November 1993 Advocate Letter

November, 1993

Dear Early Heart Attack Care Advocate:

With the emphasis to reduce time to treatment for patients with acute myocardial infarction it becomes imperative to find ways to reduce time spent within the emergency room prior to thrombolytic therapy as well as to reduce time in the field so as to obtain optimal and maximal results.

Enclosed is a graft from Dr. Bernard J. Gersh's recent article relating time to not only reduction in deaths, but also in salvage of heart muscle. As a result of this there is developing widespread interest in programs designed to reduce the overall time to therapy. In addition to this there is a HCFA Study under the Medicare program for myocardial infarction that attempts to monitor hospitals performance in this area. Needless to say all hospital emergency rooms are not created equal and there are many that need to get caught up to speed. In many institutions this has become a CQI issue in that the heart attack problem is seen as a process failure that lends itself to a process solution involving emergency room personnel as well as the community itself.

Enclosed please find a recent challenge from Dr. Louis Graff who is in charge of ACEP Observation Service section concerning help in developing guidelines for a successful ED program. It encompasses a heart attack unit such as a Chest Pain Emergency Room as well as an Observation Area for evaluating patients with suspect myocardial ischemia patients.

Please see this as an early learning curve and feel free to participate proactively in collaboration with other similar institutions in an all out effort to penetrate American communities and get the public to respond in such a fashion as to make heart disease #2 by the year 2000.

Sincerely,

Raymond. Bahr, M.D., F.A.C.P.
Medical Director
The Paul Dudley White Coronary Care System
Saint Agnes Hospital

900 Caton Avenue Baltimore, Maryland 21229-5299 (410) 368-6000 >>>>Insert Daughters of Charity text logo

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