The Heart Institute

EKGs from field lead to quicker intervention

user.org (User) — Mon, 12 Dec 2011 16:00:00 GMT

EKGs from field lead to quicker heart intervention

St. Joseph to honor EMS' Thursday for efforts in providing quick care, helping hospital to achieve Top 50 in Nation Award

Patients experiencing chest pain due to a heart problem have blockages cleared17 minutes faster, on average, at St. Joseph Medical Center, Reading, Pa., when the responding ambulance sends a wireless EKG from the scene to St. Joseph's Emergency Room.

For patients that can mean the difference between life and death, according to St. Joseph Emergency Medical Services (EMS) Liaison Michael Whalen.

�We always tell people who are experiencing chest pain to call 911 and, in looking at these response times, you can see why that is important," he explains. �The EMS crews in Berks are highly trained and they have the tools to give us what we need to prepare for every patient's arrival."

St. Joseph will honor all of the county's EMS crews for their efforts in providing swift care for patients, which was a key element in the hospital's recent selection as one of the nation's Top 50 heart hospitals. The event will be held in the Franciscan Rooms on the 2nd floor of the Bern Township Campus at 3 p.m. on Thursday, Dec. 15th.

[The Top 50 award was made by an independent firm, Thomson Reuters. Read more on the award here: http://www.thefutureofhealthcare.org/comments/204/blog.pl]

The wireless EKG system used in most area ambulances was donated by St. Joseph in 2008 and can transmit a detailed 12-lead electrocardiogram in mere minutes for diagnosis, long before the ambulance drives up to the emergency room with the patient. The EKG gives a comprehensive picture of the heart through a rhythm strip easily interpreted by the trained eye.

Such advanced knowledge, speedily supplied, allows hospital staff to act even more quickly once a patient enters the emergency room.

The hospital provided 30 monitors free to all county advanced life support (ALS) emergency medical services (EMS) which have compatible systems with the hospital. The project came about through the efforts of two doctors from Berks Cardiologists Ltd. who work in the Heart Institute at St. Joseph, Drs. Guy Piegari and Louis Borgatta.

Danyelle Whalen, a nurse and St. Joseph's Cardiovascular Patient Navigator, said treating the most acute heart attack patients � someone experiencing a ST-elevated myocardial infarction or STEMI � requires intense coordination of a multidisciplinary team, �including the 9-1-1 Center, EMS providers, Emergency Department physicians and staff, and cardiovascular physicians and staff," she noted.

She explains that each team member is �essentially part of a STEMI relay team which quickly and efficiently passes the patient through the continuum of care. Since our processes and actions are measured in minutes, quick treatment, which is so vital to reducing heart muscle damage, is achieved because of these smooth and practiced transfers," she explained.

She said St. Joseph, which is an accredited Chest Pain Center, works in partnership with pre-hospital providers to reduce time to recognition and treatment of acute heart attack patients in the field.

�As a team, we have effectively reduced time for STEMI patient treatment to 45 minutes, half the national recommendation of 90 minutes 'door-to-balloon' (from when the patient arrives at the hospital Emergency Department until the blockage is cleared)," she said. "That is something that we could not do without the active participation and responsiveness of the EMS professionals in Berks County and it was a significant contributing factor in our Top 50 Heart Hospital award."

Top 50 award on the nightly news

user.org (User) — Fri, 18 Nov 2011 16:00:00 GMT

Click on the link below for WFMZ's coverage

http://www.wfmz.com/news/Local-hospital-among-tops-in-US-in-cardiovascular-care/-/121458/4763368/-/nlbhimz/-/index.html

A Top 50 Heart Hospital

user.org (User) — Tue, 15 Nov 2011 16:00:00 GMT

St. Joseph Medical Center is named one of 50 Top Cardiovascular Hospitals in the U.S.

Thomson Reuters bestows award after studying data from more than one thousand hospitals

Reading, PA., November 15, 2011 -- St. Joseph Medical Center has been named one of the nation's 50 Top Cardiovascular Hospitals by Thomson Reuters.

The study examined the performance of more than 1,000 hospitals by analyzing outcomes for patients with heart failure and heart attacks and for those who received coronary bypass surgery and percutaneous coronary interventions such as angioplasties.

This year's winners were announced November 14th in Modern Healthcare magazine.

http://www.100tophospitals.com/top-cardio-hospitals/

�This year's 50 Top Cardiovascular Hospitals have continued to deliver excellent care and have been able to improve their performance in a tough economic climate," said Jean Chenoweth, senior vice president for performance improvement and 100 Top Hospitals® program at Thomson Reuters.

