Transcript Regional Showcase West Tennessee Presenter Disclosure Information Speakers: John Baker M.D./Emily Garner RN Presentation: Regional Showcase – West Tennessee •FINANCIAL DISCLOSURE: No relevant financial relationship exists.

Regional Showcase
West Tennessee
Presenter Disclosure
Information
Speakers: John Baker M.D./Emily Garner RN
Presentation: Regional Showcase – West Tennessee
•FINANCIAL DISCLOSURE:
No relevant financial relationship exists
Jackson Madison County General Hospital
The flagship of West Tennessee Healthcare is a 635bed tertiary care center. The only tertiary care hospital
between Memphis and Nashville, the hospital serves a
17-county area of rural West Tennessee.
Approximately 551,000 persons reside within the
service area. Within General Hospital, there exists six
'centers of excellence': the West Tennessee Heart
and Vascular Center, Kirkland Cancer Center, West
Tennessee Women’s Center, West Tennessee
Rehabilitation Center, West Tennessee
Neuroscience and Spine Center, and Emergency
Services. Each center has an historic reputation of
'high-tech, high-touch' skills.
WTH Service Area
2014 Population
Primary Service Area
Primary Service Area
Secondary Service Area
STEWART
.8
LAKE
.9
OBION
.10
WEAKLEY
DYER
BENTON
.2
GIBSON
.7
CARROLL
Secondary Service Area
HENDERSON
LAUDERDALE
.5
HAYWOOD
.1
.3
MADISON
.11
PERRY
DECATUR
TIPTON
CHESTER
.12
FAYETTE
HARDEMAN
.13
MCNAIRY
102,515
49,467
30,095
28,390
30,607
15,494
17,179
19,851
293,598
HUMPHREYS
.4
CROCKETT
.6
SHELBY
HOUSTON
HENRY
Madison County
Gibson County
Carroll County
Henderson County
Hardeman County
Crockett County
Chester County
Haywood County
Subtotal
HARDIN
WAYNE
McNairy County
Hardin County
Decatur County
Henry County
Weakley County
Benton County
Dyer County
Obion County
Lauderdale County
Lake County
Subtotal
Total Population
26,604
27,236
11,519
33,002
34,045
16,833
39,450
32,935
28,918
7,391
257,933
551,531
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West Tennessee System
Cardiac Coverage Area
•18 Counties
Hospitals
•16 Acute Care Hospitals
•2 PCI Receiving Facilities
•1 PCI Receiving Facility with CV Surgery Back-Up
EMS Systems
•17 Ground EMS Services
•10 Air EMS Bases (between 2 Different Air Services)
Initial State
Measure
Initial State
Door. to EKG Completion
21% of all cases = 5 minutes
50% of STEMIs = 5 minutes
Door to STEMI Diagnosis
70% of cases = 10 minutes
83% of STEMIs = 10 minutes
Door to Cath Lab Activation
74% of cases = 15 minutes
Door to Arrival CCL Team
83% of cases > 40 minutes
Door to Device Deployment (Door to Balloon
Time)
35% of cases ≤ 90 minutes
JMCGH STEMI Mortality Rate
25%
Target State
Chest Pain
Unit for obs
CCL
Member 1
arrives
No
Chest Pain
patient
arrives
ECG
done
STEMI?
Yes
ED
Activates
CCL
Patient
Moved to
CCL with
2 ED Nurses
Patient
Transferred
From
Stretcher to
table
CCL
Member 3 &
Cardiologist
arrives
Patient
Prepped
Arterial
Access By
MD
CCL
Member 2
arrives
ED – ECG
Goal: 10 min
ECG - CCL
Goal: 45 min
New Process for STEMI Patients
CCL - Balloon
Goal: 35 min
Balloon
Inflated
Where We Started Q32011
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Challenges
• Education – Hospital Administration, ED, EMS,
Nursing
• Rural Based Areas – long travel times (selection of
transport mode)
• Transmitting EKGs - Funding
• STEMI Walk-Ins – Community Education on Calling 911
• Preparation Time – Door In Door Out Times
• ED Accepting Transfers
• Communication/Data Feedback
Successes
 Education to all West TN Hospitals and EMS Systems
oGuidelines/Times
oEarly Recognition/Training
oEarly Activation of Transport
oEKG Transmission/Fax
 Development of Co-Management Contract with Cardiologist
 Annual STEMI 12 Lead EKG Training
oProgram with Med Center EMS, Air Evac Lifeteam
Successes
 Quarterly Regional STEMI/Chest Pain Center Accr. Meetings
oWeb/Conference Available
oMonthly Internal Meetings
 Network Visits – Building Relationships is KEY!
 Auto Accept/One-Call Policy
 Resources
Conference Calls for Transfers
Community STEMI Drills
Feedback Data
10-10-10 Plan
STEMI Treatment Zones/Map
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Successes
 Collaborating with other Facilities for their CPC Accreditation
 Community Education on Signs/Symptoms/Calling 9-1-1
 Events/Ads
 Importance of Bystander CPR – Pulse Point Free App
 Survive Don’t Drive Campaign https://www.youtube.com/watch?feature=player_detailpage&v=dQ
H8LfbzmtM
Source: NCDR Registry – PCI - Metric #16
Owner: W.TN Heart & Vascular Center
50th =
59.2mins
90th =
47mins
Source: NCDR Registry – Action - Metric #6
Owner: W.TN Heart & Vascular Center
50th =
107mins
90th =
80mins
Source: NCDR Registry – PCI - Metric #18
Owner: W.TN Heart & Vascular Center
50th =
44.8mins
90th =
27.8mins
Achievements/Awards
2014 Women’s Choice Award for Best Heart Care
Based in performance in the following categories:
•America’s Best Hospitals for Heart Failure Care
•America’s Best Hospitals for Heart Attack Care
•America’s Best Hospitals for Patient Satisfaction
2014 NCDR/ACTION Platinum Performance
Achievement Award
Remaining Challenges
 Delayed Times in DD2B/DIDO
 Outside Limited Resources
 ED Physician Turnover
 EMS FMC to PCI <90 minutes – Mission Lifeline Recommendation
Contact Info:
[email protected]
[email protected]