This story originally appeared in IHI's 2007 Annual Progress Report.
At Charleston Area Medical Center (CAMC) in Charleston, West Virginia, one of the secrets to effective acute myocardial infarction (AMI) care
is to tightly link the entities that care for heart attack patients. “Patients go from the ambulance to the Emergency Department (ED) to the cath lab to the floor,” says Dale Wood, Vice President of System Improvement and Chief Quality Officer. “That continuum of care needs to be very tight.”
Wood says that CAMC’s AMI improvement team, which included input from all of those entities, examined in detail the processes that occur as a patient passes through these areas, and identified opportunities to improve.
“It starts on the front end,” says Wood. “We learned that the ambulance company can send an EKG to the ED before the patient even gets there. Physicians have indicated that they can use this EKG. That really helps the emergency providers get things started faster.” The cath lab is alerted as well, and a special page goes out to cardiologists that distinguishes between an AMI patient and an AMI patient who needs to go to the cath lab. “They respond even faster to the cath lab patients because there is such a short time window.” Wood says the goal is for 100 percent of these patients to begin their cath procedure within 90 minutes of arriving in the ED. Ultimately the goal will be to shorten that time even further.