She continued: �The hospitals in this study have provided measurably better care and are more efficient than their peers, demonstrating incredibly strong focus by hospital leadership at a time when the healthcare system is steeped in volatility."

The study shows that 97 percent of cardiovascular inpatients in U.S. hospitals survive and approximately 96 percent remain complication-free, reflecting improved cardiovascular care across-the-board over the past year. The 50 Top hospitals' performance surpasses these high-water marks as indicated by:

> Better risk-adjusted survival rates (23 percent fewer deaths than non-winning hospitals for bypass surgery patients).
> Lower complications indices (40 percent lower rate of heart failure complications).
> Fewer patients readmitted to the hospital after 30 days.
> Shorter hospital visits and lower costs. Top hospitals discharge bypass patients nearly a full day sooner and spend $4,200 less per bypass case than non-winners.
> Increased use of internal mammary artery (IMA) for coronary artery bypass surgeries. Top hospitals have increased their use of this recommended procedure from 88 to 96 percent.

How St. Joe's became a Top 50 Heart Hospital?

According to Lori Shober, Director of St. Joseph's Heart Institute, St. Joseph has become a Top 50 Heart Hospital by having the right people and right processes in place and delivering care quickly.

"Unlike other illnesses or injuries, if you are having a true heart problem, making the right decision where to go for your care is the most important choice you make," Shober said. "So, first, if you are having chest pains, call 911 because pre hospital care is vital to quick diagnosis."

She continues: �Heart care continues with Emergency doctors who are on the receiving end of vital information from EMS providers and can quickly assess and stabilize the patient. Then our cardiologists, who use the latest techniques, even participating in clinical trials for medical equipment and procedures to determine their usefulness, diagnose the problem and determine the interventional plan. They then work in state-of-the-art interventional laboratories using the latest technology to diagnose and treat the patient. If the patient needs open heart surgery, the patient is referred to our Open Heart Team for care. And, finally, but not last, our doctors are supported in the Cath labs and in the hospital by staff who are highly trained and experienced in caring for cardiology patients."

�There will be people celebrating the holidays this year with their families and friends," Shober noted. "And they will be able to celebrate because they were treated by a team that, as this recognition shows, is among the elite in the nation when it comes to the best heart care treatment."

"We are honored by this designation and proud of our Heart Institute's commitment to quality service and role in helping to set national standards," said John R. Morahan, President and Chief Executive Officer of St. Joseph. �Being in the Top 50 in the nation recognizes our leadership position in bringing the best cardiovascular care to our region.

�We are very proud of this accomplishment," Dr. Lou Borgatta, a board certified cardiologist and a member of Berks Cardiologist, Ltd. said. "It is a result of the hard work and dedication of our physicians and staff, who strive every day to provide the best possible care for our patients. This recognition signifies what can be achieved when we focus on teamwork and offer patient-centered care."

The Thomson Reuters 50 Top Hospitals designation is the latest in a series of honors that recognize the quality of care provided by St. Joseph Medical Center. Recently, St. Joseph was acknowledged as a Blue Cross Center for Distinction for Cardiac Care, and, very recently, St. Joseph also was honored by Healthgrades for coronary intervention excellence in 2011 and with an award for the 'best patient experience.'

The study on which the Top 50 designation was based on evaluating general and applicable specialty, short-term, acute care, non-federal U.S. hospitals treating a broad spectrum of cardiology patients. Thomson Reuters researchers analyzed 2009 and 2010 Medicare Provider Analysis and Review (MedPAR) data, Medicare cost reports, and Centers for Medicare and Medicaid Services (CMS) Hospital Compare data. They scored hospitals in key performance areas: risk-adjusted mortality, risk-adjusted complications, core measures (a group of measures that assess process of care), percentage of coronary bypass patients with internal mammary artery use, 30-day mortality rates, 30-day readmission rates, severity-adjusted average length of stay, and wage- and severity-adjusted average cost

Thomson Reuters is the world's leading source of intelligent information for businesses and professionals. They combine industry expertise with innovative technology to deliver critical information to leading decision makers in the financial, legal, tax and accounting, healthcare and science and media markets, powered by the world's most trusted news organization.

