Public Education Using The Early Heart Attack Care Program: Shawnee Mission Medical Center
Susan L. Glover, RN, MHAAdministrative Director
Cardiovascular Services/Outcomes Management
Shawnee Mission Medical Center
Shawnee Mission, KS
Quick Overview
Shawnee Mission Medical Center, located 10 miles southwest of Kansas City, is a Seventh-Day Adventist healthcare organization that provides a full continuum of cardiovascular services. Inherent in the mission of this organization is health promotion and prevention; thus, the EHAC education program is offered as a community service.
The EHAC program is designed to teach individuals the warning signs of a heart attack and to recognize meaningful chest discomfort as a risk factor for a heart attack. The ultimate goal of the EHAC program is to motivate individuals to act or respond to these early warning signs. Target audiences for the EHAC program include hospital associates; community, businesses, and church organizations; local school systems; and primary care physicians.
The implementation of our EHAC program began with the development of a task force that includes physicians, critical care nurses, emergency department (ED) and cardiology personnel, educators, marketing and planning representatives, and representatives from ancillary departments, including pulmonary and laboratory personnel. The design and planning for the EHAC program was part of the implementation of the original CPEC concept as designed by Dr. Raymond Bahr, and should be considered as part of a continuum of services. In the initial planning, the awareness and acceptance of the concept by team members are essential for success.
The development of the EHAC education program consists of four steps, which include development of the instructor course content, development of the provider course content, selection of the speakers bureau, and development of the communication plan for the program. Each step is to be thoughtfully planned and executed, with the education and participation of all key members of the task force. The multidisciplinary task force provides the diversity of talents necessary for a successful program.
At the conclusion of the instructor course, participants should be able to: (1) understand the concept of "Early Heart Attack Care"; (2) identify the role of the instructor; (3) discuss the anatomy and physiology of the heart as they apply to the heart attack process; (4) identify key factors of proper history taking; (5) identify psychologic factors in EHAC. The instructor course is approximately 90 minutes in length and utilizes slides, discussion, and flip charts. The content includes the following sections: Anatomy and Physiology, History Taking, Psychologic Factors, Early Heart Attack Care Provider Course Content, Adult Learning Principles, Speakers Bureau, and Operations.
The provider course is designed for individuals in the targeted audiences and is presented in a lecture format with a standard slide presentation; it is approximately 40 minutes in length. The objectives of the provider course include the following: (1) an understanding of the concept of early heart attack care; (2) awareness of the prevalence of cardiac disease; (3) awareness of risk factors for heart disease; (4) an understanding of the different presentations of coronary artery disease; (5) recognition of mild chest discomfort; (6) verbalizing the importance of time in preventing muscle damage; (7) recognition of the deadly "D's" (death and denial); and (8) identification of strategies for overcoming resistance. The provider course is also offered in a self-study guide format for individuals who are unable to attend the lecture presentation.
The selection of an in-house speakers bureau is critical to the success of the EHAC program. One lesson learned is that having more speakers is not necessarily better. The number of speakers required will depend on the number of classes that will be given on a monthly basis. Each speaker should have an opportunity to speak at least once a month to maintain skills and knowledge. Other factors to consider when selecting speakers include clinical experience, speaking ability, availability, and ability to adequately represent the organization or program to an audience. All of the speakers in our program represent different clinical areas in the cardiovascular/critical care service line.
The fourth component in the development of the EHAC program is to have an integrated communication plan to create awareness that the program exists. In our situation, the center's research showed that while cardiovascular services were a strategic priority at the medical center, a significant number of community residents who used the hospital for other services drove past it to a downtown hospital for cardiac care. The CPEC and the EHAC programs were established to address two key objectives. First, the medical center sought to increase awareness of the importance of traveling to the nearest CPEC or hospital for treatment because "time equals muscle." Second, the medical center sought to increase residents' confidence in choosing it for cardiac care. The initial communication plan included print ads, direct mail, communication to primary care physicians, and billboards; all methods communicated the message "time equals muscle."
The print ads placed in area newspapers highlighted the opening of the CPEC and offered free EHAC classes. One print ad included a line drawing of the hospital and location with a heart-shaped balloon affixed. This visual message was reinforced by a 20-foot tall cold air balloon that was placed on the roof of the hospital bearing the campaign theme, "Take the Signs to Heart."
