The highest quality in treating chest pain
Innovations in Cardiovascular Medicine & Surgery - Fall 2018
Mehdi Shishehbor, DO, MPH, PHD
Director, Interventional Cardiovascular Center, and Co-Director, Vascular Center, University Hospitals Harrington Heart & Vascular Institute; Professor, Medicine, Case Western Reserve University School of Medicine
Donald Neu, BSN, RN
Quality and Chest Pain Coordinator, University Hospitals Harrington Heart & Vascular Institute
In May 2018, a seven-months-long process involving reams of patient data, hundreds of documents and hours of painstaking work came to fruition: University Hospitals became the first hospital system in the United States to receive the America College of Cardiology’s (ACC) Chest Pain Center Version 6 Accreditation, with 11 facilities achieving the designation.
According to the ACC, Version 6 builds upon previous versions of Chest Pain Center Accreditation to include the most updated research and guidelines for low- to intermediate-risk, NSTE-ACS and STEMI patient populations. Version 6 also incorporates the 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care, as well as specific treatment protocols for post-resuscitated patients. In addition, Version 6 integrates with ACC's ACTION Registry to satisfy reporting requirements for STEMI and NSTEMI patient populations.
For interventional cardiologist Mehdi Shishehbor, DO, MPH, PhD, Director of the Interventional Cardiovascular Center at UH Harrington Heart & Vascular Institute, the newly achieved accreditation communicates something important about UH’s commitment to its local community.
“Our vision is that quality and excellence should be parallel across the whole organization,” he says. “We want everyone to be operating at the same level, offering the same quality and the same level of expertise. We put a lot of value in the quality of care that is offered in our community hospitals.”
Don Neu, BSN, RN, quality and chest pain coordinator at UH, says he and other chest pain coordinators at UH hospitals "jumped at the chance" to earn the new accreditation. "We immediately saw the benefits of working as one team," he says. "We were able to identify issues, create positive change, and make policies system-wide, based on the latest evidence-based practices."
According to the ACC, hospitals that have earned Chest Pain Center Accreditation have proven exceptional competency in treating patients with heart attack symptoms. They have streamlined their systems from admission to evaluation to diagnosis and treatment all the way through to appropriate post-discharge care and recommendations and assistance in patient lifestyle changes.
Both Neu and Dr. Shishehbor say they would recommend the chest pain accreditation process – however rigorous it may be -- to other large hospital systems.
“Just because you’ve done something one way for years and years doesn’t mean that it is the best way,” Neu says. “Medicine is an ever-evolving art, and times change. It used to be that we drew troponin on patients at 0, 6 and 12 hours. Now it’s 0, 3 and 6. We do that because the troponins have become so sensitive that they pick up the most minute indication of myocardial damage, at an earlier time than they did even five years ago. It’s important to have an open mind and be willing to look at what the current best practices are and then be willing to challenge yourself to meet those.”
“Sometimes you are surprised,” adds Dr. Shishehbor. “You may think that you already have all of the pieces together, but this kind of process forces you to ask questions, forces you to commit time and resources to something that is extremely important. When you go through the exercise and make that commitment, you look at every angle to make sure everyone is aligned in taking care of these patients.”
For more information on the system-wide chest pain accreditation process at UH, please email Donald.Neu@UHhospitals.org.