National Heart experts at St. Joseph Symposium

user.org (User) — Wed, 23 Mar 2011 16:00:00 GMT

Nation's leading heart care experts to present at St. Joseph Symposium

There is a very good reason why some of the country's leading university experts in heart care will be presenting at the Heart Institute at St. Joe's this Saturday: To teach. And to learn.

Physicians from around the region are invited to our Fifth Annual Cardiovascular Symposium, this Saturday, March 26, featuring physician-to-physician clinical updates and presentations by leading physicians from the University of Connecticut, Columbia University, Penn State Heart and Vascular Institute, the University of Maryland and the St. Joseph Medical Center Heart Institute.

Presenters are:

Gary V. Heller, MD, FACC; topic is Non-Invasive Detection of CAD and Emphasis on Cardiac PET

Martin B. Leon, MD, FACC; topic is Catheter-based Aortic Valve Replacement: Is the future here?

Gerald V. Naccarelli, MD, FACC; topic is Atrial Fibrillation: New Information on an Old Disease

Robert A. Vogel, MD, FACC; topic is Lipid Update: NCEP ATP IV

Mayank R. Modi, MD, FACC; topic is CHF: Update on Guidelines

Alec B. Platt, MD, MSCE; topic is Sleep Apnea and Heart Disease

The symposium is being hosted by Andrew R. Waxler, MD, FACC

The conference has a waiting list, but for more information, call 610-378-2176.

Cardiac Electrophysiology. Leading-Edge Technology

user.org (User) — Mon, 21 Feb 2011 16:00:00 GMT

ST. JOE'S IS AT THE FOREFRONT of diagnosing and treating cardiac arryhythmias-rhythm disorders of the heart. We use sophisticated 3D mapping displays superimposed on patient CT Scan images to locate the tip of an ablation catheter in the precise area within the heart to be treated. These technologies, combined with the knowledge and experience of our board-certified electrophysiologist, have enabled new, more effective arryhythmia treatment. The result: better outcomes for our patients.

3D mapping and advanced cardiac electrophysiology treatment options are not a "someday." They're here at St. Joe's today. It's innovation at work. And it's one more reason why St. Joseph Medical Center is one of the best hospitals that you'll find anywhere.

Whether it's life-saving emergency care, comprehensive cancer treatment, minimally invasive surgery options, kid-friendly pediatrics, compassionate women's health services or leading-edge heart care, you don't take chances withyour family's health. There is a real difference in the quality of care at St. Joe's. And it matters. Insist on St. Joe's. Because you deserve healthcare this good.

Advanced Medical Science and a Team Approach

user.org (User) — Sun, 30 Jan 2011 16:00:00 GMT

WHEN YOU'RE KNOWN FOR YOUR EXPERTISE in caring for the most complicated heart surgery cases, the expectations are higher. At St. Joe's, we're delivering excellent heart care because we are devoted to advanced medical science and a genuine team approach to healthcare.We leverage the extraordinary experience of our physicians, our surgeons, our cardiologists-our entire medical staff-and our nursing and clinical care teams through an initiative called "quality through evidence-based practice." Our collaborative approach is based on the best academic and clinical research, backed with the best technologies and always delivered with compassion and patient focus. The results speak for themselves, and our patients are much better off for it.

Our innovative team approach to advanced heart care and the quality outcomes that result aren't a "someday." It's real life. It's here at St. Joe's today. It's innovation at work. And it's one more reason why St. Joseph Medical Center is one of the best hospitals you'll find anywhere.

Whether it's life-saving emergency care, comprehensive cancer treatment, minimally invasive surgery options, kid-friendly pediatrics, compassionate women's health services or leading-edge heart care, you don't take chances with your family's health. Insist on St. Joe's. Because you deserve healthcare this good.

Trans-Radial, An Innovative New Option

user.org (User) — Fri, 21 Jan 2011 16:00:00 GMT

ST. JOE'S HAS AN INNOVATIVE NEW OPTION for heart catheterization patients�one that has been shown to be safer and more effective, with fewer potential complications. Trans-radial heart catheterization uses an artery in the wrist for heart catheterization access instead of the traditional groin access.With �trans-radial" access, recovery is more comfortable and much faster. In fact, in most cases, �recovery" is mostly for the sedation to wear off. The result: patients are back to their lives within hours, not days.

We've even created the area's first Radial Access Lounge�specially decorated private rooms with recliners,Wi-Fi connectivity, flat screen televisions, a sofa for family and a hospitality cart with refreshments�all designed to increase convenience and comfort for patients and families alike.

