Pulsara Blog

Arkansas hospital achieves consistent <60 minute average door-to-balloon time for STEMI and 80% decrease in average door-to-CT time for stroke

National Park Medical Center (NPMC) is a 163-bed hospital that has been delivering healthcare to the community of Hot Springs, Arkansas, for nearly 70 years. Offering a full range of inpatient and outpatient services, NPMC, which is part of the Lifepoint Health family of hospitals, is also home to the Heart and Vascular Center of Central Arkansas. The facility was recently recognized for excellence through the receipt of Chest Pain Center Accreditation with PCI through the American College of Cardiology Accreditation Services. 

Previously, when the emergency department received an ambulance call that a patient was experiencing chest pain and possibly a STEMI, an ECG would be sent from the ambulance to the emergency department by fax. But the transmission wasn’t always successful, according to Emergency Room Director Priscilla Couch, RN, MSN. And even when the ECG did make its way to the ED, there were hiccups in communicating the information to vital members of the healthcare team. “Our ER doctor would call the cardiologist and try to explain the patient’s condition without a visual, which takes time,” recalls Couch. “Then, with limited information, the cardiologist would have to decide, well, is that a real STEMI or not?” That deliberation would leave Couch waiting before she put out calls asking cardiac cath lab staff, including an interventional cardiologist, radiology technologists, and a cardiac-care nurse, to assemble. “When a patient is experiencing a STEMI, those are precious minutes that are being wasted,” Couch says.

In an effort to improve patient care, National Park Medical Center chose to adopt Pulsara, a mobile healthcare communication program that unites care teams on a single dedicated channel for each patient.

LewisGale Hospital Montgomery in Blacksburg, Virginia, recently achieved a record door-to-balloon time of 14 minutes for one of their STEMI patients—one of their fastest ever. 

LewisGale has been working to create clearer lines of communication between its team members. They implemented Pulsara to successfully create a streamlined process for team communication around potential heart attack patients. 

Dr. John Patterson, a cardiologist at LewisGale, described how Pulsara allows him to receive notifications and information about a new patient instantly: "With this platform, I have the ability to see the EKG and activate the cath lab. All of this happens immediately so that it shortens the length of time it takes from the time the patient starts having their heart attack to the time they arrive at our hospital, to the time that we fix it. All of these times get shortened significantly with a platform like this." 

How one Arkansas hospital is using healthcare communication technology to dramatically speed up time-to-treatment for STEMI patients

BOZEMAN, Mont., April 4, 2022 — Pulsara, the leading mobile telehealth, communication, and logistics platform that unites healthcare teams and technologies across organizations during dynamic events, published new details on Arkansas-based Ouachita County Medical Center’s record improvements in patient care. The Ouachita County Medical Center Case Study reveals the challenges many hospitals face when trying to transfer patients quickly, and the solution they found that enabled faster transfers and streamlined communication across organizations, ensuring secure and efficient patient care.

As a small medical center in rural southern Arkansas, Ouachita County Medical Center (OCMC) faced a lengthy and inefficient process when transferring STEMI patients to percutaneous coronary intervention (PCI) facilities that could provide critical care. Jennifer Ray, RN, OCMC’s ER and ICU manager, explained that in 2017, the average door-in, door-out (DIDO) time was 72 minutes for the 19 STEMI patients who came into the OCMC ER—more than double what the American College of Cardiology Foundation and the American Heart Association recommends.

How one rural Arkansas county is using integrated telehealth, communication, and logistics technology to treat patients faster

Bozeman, Mont., Jan. 12, 2022 —  Pulsara, the leading mobile telehealth, communication, and logistics platform that unites healthcare teams and technologies across organizations during dynamic events, published new details on Arkansas-based Saline Memorial Hospital’s record improvements in patient care. The Saline Memorial Hospital Case Study reveals the unique challenges care teams were facing with a rapidly growing and dispersed population, and the solutions they found to markedly reduce treatment times, establish secure and reliable ECG transmissions, and improve real-time care team communication. 

It has been a challenging year in healthcare. The second year of the COVID-19 pandemic has brought burnout, staffing shortages, and the continued struggles associated with trying to care for patients during a pandemic. 

In the midst of it all, many healthcare systems have risen to the challenge and devoted themselves to providing better, faster, and more efficient care for their patients. They've achieved amazing things in 2021, and, in spite of the setbacks and challenges, have found ways to continue to deliver top-notch care for their patients.

Join us as we take a walk through Pulsara's 2021 case studies, celebrate the stories of some of our partner organizations, and highlight the amazing results they've achieved this year!

Ouachita County Medical Center (OCMC) is a not-for-profit hospital with 99 beds, serving residents of the rural community surrounding the city of Camden in southern Arkansas, about 100 miles from Little Rock. As a smaller, non-PCI facility, OCMC often coordinates transfers for their STEMI patients to PCI facilities.

Previously, when a patient arrived in the OCMC emergency room with a STEMI, whether by ambulance or private car, staff would first page a cardiologist at the patient’s preferred receiving facility, then wait for the physician to call back. Only then could they start the process of transferring the patient to a percutaneous coronary intervention (PCI) facility that could provide critical care. “Then we had to get a bed confirmed, and then we had to wait to get our EMS service to take the patient. And then, usually, most of those patients at that time went to Little Rock, which is about an hour and a half from where we are,” explained Jennifer Ray, RN, OCMC’s ER and ICU manager. “So the timeliness of the patient getting in and out was very, very slow.” How slow? During 2017, the average door-in, door-out (DIDO) time was 72 minutes for the 19 STEMI patients who came into the OCMC ER—more than double the 30 minutes or less recommended by the American College of Cardiology Foundation and the American Heart Association.

