Partnering with the "Enemy"
An inspirational story of two hospitals and an EMS

February 2013

The Society of Cardiovascular Patient Care recently heard about an unusual, yet extremely successful, partnership — one that involves two accredited hospitals and an EMS. Although some in the industry would call these hospitals "competitors," this partnership was formed to overcome the obstacles of treating patients in a relatively rural area. They preferred to overlook the "competitive" factors and worked together in order to streamline the treatment process and save more lives.

It all started because both Schneck Medical Center in Seymour, Indiana, and Columbus Regional Hospital in Columbus, Indiana, serve a rather rural area. "Originally, we were transporting our STEMI patients up to Indianapolis to receive treatment and we were completely bypassing Columbus Regional Hospital," says Matt Chandler, Director of Cardiovascular Services at Schneck. "However, it was wasting valuable time in the treatment process." Another hurdle the hospitals faced is that it is hard to recruit and keep cardiologists in the area.
During this time, both Schneck and Columbus Regional were working on their Cycle 3 accreditation processes. As part of the process, both of the hospitals teamed with Jackson County EMS. As they moved through the processes with JCEMS, the hospitals started talking with each other and discovered new ways to achieve their shared goal of providing better treatment to patients. "Working with JCEMS was a turning point for all of us. We began tracking the JCEMS success rate of accurately diagnosing a STEMI by EKG, and we found that they were accurate 100% of the time," says Mr. Chandler. "Schneck and Columbus Regional just had to develop the right processes between our teams in order to facilitate the treatment that each group would provide."

The system that the three teams created starts with a STEMI activation call from the field. "We connect to Schneck from the field to inform them of a STEMI. Schneck then activates the cath lab at Columbus Regional through a one call STEMI line. They share the information as we are transporting the patient," says Dennis Brasher, Executive Director of the JCEMS. "The response team at Schneck meets us as our ambulance arrives at the bay. The paramedic hands over the EKG results to the doctor who is already prepared with a team and a STEMI kit. Our goal is to have the patient stabilized at Schneck and ready for transport to Columbus Regional in 5 minutes or less."

Simultaneously, as the Schneck and JCEMS teams are providing the initial treatment, the Columbus Regional Cath Lab team is activated and they assemble to meet the patient. "In a heart attack, every single second counts," says Staci Glick, RN, co-CPC coordinator at Columbus Regional. "Our hospitals are only 30 minutes apart, but based upon the location of the patient, that 30 minutes can be the difference between life and death. With the initial treatment provided by JCEMS and Schneck, we are able to save more lives."

In order to spread the message of the partnership, the teams put on a collaborative mock code in February 2012, and asked the Mayor and all first responders to participate. The entire process was filmed, documented and dissected during a post-event discourse. "Between the mock code and our quarterly meetings, we are able to identify process changes that allow us to improve our quality and reduce the amount of time it takes to treat the patient," says Julie Bailey, RN, co-CPC coordinator at Columbus Regional.

"National standards measure ER-door-to-balloon time, but we also measure address-to-balloon time. In other words we measure from the moment we meet them at their door – not ours. Although the national recommendation for door-to-balloon time for a transferring hospital is 120 minutes, in the last year our teams averaged 92 minutes from the patient's front door to balloon time," said Mr. Chandler.

However, some results can't be measured, they can only be seen. "There's nothing prettier than the radiographic images that Columbus Regional sends us after they have treated a patient," says Mr. Brasher. "When you look at the pre- and post-balloon pictures and you see that a patient’s heart is pumping again and the blood is flowing, it creates that indefinable moment of joy when we realize that we were all able to do our jobs and save a life."

The Society of Cardiovascular Patient Care thanks everyone at Schneck Medical Center, Columbus Regional Hospital and Jackson County EMS for taking the time to work together in order to create new processes within their systems that focus on enhancing patient care. If you would like to share your story, please submit your information to community@scpcp.org.

For more info:
Schneck Medical Center
Columbus Regional Hospital
Jackson County EMS