Trans-radial heart catheterization is not a �someday." It's here at St. Joe's today. It's innovation at work. And it's one more reason why St. Joseph Medical Center is one of the best hospitals that you'll find anywhere.

Whether it's life-saving emergency care, comprehensive cancer treatment, minimally invasive surgery options, kid-friendly pediatrics, compassionate women's health services or leading-edge heart care, you don't take chances with your family's health. Insist on St. Joe's. Because you deserve healthcare this good.

Transitioning to Trans-radial

user.org (User) — Mon, 6 Dec 2010 16:00:00 GMT

St. Joseph Medical Center is seeing into the heart from the wrist using a procedure that increases patient safety and comfort

Reading, PA., November 8, 2010 -- Patients at St. Joseph Medical Center who need a heart catheterization are giving a hand--literally--to their doctor for a new procedure that dramatically lowers potential complications and gets patients back on their feet almost immediately.

For the last year, St. Joseph Cardiologist Dr. Guy Piegari has been giving patients the option of accessing their heart through an artery in the wrist, called trans-radial artery catheterization, instead of through the femoral artery, found in the groin.

Less potential for bleeding, more comfortable for patients

Using the radial artery approach has become the preferred method outside the United States for the majority of patients, according to Dr. Piegari.

�It has been shown to be the safest way to access the central circulation with less risk of bleeding complications," he explains. �Patient comfort also is a major advantage since gaining access to and closing the artery (after the procedure) is usually less painful."

Femoral access site recovery usually involves the patient lying on their back for a few hours in bed and requires limitations with lifting and excessive walking for 2 days afterwards. These are no longer issues when radial access is used.

The Trans-radial approach also allows for the performance of the procedure in patients who have no access from the groin because of peripheral occlusive disease (blocked arteries in the legs). And, Dr. Piegari adds, the procedure is far more comfortable and safer for overweight patients.

�As we all adjust to changes in how health care is delivered in the US this procedure will be become a cornerstone for invasive cardiology. It greatly increases those procedures that can be safely done as an outpatient, and it saves money for the patient and the hospital," Dr. Piegari noted.

New Lounge reduces anxiety

St. Joseph also has created the area's first Radial Access Lounge designed to increase the comfort for patients and families.

The lounge offers private rooms with recliners for patients (instead of uncomfortable litters), Wi-Fi connectivity, flat screen television, a sofa for family and a hospitality cart with refreshments.

�The café reduces the anxiety associated with invasive heart procedures," explains Lori Shober, the Director of the Heart Institute. �When the patient comes back from the procedure their 'recovery' is mostly for the sedation to wear off (about 90 minutes). If everything checks out and the patient is feeling well, they are discharged to their home." Patients can change into their street clothes as they have a lunch or a snack that they can order off a menu while they wait to be released.

�If you talk to any patient who has gone through a cardiac catheterization from the groin access, they will tell you the thing they dreaded the most was the requirement to lay still so the femoral incision could begin closing. The biggest complaints are back discomfort and about the pressure being applied to their groin."

St. Joe's Earns Chest Pain Accreditation

user.org (User) — Fri, 2 Jul 2010 16:00:00 GMT

Reading, Pa., March 4, 2010 -- St. Joseph Medical Center has taken its place among the top hospitals in the country in treating chest pain. The hospital was officially granted accreditation as a Certified Chest Pain Center with PCI by the Board of the Society of Chest Pain Centers, Columbus, OH.

�This accreditation reflects our commitment to a protocol-driven and systematic approach to reduce treatment time during the critical early stages of a heart attack," said John R. Morahan, St. Joseph's President and Chief Executive Officer. �The additional designation �with PCI' illustrates our commitment to conducting percutaneous coronary intervention (PCI), also known as catheterization and angioplasty, on patients suffering from heart attack well within the national standard of 90 minutes of arrival at our Emergency Department."
[more]

The Chest Pain Center's approach also puts into place systems that enable hospital's to better monitor patients when it is not clear whether they are having a coronary event. Such observation helps ensure that a patient is neither sent home too early nor needlessly admitted.

To quickly assess if a patient is having a problem that requires intervention, St. Joseph receives a 12-lead EKG conducted, in many instances, by first responders in the field (i.e. ground and air ambulance, fire and rescue). If positive, the Emergency team activates the Interventional Cardiac Team. If the patient is a walk-in to the Emergency Department, the hospital immediately conducts its own 12-lead EKG test and, if positive, the same interventional protocol is followed.

