By: Diana Barnes-Brown for Heart1In a recently published study, Harlan J. Krumholz, M.D. and fellow researchers at Yale University Medical School identified a series of factors that are crucial in enabling hospitals and care centers to respond quickly and efficiently to the needs of heart attack patients.
| Learn More |
Signs of heart attack can be intense or subtle, and there are differences in heart attack symptoms for men and women. Some common signs of heart attack may include:
Chest pain or feeling of intense pressure, as though something very heavy is on the chest.
Sharp pain in the arm, shoulder, neck, back, or stomach.
Shortness of breath
Sudden sweating
Nausea
Faintness or sudden weakness
In women, there may be fewer cases of sharp, serious pain (sometimes nicknamed “Hollywood heart attacks”), and more diffuse symptoms easily written off as “not that bad.” But any potential heart symptoms are potentially life threatening, and should be investigated as soon as possible.
|
The study was a unique study, noted Krumholz, because unlike studies with similar focuses, which usually gather data on a huge scale, this one examined only 11 hospitals. The hospitals were chosen as exemplar hospitals in heart attack care because all were able to successfully restore blood flow to heart tissue in heart attack patients within 90 minutes – usually fast enough to prevent severe or permanent damage. But, in such medical situations when racing the clock cannot come at the expense of quality care, how do caregivers juggle the dual needs of patients in crisis?In a recent report by Healthday News, Krumholz explained that his approach was inspired by the belief that “you have to get on the ground and talk to people to learn how these places achieve things that are beyond the reach of other places.” This more microanalytical, or even ethnographic approach, which focuses on detailed accounts and particular situations often helps answer puzzling questions not addressed by the low level of detail in larger studies.
While the hospitals were all similar in the quality of their cardiac care capabilities, there were also many differences. The hospitals, which are not named in the study, varied significantly in size; for example, from 111 to 870 beds.
The study found that these hospitals shared eight key characteristics in heart attack care: Explicit goal setting about quick treatment, support from senior management, creative or innovative protocols, flexibility in changing set regimens if necessary, uncompromising leadership, teamwork, success in quick data retrieval (such as past medical records) and institutional/organizational culture that values learning from mistakes.
One of the big challenges of successful heart attack care involves balancing inevitable conflicts in the cacophony of care needs, rules, the need for moment-to-moment responsiveness, and institutional capabilities. In the case of all the hospitals in the study, caregivers had the benefit of intensive feedback and blame-free delivery of the feedback. This means that it was possible to inform caregivers of their strengths and weaknesses without condemnation for mistakes or forced adherence to unsuccessful protocols.
The research team is currently working with national and international heart care organizations to develop educational materials that will teach heart care practitioners the guidelines for successful heart attack treatment. One such venture involves the development of a national campaign with the American College of Cardiology. The researchers hope to emphasize the need for commitment and flexibility in the mission to improve heart attack care and increase survival rates.
