Dr. Brian Dockery, cardiologist at Cookeville Regional, immediately met to evaluate “heart attack patient” J.D. Mullins, CEO at Clinton County Hospital, in the ambulance bay at Cookeville Regional when Clinton County EMS arrived.
COOKEVILLE – On Wednesday morning at 10:12 a.m. a “patient” entered the Clinton County Hospital Emergency Department with signs and symptoms of a heart attack. This was the setting for the mock Code 37 drill that began as a collaborative training exercise between Cookeville Regional Medical Center, Clinton County EMS, Air Evac LifeTeam and Clinton County Hospital in Albany, Kentucky.
The Code 37 activation is a “one call” activation protocol that helps the receiving facility (CRMC) better prepare for the patient’s arrival. EMS agencies and transferring facilities utilize this in the Upper Cumberland Region/ South Central Kentucky for the activation of Interventional Cardiac Care once it has been determined the patient is having a heart attack.
“We have a great working relationship with Clinton County Hospital so we reached out to them to see if they would be interested in doing a mock Code 37 drill with the goal of improving patient care for future patients of Clinton County Hospital experiencing heart attacks. It was also our goal to review the transfer and receiving process from their Clinton County Hospital to Cookeville Regional Medical Center. Once they agreed, we set the date and Mr. J.D. Mullins, the CEO of Clinton County Hospital graciously volunteered to be the “heart attack patient,” said Brenda Davis- Bryant, R.N. and Chest Pain Accreditation Coordinator at Cookeville Regional.
Janice Beard, chief nursing officer at Clinton County Hospital and Bryant stood in the Emergency Room at Clinton County and passively monitored the process. They then headed to Cookeville Regional to complete the transfer process.
“Our concern is always the patient at Clinton County. We want to get them to a hospital that can give them the best heart care because time is heart muscle,” said Beard. “Anytime there are improvements that can be made we want to be able to make them.”
Clinton County EMS transported the patient by ground, and once they arrived Cookeville Regional was waiting.
“When the patient arrives in the hospital bay at Cookeville Regional, the cardiac cath team and cardiologist are waiting for them. It truly is a team approach between our transferring facilities, EMS agencies, the emergency department and our cardiologists and the cardiac cath team,” said Bryant.
“The Upper Cumberland area and Clinton County EMS agency paramedics can immediately start treating the heart attack on the way in to the hospital, preventing further heart muscle damage from occurring. That is why we highly encourage the public to call 9-1-1 at the onset of chest pain or signs and symptoms of a possible heart attack.”
Once the drill had been completed a debriefing was held at CRMC with key personnel of all agencies involved to identify areas of the process that could be improved.
Beard shares, “We felt this drill was successful because we saw areas of improvement for our facility (Clinton County Hospital). The Code 37 protocol is great thing. Anytime you don’t delay because a process is in place it is harder to miss things. When ST elevation (where activity of a heart attack is show on an electrocardiogram) is happening you know what to do, there is no questioning it. Clinton County Hospital feels fortunate to have this protocol in place. Plus, the training that our nurses and physicians have makes us feel better prepared. Cookeville Regional has been great to work with and is a great resource to us.”
Mitch Stonecipher, director of Invasive Cardiovascular Services of Cookeville Regional, adds, “This truly is a collaborative effort. CRMC is consistently outperforming the national standards for door-to-balloon time and is doing very well with the delivery of Interventional Cardiac therapy for Code 37 transfer patients, however there is always room for improvement and this collaborative exercise can be instrumental in identifying areas of the process that can be refined. It is our hope that CRMC will be viewed as an extension of care for transferring facilities and EMS agencies of the Upper Cumberland and South Central Kentucky. Their patients are our patients and vice versa. When our patients do well it is a victory for everyone involved.”
Dr. Stacy Brewington, interventional cardiologist at Cookeville Regional, stated, “It is good that we can partner with our neighboring communities in advancing the treatments of heart disease. Too often smaller communities don’t have access to advanced therapies and I am happy we can provide this.”