Morahan congratulated the St. Joseph Team that �worked diligently over the past 18 months to achieve this milestone."

While the final report has not been formally delivered to the hospital, St. Joseph was recognized for 51 distinctive practices, meaning that these practices are the best among all of the other hospitals that have sought accreditation, according to Sharon Strohecker, St. Joseph's Chief Nursing Officer and Vice President of Clinical Services.

�Earning Chest Pain Accreditation means that St. Joseph practices and achieves the highest standards of chest pain intervention and treatment available in the country," added Lori Shober, Director of St. Joseph's Heart Institute.

St. Joseph's multidisciplinary heart care teams remain on call 24-hours a day, 7 days a week. Patients presenting in the ER with chest pain and diagnosed with significant cardiac symptoms go right to the Catheterization lab for intervention, such as angioplasty or stent placement. According to its most recent analysis, the hospital offers interventional procedures often in less than 60 minutes, far faster than the national standard of 90 minutes.

About Chest Pain Centers
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. The goal of the Society of Chest Pain Centers is to significantly reduce the mortality rate of these patients by teaching the public to recognize and react to the early symptoms of a possible heart attack, reduce the time that it takes to receive treatment, and increase the accuracy and effectiveness of treatment.

The Chest Pain Center at St. Joseph Medical Center has demonstrated its expertise and commitment to quality patient care by meeting or exceeding a wide set of stringent criteria and completing on-site evaluations by a review team from the Society of Chest Pain Centers. Key areas in which a Chest Pain Center must demonstrate expertise include:

Integrating the emergency department with the local emergency medical system
Assessing, diagnosing, and treating patients quickly
Effectively treating patients with low risk for acute coronary syndrome and no assignable cause for their symptoms
Continually seeking to improve processes and procedures
Ensuring Chest Pain Center personnel competency and training
Maintaining organizational structure and commitment
Having a functional design that promotes optimal patient care
Supporting community outreach programs that educate the public to promptly seek medical care if they display symptoms of a possible heart attack

St. Joseph Chest Pain Team Members

Hani Salha, MD, Physician Leader, Chest Pain Team Leader

David Wright, MD, Medical Director, Emergency Services

Beverly Livezey, Vice President, Cardiology Services

Lori Shober, Director, St. Joseph Heart Institute

Michele Jones, Director, Emergency Services and Professional Practice

Barbara Pizzo, Manager, PVL/EEG/Non-Invasive Cardiology

Liz Clark, Director, Process and Outcomes Management

Loretta Boyd, Team Leader, Performance Improvement

Deb Demiter, Administrative Director, Radiology

Karen Drumheller, Resource Manager, Nursing Education

Steve Deihl, Manager, 1 North Nursing Unit

Dan Monaghan, Manager, Critical Care and 2 North Nursing Units

Chris Allen, Manager, 1 South Nursing Unit

Deb Motika, Manager, Chemistry Lab

Jim Tunnessen, Emergency Medical Services Liaison

Karen Mengle, Special Projects Coordinator

Cindy Diehl, Case Manager

CAP Inspection: Respiratory Therapy and Cardiology Fare Well

user.org (User) — Mon, 28 Jun 2010 16:00:00 GMT

The College of American Pathologists (CAP) inspectors completed their unannounced inspection of Respiratory Therapy and the Cardiac Cath laboratory last week, commenting that they were very well run, very efficient, and the units were well prepared for the inspection.

Respiratory completes more than 15,600 blood gases per year (which has doubled since the move in 2006), and has three new blood gas machines. Two are located in the Critical Care Unit to serve the hospital, and one is located in Respiratory to provide care to outpatients and to the Emergency Department.

Donna Engle, coordinator for the Pulmonary Diagnostic area, has been at SJMC for 23 years. She has an extensive quality assurance program and performance improvement program. She is also in charge of proficiency testing - samples come from the manufacturer with unknown values. Respiratory runs the samples and reports the values to the company. This assures the values they report clinically are valid and reliable.

Respiratory also can run blood samples for coroner cases and test pleural fluids in addition to their normal blood gas volumes.

Clarinda (Rindy) Gerow, RN, is responsible for the Cath Laboratory's quality assurance program and CAP proficiency testing. The inspectors were particularly impressed with the cath laboratory's competency program, stating it should become best practice.