A project to improve outcomes for Lincolnshire’s sickest heart patients has exceeded national targets in the first 18 months.
The Lincolnshire Heart Centre is trying to improve survival rates for patients who suffer an out of hospital cardiac arrest (OOHCA) requiring support from a ventilator as they cannot breathe for themselves. An OOHCA is where someone has a cardiac arrest in the community and has to be put on a ventilator before admission to hospital. It is a leading cause of death in the UK and these patients need to be treated as quickly as possible to stand the best chance of survival.
The team, based at Lincoln County Hospital, is making a real difference to the lives of Lincolnshire people. With support from staff in intensive care, and working with East Midlands Ambulance Service and Lincolnshire and Nottinghamshire Air Ambulance, people are being seen and treated quickly, and survival rates from heart attacks are higher than the national average.
As part of this project the heart centre has seen an increase in survival rates for OOCHA patients from 5% to nearly 50%. Currently the survival rate nationally for these patients is between 5% and 9.6%.
Since the introduction of the new service these patients now bypass their local hospital and are admitted directly to the heart centre where their condition can be treated most effectively. There is a seamless journey for these patients brought in as emergencies to the heart centre, who then go onto the intensive care unit (ICU) and ultimately rehabilitation. This service redesign was undertaken within existing budgets and without additional investment.
Alun Roebuck, Consultant Nurse in Cardiology at Lincoln, said: “This collaborative project has been a fantastic success in helping us provide care for the sickest patients in Lincolnshire. Many of these patients have been dead for several minutes so getting to them quickly and treating their symptoms in the most appropriate place is key to their survival.
“Achieving survival rates for our patients that are better than the national average is a real accomplishment in such a rural area as Lincolnshire.”
The Lincolnshire Heart Centre introduced the PPCI (primary percutaneous coronary intervention) treatment in April 2013. The procedure involves using a small balloon to restore blood flow to a blocked artery. Once unblocked, the artery is kept open by implanting a metal tube called a stent. When performed as an emergency for a heart attack this is known as a primary angioplasty and is the most effective treatment for patients suffering the most severe form of heart attack.
In the first five years since the introduction of PPCI there has been a decrease in the number of patient deaths from 13% to 4%.
The project has also been shortlisted the Health Service Journal’s Value in Healthcare Awards in the Emergency Medicine, Service Redesign and Specialist Services categories.
Winners will be announced at an awards ceremony at Manchester Central alongside the HSJ Value in Healthcare Congress.
The target from the time that an ambulance is called until the coronary artery is opened using PPCI is less than 150 minutes. Known as call to balloon, the heart centre achieved this in 88.7% of cases against the national average of 82.3%.
The centre also exceeded the recommended target from the time of the patient arriving at the heart centre until the coronary artery is opened using PPCI which is less than 90 minutes, this is known as door to balloon. The heart centre achieved this in 96.8% of patients against a national average of 88%.
The centre has also exceeded national targets in providing secondary prevention (drugs that reduce the likelihood of the patient having another heart attack) for patients discharged from the hospital. These drugs include being aspirin, beta-blockers, ace inhibitors and statins. The Lincolnshire Heart Centre achieved 100% compliance in prescribing these preventative medications.