, MD, Executive Director of Cardiovascular Ser vices at Mercy Medical Center in Canton and Medical Director of Mercy Heart Center. " T hat's t y pica l for Merc y and what we accomplished with our Emergency Chest Pain Center (ECPC) and the cath lab in our Emergency Department. For STEMI patients, we've shattered the national door-to-balloon benchmark of 90 minutes with a world record time of five minutes." Mercy's ECPC, co-directed by Dr. Sabe, was the first accredited chest pain center in the nation in 2003. Today, there are more than 400 across the country. Mercy was also the first, in 1998, to establish a cath lab in its ED. Unfortunately, the concept of an ED cath lab has not been adopted nationwide. In an effort to reverse this trend, Dr. Sabe and his colleagues presented 11 years of data at the American College of Cardiology 2013 annual meeting. "I waited until we exceeded 1,000 STEMI patients to compa re door- to-balloon times of those who were catheterized in the hospital's inpatient cath lab to those who were catheter- ized in the ED cath lab," Dr. Sabe says. "The median time saved for patients reperfused in the ED cath lab was 30 minutes. And it did reflect in mortality." In fact, when Dr. Sabe compared the mortality for one year, the benefit for the patients who were reperfused in the ED cath lab exceeded those in the hospital's inpatient cath lab by an average of 50 percent. "It saves lives. Having a cath lab in the ED saves time and saves lives." PHOTO COURTESY OF METROHEALTH, CLEVELAND OH William Lewis, MD, Chief of Cardiology and Director of the Heart & Vascular Center at MetroHealth Medical Center in Cleveland 8 | Cleveland/Akron/Canton MD NEWS ■ M D N E W S . CO M ■ M A R C H /A P R I L 2 0 1 5 COV ER FE AT UR E