What is a heart attack or acute myocardial infarction (AMI)?  A heart attack occurs when blood flow to a section of the heart muscle becomes blocked.  If the flow of blood isn’t restored quickly, the section of the heart muscle becomes damaged from lack of oxygen and begins to die.

 

 

 

 

Since 2004, all Baystate Health facilities have been publicly reporting processes of AMI care through the Hospital Quality Alliance (HQA).  This reporting helps to ensure that every patient who comes to BH with an acute myocardial infarction receives all appropriate interventions to reduce morbidity and mortality.  By working together, Baystate Health Ambulance (BHA) has helped Baystate Medical Center (BMC) to get to the top 10% of hospitals in the country for “door to reperfusion time.”  This refers to the time interval between ED arrival and receiving thrombolytics or undergoing a percutaneous coronary intervention (PCI-guidewire crosses the blockage in the artery).

 

Highlights

 

Baystate Health Ambulance 

• An early recognition and pre-hospital notification system has decreased the time between when an emergency call is received to when the patient receives appropriate AMI care:
  • The average time to ER notification of a STEMI (ST Elevation MI) after patient contact is 9.2 minutes, slightly elevated from the 2011 average of 7.2 minutes after patient contact but within the set benchmark of 10 minutes.
• Several pre-hospital care interventions have been put into place:
  • Obtaining a 12-lead ECG with interpretation on all chest pain complaints within 10 minutes of patient contact; average time to 12-lead ECG after patient contact is 8.7 minutes, slightly above the 2011 average of 6 minutes but within the set benchmark of 10 minutes
  • Completing a thrombolytic screen

When a possible STEMI is identified, the emergency department and the interventional cardiology team are notified. This allows time to prepare and assemble the appropriate personnel for thrombolytic therapy administration or primary PCI.  This system helps to decrease time-to-treatment by having key personnel on hand when the patient arrives at the hospital.  

 

Baystate Medical Center 

BMC continues to have outstanding compliance with guidelines for AMI care.  99.65% of patients with AMI received every recommended intervention.

• Interventions include:
  • Reliable use of aspirin and beta blocker medications on admission and at discharge.
  • Reliable use of ACEi/ARB medications for patients with reduced ejection fraction.  
  • Timely administration of clot buster medication or access to angioplasty. 100% of eligible patients received PCI within 90 minutes of arrival.
  • CMS risk-adjusted 30-day AMI mortality is better than the national rate;BMC is only one of 95 hospitals nationally to achieve this rating out of 4,569 hospitals.

 

Baystate Mary Lane Hospital 

• BMLH continues to have excellent compliance with the guidelines for AMI care, including reliable use of aspirin, beta-blockers, and ACEi/ARB medications for patients with reduced ejection fraction.
• BMLH uses comprehensive cardiac care worksheet in the ER as a guideline for initiating cardiac-related treatments.

 

Baystate Franklin Medical Center 

• BFMC continues to have excellent compliance with the guidelines for AMI care, including reliable use of aspirin, beta-blockers, and ACEi/ARB medications for patients with reduced ejection fraction.
• A protocol has been implemented with Baystate Medical Center for rapid treatment and transfer of patients with a particular kind of heart attack.

 

 

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For more information on Baystate’s Heart and Vascular Program

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