The direct mail campaign was targeted at former patients (within the past 3 years) to announce the opening of the CPEC and included an invitation to the EHAC workshops.
Primary care physicians received a Valentine's Day balloon bouquet and candy jar announcing the upcoming opening of the center. Physicians are now being encouraged to offer Early Cardiac Care classes to their patients in conjunction with the medical center.
In addition, billboards were placed throughout the medical center's service area to announce the opening of the CPEC. A billboard with a "beating" heart was placed in a key freeway location to coincide with the direct mail promotion.During the first year, 2,700 community residents attended an hour-long EHAC class as a part of the introduction of the new service. In addition, we received approximately 1,000 requests for EHAC self-study guides, which summarized the information presented in the classes. Thereafter, the classes continue to have approximately 700 attendees annually.
The implementation of an EHAC community education program is an integral part of the development of a CPEC. As we now know, heart attacks don't just happen, they have beginnings. The ultimate goal is to widely communicate the message to communities in an effort to change behavior and take advantage of the early warning signs of a heart attack. The investment in an EHAC program as part of the CPEC is one that will have significant returns in the effective treatment of patients with unstable angina and heart attacks.
References
1. Bahr RD. Emphasizing chest pain as a symptom of heart attack. JAMA. 1993;270:2345-2346. Letter.
2. Bahr RD. Access to early cardiac care: chest pain as a risk factor for heart attacks, and the emergence of early cardiac care centers. Md Med J. 1992;41:133-137.
3. Bahr RD. Prodromal symptoms of a heart attack. J Am Coll Cardiol. 1992;20:3.
Return to Index of Articles for Clinician;
Volume 14.4
- Faculty Listing 3
- Introduction: Community Message in Acute Myocardial Ischemia 4
- Concept of Community Chest Pain Centers in Emergency Departments 5
- Reawakening Awareness of the Importance of Prodromal Symptoms in the Shifting Paradigm to Early Heart Attack Care (EHAC) 7
- The Role of Emergency Medicine in the Future of American Medical Care: A Summary of the Josiah Macy, Jr, Foundation Conference 12
- From ACC/AHA Guidelines to Best Practice: Can "Acute MI Report Cards" Save Lives?Measuring Quality of Care for Patients With Cardiovascular Disease 16
- Improving Lay Responses to Cardiovascular Emergencies and the Potential of Shifting the Paradigm to Early Heart Attack Care 18
- National Survey of Chest Pain Centers Rationale and Potential Results 21
- Outpatient Rule-Out Myocardial Infarction in Observation Units 22
- Reducing Time to Thrombolytic Treatment 24
- Intervention Programs to Reduce Patient Delays in Acute Myocardial Infarction 29
- Public Education Using the Early Heart Attack Care Program Shawnee Mission Medical Center 31
- School Component: Early Heart Attack Care Program Development and Evaluation 33
- Educational Strategies to Prevent Prehospital Delay in Patients at High Risk for Acute Myocardial Infarction 36
- Precipitating Factors in Acute Cardiovascular Disease 41
- Use of Myocardial Perfusion Imaging in the Emergency Department for Risk Stratification 44
- The Evolution of Chest Pain Centers: The Impact of Technological Advances on the Evaluation of Patients With Possible Acute Ischemic Coronary Syndrome 47
- Critical Pathways for Triage and Treatment of Chest Pain Patients in the Emergency Department 53
- Chest Pain Centers: An Emerging Model for the Emergency Evaluation of Chest Pain and Treatment of Acute Myocardial Infarction 56
- The Key to Success in the Chest Pain Emergency Department: The Observational Role of theNurse 59
- Triage in Moderate Risk Patients With Chest Pain: The Emerging Role of Real-Time Continuous ECG Monitoring 61
- Diffusion of Innovations: The Introduction and Impact of the Chest Pain Emergency
- Department and its Comparison to the Coronary Care Unit Development 64
- Economics of Chest Pain Centers: What Really Matters? 68
Home | What's New | What is EHAC? | Abstracts & Articles
Reader's Digest | Contact Us | Search
Tips for Searching
www.ehac.org.
Site by AllSoldOut Internet Solutions
Visit the Clinical Information EHAC site at www.chestpaincenters.org.
Copyright © 1996-2001
by St. Agnes Healthcare. All Rights Reserved.
|
ABOUT
US FROM
DR. BAHR MORE
INFO SUBSCRIBE |