Doctoring Health Care Reform Reflection

57 minutes…Inspiring

There’s a lot about health care news that can get you down.

There’s the un-insured.

The obesity crisis.

Stifling regulation. 

Adverse effects from drugs and devices. 

Mistakes even.

Today, though, I would like to tell you about an inspiring success story here at my little hospital–a cabin in the woods of sorts. Our motto is “feel better.”  We put the cutest babies on billboards. It’s not our culture to brag and strut.

But I am a cardiologist–and a bike racer.

Here’s the news:

It was announced to the medical staff during today’s grand rounds that our door-to-balloon time for opening an occluded coronary artery during a heart attack averages a lightening quick 57 minutes. This obliterates the standard benchmark of <90 minutes.

It’s well known that the most important aspect of caring for a heart attack (besides preventing it in the first place) is opening the clotted artery. Doing so restores blood flow to the starved heart muscle and prevents subsequent sudden death and heart failure. The biology of this miracle is not the focus of this post; rather, I would like to emphasize something even more striking: the collaborative effort that this task entails. The chief of our medical staff mentioned the valiant effort of the (on-call day-and-night) interventional cardiologists in this success. It’s true, the cardiologist is the quarterback, but few procedures in medicine better illustrate the importance of teamwork.

It starts in the field with an educated EMT crew equipped with 12-lead ECG machines that transmit remotely. Next, the emergency department triages the patient immediately to the cath lab. Filling out forms and checking boxes gets done after the patient arrives in the cath lab. Both the interventional cardiologist and the on-call cath lab staff respond immediately to the call and meet the patient in the lab. Once in the lab, the heart attack patient is cradled in the arms of mother-healthcare: a system that’s at its best when using modern technological fury. Slick wires, stents, digital-Xray. All that, and more.

The thing that’s so inspiring about our door-to-balloon time is how well people work together toward a common goal. For those 57 minutes, all that happens is directed towards saving heart muscle. (Don’t worry, I still hear them call “time-out.”)

And the MI team aren’t satisfied with crushing the benchmark, they want to go lower; they want to squeeze out things that bog down the times. (For example, the largest delays occur when patients are transported to non-interventional hospitals.)

As an optimist about medicine, this 57-minute story of human cooperation gives me hope. It makes me wonder why we can’t harvest that same energy and spirit to attack runaway medical problems like obesity, diabetes and high blood pressure. Imagine.

Or…how about this thought nugget?

Might the policy-makers, the smart people, who want to protect patients by micro-managing and over-regulating, see that when left to do what’s right for the patient, health care people get the job done.



4 replies on “57 minutes…Inspiring”

thanks for a real “feel better” story
i hope if i ever need this….
that team feels the same as yours

We winter in Tucson. Last January I was at a fire station getting an EKG because my wretched arrhythmia had fired off while riding. While there I was talking to the EMT staff about where they take the bad hearts for emergency treatment. In their fire district they have a 60 minute or less time from patient pickup to cath lab, and they are justifiably proud of the work that’s been done to achieve that. Those guys do give a damn and I am very happy to be on their turf all winter.

Thx Alison and wcinc.

You bet they care. That’s the thing, when you give people responsibility for others, most that I have seen rise to the occasion. Perhaps because our moral default is to help others–if given the chance.

One of the biggest mistakes I see made, are those regulators who don’t allow people to independently think.

I can remember back to the early days of AEDs. The notion held that regular people were not skilled enough to operate the life-saving machine. How wrong that turned out to be.

Two things: first a big AMEN to letting healthcare teams do their jobs. Second, a general thank you. A friend of mine was brought back to life after a heart attack by a team much like yours. She’s in her mid 40s, totally unexpected & we could have lost her. So many of us owe our lives to dedicated people like you, whether we have heart trouble running in our families or it comes as a surprise. Thank you.

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