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.

GROWING UP IS HARD.

As a young industry, EMS had its cute years. We were the baby of the family. Our oldest brother, Police, followed Mom and Dad’s orders to a T. Police was a rule-following perfectionist who aimed to please. Then, there was the middle child, Firefighter. She was similar to her brother, following in his footsteps and enjoying the attention of being the baby of the family ... until we came along. Then, she started taking on a new role – differentiating herself from her older brother while at the same time, nurturing us.

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.

At Pulsara, our purpose is to improve the lives of patients and caregivers through innovative communication. For us, that means delivering a platform that standardizes communication for ALL teams involved in patient care — including prehospital providers like EMS, urgent care centers, nursing homes, critical access hospitals, and other referring facilities, teams within the destination hospital, and teams who need to communicate between healthcare organizations in cases that require a consult or transfer.

"Moral injury, as defined by researchers from veterans hospitals, refers to the emotional, physical and spiritual harm people feel after 'perpetrating, failing to prevent, or bearing witness to acts that transgress deeply held moral beliefs and expectations,'" according to a recent article by Kaiser Health News.

Even if you aren’t a diehard NASCAR fan, you’ve likely still heard the same champion names over and over. But 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 is that the race is won and lost during the pit stop!

During the longer races, drivers will make up to a dozen pit stops. Instead of victory being about having the fastest speed down the stretch, it’s more about identifying bottlenecks and delays while eliminating mistakes.

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.

My Grandfather (who was a very wise man) used to say “It’s a lot easier to pull a rope than push it.” Of course, as a kid I thought he had lost his mind. “Who would ever try to push a rope? It makes no sense!” 

I was right, it makes no sense. Yet, we find ourselves everyday trying to push ideas, initiatives, and process changes on others, and then we just can’t figure out why our “great ideas” don’t get off the ground.

We see this frequently in healthcare. My background is in ED Nursing and EMS, and in my roles in these fields, we pushed each other daily in efforts to get THEM to do things the way WE want them done.

The biggest pain point I encountered when working nights in the ED was communication — mainly, waiting. Call lists, pagers, and phone trees were our reality when we needed to act fast. But think about it: do we communicate this way in any other aspects of our lives? Why can I order a ride to the airport from a complete stranger with a few taps on my smartphone, but I need to use a pager to connect with providers I know personally? In medicine, when time is of the utmost importance, we still communicate like it’s 1985.

Dr. Brijesh Mehta is a Neurointerventional Surgeon, currently practicing at Memorial Neuroscience Center in Hollywood, FL. He recently gave a TED talk describing how his teams have leveraged new research, technology, and data to improve stroke care and give patients better outcomes. 

In the talk, Dr. Mehta describes how large vessel occlusion stroke (LVO) is "like a wildfire in the brain." He also says there used to be little we could do to stop the devastating effects, but now, thanks to new technologies and procedures such as thrombectomy, patients are regaining functionality and leaving the hospital much sooner than they had in the past.

I recently read an interesting review on a very important topic in healthcare: DIVERSION. The article reviews how the state of Massachusetts banned the practice of busy hospitals diverting patients coming in via EMS to other facilities, and the long-lasting impacts of that ban.

A few weeks ago, I wrote about how we strive to improve the lives of ED Nurses and the patients they serve. This week, I want to focus on ED Doctors (did you know Pulsara was founded by one?). In this post, my aim is to help ED Doctors understand how a communication platform like Pulsara can make their lives better.

When our care teams are all on the same page, communication is seamless, and treatment times are reduced, ultimately improving quality of care. How you can leverage the Pulsara communication platform to connect your care teams—whether in your organization or dispersed across many organizations?

Learn how communities across the country are leveraging community paramedicine and mobile integrated health for better patient care.