Rush University Medical Center is the first academic medical center in Chicago to be accredited a Chest Pain Center. Recent advancements in the treatment of heart attack have greatly reduced the deaths and disabilities from heat attacks, but successful treatments are time dependent and necessitate rapid initiation.
To earn Chest Pain Center accreditation by the Society of Chest Pain Centers, hospitals must meet or exceed a wide set of stringent criteria and demonstrate commitment to reducing the time it takes to receive treatment, and increase the accuracy and effectiveness of treatment in a coordinated process that can save lives.
One of the criteria of a Chest Pain Center is to significantly reduce the time it takes for a patient experiencing symptoms of a possible heart attack to see a physician, thus reducing the time to treatment during the critical early stages when treatments are most effective. In addition, hospitals must create more effective systems to get patients into the catheterization lab so a blocked coronary artery can be opened in the shortest amount of time. Another goal is to provide a specialized observation setting where physicians are better able to monitor patients when it is not clear whether they are having a coronary event. Such observation ensures that a patient is neither sent home too early nor needlessly admitted to the inpatient unit.
To achieve Chest Pain Center Accreditation, Rush has implemented numerous strategies. The Emergency Department now has a single tele-pager activation process that calls six health care specialists, including an interventional cardiologist and two additional cardiologists to the emergency room to quickly determine the accurate diagnosis and initiate treatment. This is a 24 hours-a-day, 7 days-a-week process and system. Unlike many hospitals, the Emergency Department staff has the authority to activate this process without a cardiologist’s consultation based on certain diagnosis criteria. In addition, Rush Emergency and Cardiology faculty and staff meet once a month to review cases and discuss potential improvements. These meetings also include personnel from the departments of Quality Improvement, Hospital Administration, and Nursing.
“Everyone knows their job and works together in a supportive, respectful team environment to rapidly make decisions,” said Dr. Yanina Purim-Shem-Tov, Chest Pain Center Medical Director and Emergency Medicine physician.
This rapid response has reduced the time it takes from the patient's arrival in the emergency department to receiving angioplasty, an artery opening procedure. The American Heart Association recommends "door to balloon time" be less than 90 minutes. Each 30 minute delay in restoring blood flow increases the one-year mortality by 7.5 percent.
"Rush is committed to improving hospital response to heart attack victims. Minutes can make the difference between life and death," said Dr. Gary Schaer, director of the cardiac catheterization lab.
The accreditation process required close coordination between Rush’s Emergency Department, Cardiology, Pharmacy, Internal Medicine and other departments throughout the medical center. To coordinate and implement the Chest Pain Center, Rush created a multi-disciplinary leadership committee consisting of physicians, nursing leaders, pharmacy, security, environmental services and others.
However, even with advancements at hospitals, patients must still quickly recognize the signs and symptoms of a heart attack. According to the Society for Chest Pain Centers, patients wait too long after the onset of heart attack symptoms before seeking medical care. Accordingly, Rush is committed to teaching the public to recognize and react to the early symptoms of a possible heart attack.
Heart attacks are the leading cause of death in the United States, with 600,000 dying annually of heart disease. More than five million Americans visit hospitals each year with chest pain.
“This is a great accomplishment for our team. We strive to be leaders in the management of acute coronary symptoms within the Chicago community. This achievement is consistent with our commitment to quality and is a testament to the whole team which has been working tirelessly to achieve this important milestone,” said Dr. James Calvin, chief, section of Cardiology at Rush.
The Society of Chest Pain Centers is a patient-centered professional society based in Columbus, Ohio with a focus on heart disease and a mission of educating the public and healthcare professionals on the importance of rapid diagnosis and treatment of those experiencing chest pain. The Society promotes evidence-based medicine, delivered through a Chest Pain Center model that addresses the diagnosis and treatment of acute coronary syndromes, acute heart failure, and promotes the adoption of process improvement science by healthcare providers.