R.I. Hospital model in fast heart-attack care

PROVIDENCE – A systematic effort to improve heart-attack care at Rhode Island Hospital has sharply improved response times and led the facility to be chosen as a national model by VHA Inc., a national health care alliance, which spotlighted the hospital at an event last month.
Time is critical when treating a heart-attack patient. The diagnosis must first be confirmed, then an emergency percutaneous coronary intervention is performed and blood thinners are administered, then the patient is taken to the catheterization lab, where a catheter and balloon are inserted in order to identify the blocked artery and then unblock it.
The time it takes from the arrival of the patient to the time the balloon is inserted is measured as door-to-balloon time (DTB) and is a critical factor in the outcomes of patients; in 2006, the Joint Commission on Accreditation of Healthcare Organizations, which accredits hospitals, set the standard at 90 minutes, down from 120.
Dr. David O. Williams, director of interventional cardiology at Rhode Island Hospital, in 2004 said the hospital was meeting the lower, 120-minute standard only about 40 percent of the time. But with new processes and the location of a new cath lab within the ED, the hospital now averages less than 70 minutes for DTB, placing it within the top 10 percent nationwide. •

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