When our customers experience the benefits of Pulsara—from faster door-to-needle times and minimized errors to improved team communication and reduced costs—it goes without saying that we love to share and celebrate their successes. LewisGale Regional Health System in southwest Virginia is just such a case, recently releasing both a press release and video testimonial about how Pulsara is helping them better support their patients and care teams.

From their press release:

“EMS plays a vital role in improving care for these patients, and we’ve known for some time that patients with life-threatening conditions receive faster treatment when EMS activate the appropriate hospital team from the field,” said Steven Pasternak, MD, emergency department medical director at LewisGale Medical Center. “This new, cloud-based, mobile technology further decreases the amount of time it takes to communicate vital data and activate hospital teams compared to traditional methods of communication between ERs and EMS. For example, if a patient has had a suspected cardiac event, the EKG administered by EMS in the field can be transmitted in real-time to the hospital, which enables the hospital to be ready to perform, if necessary, a cardiac catheterization procedure to open blocked arteries as soon as the patient arrives.”

EMS plays a critical role in identifying, treating, and directing stroke patients into a system of care. Time is brain for stroke patients, and as the first on-scene, your response time is critical to quickly identifying stroke symptoms, alerting the right care teams, and getting the patient the care they need. Every minute you can shave off their treatment time saves tissue and makes a big difference to the patient's quality of life. 

With those things in mind, here are 10 things you need to know about stroke:

What do EMS and hospital care teams have in common with NASCAR drivers?

Quite a bit, as it turns out. The success or failure of both hinges on one thing: time. 

It might surprise even dedicated fans to learn that all of the cars on the track are limited to the same top speed and horsepower range. With this being the case, how can it be that there is such a large disparity between first and last place?

The answer: The race is won and lost during the pit stop.

With Valentine’s Day just around the corner, hearts are everywhere—heart decorations, heart candies, heart cards, even heart pancakes for the more creative sweethearts. But one of the most important hearts of all too often gets overlooked: Your heart (or your heart health, to be specific)! 

February is American Heart Month: a national event to raise awareness about heart disease and what you can do to decrease your risks. Heart disease is the #1 cause of death for Americans, killing over 650,000 people annually. It is responsible for 1 in 4 deaths in the U.S. each year, and one person dies every 36 seconds from cardiovascular disease (that's heart disease and stroke combined). And that's not just for older adults; heart disease is becoming more and more common in young adults, making it important to learn whether you might be at risk.

Picture this:

About 12 hours into your 24-hour shift, you and your partner are finally sitting down to your first real meal of the day.

Just as the first bite of warm food hits your lips, the tones drop—an all-too-familiar scenario in the world of first responders. 

You’re dispatched to a 51-year-old male reporting chest pain. You walk in the door to a very distraught family, gathered around a man clutching his chest. He is pale and sweating profusely. You meet your partner’s eyes, and you know you’re both thinking the same thing. You quickly obtain the ECG and your suspicions are confirmed: tombstones in leads II, III, and AVF.

With state-of-the-art facilities and well-trained caregivers, St. Bernards’ cardiac teams were already achieving door-to-balloon (DTB) times well within the recommended guidelines for STEMI response. But that didn’t stop them from looking for ways to get even better.

“We have a lean process for STEMI response, but we needed a way to see the bigger picture for identifying areas we could improve,” said Lindsey Stacy, the hospital’s STEMI coordinator.

Longview Regional Medical Center (LRMC) has long had a well-designed and fully functioning process for identifying and rapidly treating STEMI patients. The hospital was meeting its goal of keeping door-to-reperfusion times under 60 minutes; as a result, patient outcomes were generally very good. Despite their satisfactory performance, the teams at LRMC believed they could reduce their treatment times even further to improve patient outcomes.

Since COVID-19 began spreading in the United States in March, emergency departments have seen a sharp decrease in the number of STEMI and stroke patients coming through their doors. For almost two months, polls and anecdotal evidence have suggested that this is happening all over the country, as well as in countries like Spain, the UK, and China. The Journal of the American College of Cardiology decided to conduct a formal study of nine major hospitals across the U.S. On April 7th, they released the results, confirming with statistical evidence what doctors have been experiencing: on average, the nine hospitals saw a 38% reduction in cath lab activations for STEMI patients.

Saint Mary’s Regional Health System is a Joint-Commission-accredited Level III Trauma Center, located in Russellville, Arkansas. The 170-bed hospital has delivered care to the River Valley community for the past 90 years, and alongside Pope County EMS since 1967.

Saint Mary’s and Pope County EMS have a long-standing relationship built on a shared value of putting patients first. As the only hospital and EMS agency serving their region, they together perform emergency response for 28,000 patients annually.

Because time is muscle during a STEMI, early intervention directly translates to lowering mortality and morbidity rates. At CarolinaEast and surrounding EMS agencies, making the appropriate communication changes has been an effective catalyst in reducing time to treatment and saving patients’ lives.

In emergency conditions like STEMI, patient outcomes depend heavily on the time between onset of symptoms to definitive treatment. As such, clinicians should make every effort possible to reduce any delays during that period. 

To that aim, an algorithm developed by the American Heart Association, and published earlier this week, establishes a standardized process which encourages pre-activation of the ED and determines when direct-to-cath-lab protocols are appropriate.

Pulsara is a communication platform that connects teams across organizations. Want to see how it works? While the demo video below focuses on a STEMI case started by EMS, STEMI is only one of the many conditions your teams can use Pulsara for. Additionally, care teams can start a case on Pulsara in the ED for walk in patients, from anywhere else in the facility for inpatients, and can use the platform to manage interfacility transfers.