Setting the Pace for Heart Care

When Betty Marsh suffered a heart attack in rural Harrington, one hour west of Spokane, a new fast-track treatment program gave her the gift of time.

For heart attack victims, speed is everything.

“Because we live in a rural area, the clock is already against us,” says Tom Martin, CEO at Lincoln Hospital in Davenport.

That’s why Lincoln Hospital spearheaded a partnership with Sacred Heart Medical Center. The new Cardiac Level 1 Program, whereby a patient suffering a heart attack can be whisked via a Northwest MedStar helicopter from Davenport to Spokane for immediate treatment, is now fully operational.

Recent research shows that fast diagnosis and early intervention at the nearest ER, combined with rapidly opening blocked arteries by performing coronary angioplasty, yields the best long-term results for heart attack victims. The treatment requires a catheterization lab staffed by a team of highly trained physicians and clinicians, something only one-third of all hospitals in the country offer, including Sacred Heart.

The idea of a Cardiac Level 1 Program may be new to Washington state, but it has been saving lives in rural Minnesota for the last couple of years. Medical teams from Lincoln Hospital and Sacred Heart visited there earlier this year to see the program in action.

“Along with 12 other critical access hospitals in the state, we received a grant from the Department of Health & Human Services to instruct our emergency physicians and nurses in national best practices for the care of cardiac patients,” Martin shares. The role of providers in the rural hospital is to do an EKG and offer aspirin therapy within 10 minutes of arrival so if a blockage is found, transport to Sacred Heart can be arranged immediately.

“This is an exciting new concept,” says Ralph Monteagudo, MD, chief of staff at Lincoln. “It is crucial for people to understand that driving 35-70 minutes with chest pain is difficult at best.” In fact, doing so is very risky, since something could happen en route.

Lincoln County residents experiencing chest pain need to know one very important thing: heading to Lincoln Hospital first can be the difference between life and death.

Betty's story
It was a spring afternoon when Betty, an active 62-year-old, felt what she thought was indigestion. When the pain went to her back, she knew she needed to get to the nearest hospital.

As Betty arrived at Lincoln Hospital, the Emergency Department team quickly recognized she was having a heart attack due to a clot stopping the flow of blood to the heart muscle.

Within minutes, Lincoln staff made the calls needed to initiate the new Cardiac Level 1 protocol which assures the helicopter team at MedStar and the Cardiac Catheterization Lab team at Sacred Heart are prepared to provide the right care at the right time.

While the medical professionals work for different organizations, they all have a single goal: the best outcome for patients.

“Dr. Panke and his team at Lincoln Hospital worked fast and knew exactly what to do,” Betty says.

She was quickly transported by helicopter to Sacred Heart. Her medical records already had been provided and once she arrived, the Cath Lab team immediately began the balloon angioplasty procedure. They inserted a catheter through an artery until it reached the blockage, and placed a stent to open the artery again for blood flow to the heart. She was then admitted to Sacred Heart’s cardiac intensive care unit for monitoring and discharged two days later.

Did the protocol work?

“Indeed it did,” says cardiologist William Stifter, MD, of Heart Clinics Northwest in Spokane, who sees patients monthly at the Davenport clinic and works closely with Lincoln Hospital.

Her experience illustrates the importance of rural hospitals and major medical centers working hand in hand to save lives when every minute counts. Within 93 minutes, Betty had been treated at Lincoln Hospital, transported to Sacred Heart, had her artery opened in the cath lab, and a stent inserted.

“We are meeting and exceeding our goal to provide optimal treatment for heart attack victims through this team approach,” says Dr. Stifter.

“This quality program is making an immense difference to heart attack patients,” says Michael Ring, MD, medical director of Sacred Heart’s cardiac services. “It allows us to deliver the most effective care to all who show up in our emergency room.”

Protocol forms the basis for success
It’s all about consistency. A standard protocol throughout the region is the foundation for the success. No time is wasted on determining how to intervene or where to pass on important information—it’s all standardized to save precious minutes at each step.

The Cardiac Level 1 protocol tracks 12 points of progress for each patient. Emergency room nurses, critical care transport teams, catheterization lab staff and physicians all provided input and have standardized the procedures needed at every step of the process, to optimize patient care.

All the cardiology groups in Spokane are on board with this program and the protocols to produce the best results for patients. Sacred Heart leaders recently hosted a workshop with other rural hospitals to expand the Cardiac Level 1 program to additional communities in eastern Washington.