Medical City Dallas sets record with 11-minute door-to-balloon response time for cardiac care
When it comes to heart patients, the operative word is “fast.” And at Medical City Dallas, they’re breaking records for quick, effective treatment.
The emergency team at Medical City Dallas has been working to improve times for all patients with a particular focus on heart patients. Staff has been working with the American Heart Association through the Dallas Caruth initiative to speed times from intake to procedure. This initiative has played a large role in getting everyone on the same page, says Kim Patterson, RN Supervisor of Emergency Services and Chest Pain Center Coordinator.
“We began in November 2011 with an education process from the AHA, where they worked with our EMS teams,” Patterson explained. “EMS calls with the patient report, transmits the EKG via LifeNet from the field, and transitions the patient immediately to the cath lab. This process ensures the hospital has a clear picture of the patient before they even arrive.”
From there, the internal team jumps into action. A one-page system alerts the cath lab team and the interventional cardiologist. When the patient hits the ED doors, the ED physician, nurse and tech complete a rapid assessment for three to five minutes before moving the patient to the cath lab while on the EMS stretcher.
“The cardiologist meets the patient in the cath lab, the patient is placed on the table and the procedure starts,” Patterson said. “For these patients, time is a critical concern and a streamlined process leads to better patient outcomes.”
Some estimates put the national door-to-balloon average at around 90 minutes, while Medical City’s average is/was? 60 minutes. As the new process and procedure fell into place those times dropped steadily into the 20 minute range, and even down to as low as 13 or 14 minutes. Then came what Patterson calls “the perfect storm.”
The Medical City team is used to speedy procedures, but even they were taken by surprise with this one.
“The patient had two prior heart attacks,” she said. “He knew what was going on, so he called 911 immediately. Upon the EMS phone call from the field the ED activated the Code STEMI team. The patient remained on the EMS stretcher to the cath lab, and the vessel was opened in a record 11 minutes.”
“Our door-to-balloon times are consistently improving, and it has been phenomenal to see this transition,” Patterson says. “Before, patients would stay in the emergency department for 30 minutes, the cardiologist would see the patients in the ED, review the EKG, and that took a while as well. Now we’re just in the ED long enough to stabilize, and it’s straight to the cath lab. Everyone has really been on board with this, and the process has worked tremendously. We are really proud of how we improved patient care, and are so grateful to the AHA and Dallas Caruth for instituting the program.”
The Medical City Dallas team would like to extend a special thank you to the Caruth family, Russell Griffith and Leilani Stuart Directors of Dallas Caruth Grant-American Heart Association Southwest Affiliate.