Michigan Hospitals Commit to Faster D2B


February 8, 2007

Feb 9, 2007 —A new multihospital initiative began in Michigan this week that will rush faster treatment to the state’s residents who suffer heart attacks. Thirty-five hospitals are banning together as part of a statewide project coordinated by the Michigan Chapter of the American College of Cardiology and the University of Michigan Cardiovascular Center with support from Blue Cross Blue Shield of Michigan/Blue Care Network.

Goal No. 1 is to reduce the time it takes to deliver heart-attack care — from the minute a patient arrives at the emergency room to the minute doctors deploy artery-opening balloons to restore blood flow through the blocked vessels that cause most heart attacks.

“Every minute that can be saved is critical, because it keeps a bit of the patient’s heart muscle from dying or being weakened by lack of oxygen,” says U-M’s Mauro Moscucci, M.D., who will help lead the project. “In other words, time is muscle.”

“This is an example of a health plan, hospitals and doctors working together to make our state a national leader in improving the quality and efficiency of heart attack care,” says Thomas Simmer, M.D., BCBSM senior vice president and chief medical officer.

The effort represents a large-scale implementation of ACC’s national campaign called “Door to Balloon: An Alliance for Quality.” Many other health organizations including The American Heart Association are project partners.

Michigan has a jump-start on the national effort because of previous statewide efforts to help hospitals improve other aspects of heart care, and D2B times. Under the Blue Cross Blue Shield of Michigan Cardiovascular Consortium (BMC2) (www.bmc2.org) led by Moscucci and BCBSM’s David Share, M.D., and coordinated by Eva Kline-Rogers, RN, MS, a group of 17 Michigan hospitals have been working to improve their angioplasty practices.

Michigan is already ahead of the national curve on D2B times, though its hospitals still have room for improvement. Current Medicare data show that 71 percent of Michigan heart attack patients get their angioplasty within 120 minutes of arrival — far better than the national average of 56 percent.

The national and Michigan efforts are both aiming to get D2B time down to 90 minutes or less for at least 75 percent of patients experiencing the most common type of heart attack, called STEMI for ST-elevated myocardial infarction. Only STEMI patients have been shown to receive more benefit from emergency angioplasty — which is also known as primary percutaneous coronary intervention or primary PCI — than from fibrinolytic (clot-busting) drugs that can be given at most hospitals.