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Your Healthy Family: How Simulation Center helped NCH cut time to treat heart attack in half

Posted at 10:16 AM, Mar 16, 2022
and last updated 2022-03-16 11:11:45-04

NAPLES, Fla. — The NCH Simulation Center played a key role in helping the healthcare system cut its STEMI treatment time by more than half. A STEMI is a serious type of heart attack involving a blocked coronary artery.

"Behind the scenes, there's an enormous amount of teamwork in place," Dr. Douglas Harrington, the Medical Director of the Judith & Marvin Herb Family Simulation Center, said. "Where a lot of hospitals just kind of run with what happens just by natural events, we're actually actively going in and looking at every metric in the hospital and what we can do better at."

Dr. Harrington said improving NCH's STEMI protocol was a good place to start. STEMI stands for ST Elevation Myocardial Infarction. It's a serious heart attack in which an artery in the heart is blocked. A Cardiologist uses a catheter through the leg or arm to insert a balloon in that blocked artery to open it back up.

Dr. Robert Cubeddu, the President of the NCH Heart Institute, said when it comes to a STEMI, Cardiology Divisions follow a key metric at the national level called the "Door to Balloon Time."

"The time it takes from when the patient hits the emergency room, to the time it takes us to open up the artery," Dr. Cubeddu said.

Compared to other hospitals, he said NCH was under-performing, and they wanted to change that.

"I think that's the role of simulation. That if you identify an area of improvement, or an area of optimization or a problem, we'll then do a needs assessment. And then you can bring that to the simulation center and we can help you optimize your project for better results," Dr. Harrington said.

He said the Simulation Center did two simulations in which an actor came into the Emergency Room with chest pain to see how quickly they could get that patient treated.

"We saw areas of further improvement. So by doing these dry runs in the real environment, it improved the process even better," Dr. Harrington said.

In a third simulation, Dr. Harrington said they put their high-definition mannequin, which mimics a live patient, in an ambulance with Collier County EMS.

"Called the Emergency Room that there was a heart attack and process, they brought the mannequin to the hospital and ran the whole scenario," he said.

"It involved the EMS, the check-in people in the ER, the ER doctor, the Cardiologists on call, the Catheterization Lab to be activated. And with the simulation, we could actually test every single member of the team," Dr. Harrington said.

Working together for about three months, NCH Healthcare system got their STEMI Door to Balloon Time down to 28 minutes.

"Putting us at the 99th percentile in performance for the abrupt treatment of heart attack," Dr. Cubeddu said.

"This process of improving our heart attack protocol, this success can be translated into every aspect of the hospital care," Dr. Harrington said.

To learn more about the NCH Judith & Marvin Herb Family Simulation Center, click here.