Case study: NC program speeds heart attack care

In the past, up to 40 percent of North Carolina heart attack victims who needed clot-busting drugs or angioplasty weren't getting them--or got treated too late. However, over the past two years, a statewide project taking place in North Carolina has changed that picture, by dramatically streamlining the way its providers care for heart attacks.

The heart attack program is funded by the hospitals, Blue Cross and Blue Shield of North Carolina and the Doris Duke Foundation, which, among other things, have made sure ambulances get EKGs. Under the program, paramedics, doctors and 65 hospitals have agreed to collaborate more closely to make sure patients got the right care. Most notably, 55 smaller hospitals without cath labs agreed to send heart attack patients to bigger hospitals for angioplasties, rather than try to treat the patients solely with clot-dissolving drugs and keep the service revenue for themselves.  Also, the larger hospitals equipped with cath labs have agreed to take such patients even if they don't have an open bed.

The new standards call for paramedics to make some judgment calls usually reserved for cardiologists, including one case in which a rural paramedic diagnosed heart attack and put a team on alert to conduct a cath. Under the rules of the program, once the paramedic made the call, the team had to be in the lab within 30 minutes.

To learn more about the program:
- read this Associated Press piece

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