By Aaron Nicodemus
The Worcester Telegram & Gazette
WORCESTER, Mass. — For the second consecutive year, UMass Memorial Medical Center had the lowest heart attack death rate of any hospital in New England, and tied for the fifth lowest rate in the country.
The Centers for Medicare and Medicaid Services gathered data from more than 4,600 hospitals across the country on patients older than 65 who died within 30 days of coming to a hospital with a heart attack. The results were adjusted to account for older or sicker patients, so that hospitals that treat such patients were not measured unfairly.
The news continued the turnaround for UMass Memorial’s cardiac care unit, which voluntarily suspended operations for six weeks in September 2005 after the unit had a mortality rate significantly higher than the state average.
UMass Memorial’s heart attack death rate for the years 2005 to 2008 was 11.7 percent, two hundredths of a percentage point lower than Cape Cod Hospital in Hyannis. In the region, the next best performing hospitals on this measure were Marlboro Hospital, at 13.1 percent, and Milford Regional Medical Center, at 13.9 percent.
The rate was based on the 30-day survival rate of 833 Medicare patients treated at the hospital between July 1, 2005, and June 30, 2008. The statistics did not include patients covered with private medical insurance, state health insurance or who are uninsured. The national rate for this measure is 16.6 percent.
Dr. Robert A. Phillips, director of the heart and vascular center of excellence at UMass Memorial, said a big part of the hospital’s success rate has been its reduction of the time between a patient’s arrival in the emergency room and the commencement of a procedure that restores blood flow to the heart.
This rate is known as door-to-balloon time, because it measures the time it takes for doctors to insert a tiny balloon through a vein or artery into the heart, to remove blockages that can cause a heart attack. A wire-mesh stent can be left behind to keep the vessel propped open.
UMass Medical’s door-to-balloon time averages 60 minutes, he said, compared with the national standard of 90 minutes.
Part of the hospital’s success is due to a collaboration between all of the emergency medical technicians, doctors and nurses throughout Worcester County and northeastern Connecticut.
These medical professionals have been trained to read a patient’s electrocardiogram and predict whether the patient is having a heart attack. Once the hospital is alerted an incoming patient is having a heart attack, it mobilizes its cardiac team to be on standby.
In the past, a patient having a heart attack would enter the emergency room, and the assessment would occur through a series of steps.
The cardiac team relied on a hospital cardiologist to examine the EKG and determine if the patient was having a heart attack. That could cost precious time, he said.
“The idea was to activate everything at once,” said Dr. Phillips. With the assessment out of the way, the cardiac team can immediately begin treating the patient with a cardiac catheterization and clear potential blockages in the heart.
Emergency room doctors, nurses and emergency personnel deliver a correct evaluation of an EKG about 90 percent of the time, he said, leaving a small fraction of the time when the cardiac team is mobilized for a patient who is not having a heart attack.
“This represents a commitment on behalf of all of our doctors, nurses, support staff, emergency medical personnel and our numerous regional partners,” he said.
The data from the Centers for Medicare and Medicaid Services can be found at www.hospitalcompare.hhs.gov.
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