FMH Interventional Cardiology Program
The FMH Interventional Cardiology program began when the hospital received Maryland Health Care Commission approval to provide emergency angioplasty for patients experiencing STEMI (ST Segment Elevation Myocardial Infarction). The American Heart Association and American College of Cardiology's recommendation is that STEMI victims receive life-saving angioplasty/stent placement within 90 minutes of coming to an emergency room.
Each year our interventional cardiology program sees more than 130 STEMI patients. Our door to balloon time averages 50 minutes, one of the best times in the State of Maryland. STEMI patients are identified in two ways, (1) if 911 is called the Frederick County EMS paramedics and EMTs perform a 12 lead EKG which is then transmitted electronically to the FMH Emergency Room and (2) by 12 lead EKGs done within 10 minutes of arrival to our ER. Transmission of the EKG to the FMH ER allows the Emergency Room physician to activate the Code Heart Team prior to patient arrival. 24 hours a day/7 days a week our team of an experienced
interventional cardiologist and specially trained RNs and technologists respond to the Code Heart calls within 30 minutes.
Our interventional cardiology program also allows FMH to provide a full service community based diagnostic cardiac catheterization program. FMH subsequently received approval from the state of Maryland and Johns Hopkins Research to participate in the C Port E elective angioplasty program. The C Port E program is a multi-state, multi-hospital research protocol which is looking at the outcomes of hospitals that provide elective angioplasty without open heart surgery on site. This program allows FMH to provide elective angioplasty/stent placement to patients who require this procedure.
More recently, our program expanded to include electrophysiology (EP) services. Our specially trained group of board certified electrophysiologists allows FMH to provide the following procedures: pacemaker insertion/battery changes, defibrillator insertion and generator changes, complex device insertions for patients experiencing severe heart failure as well as cardiac ablation procedures for arrhythmias.
For all of our interventional cardiology procedures, the team works in state-of-the-art procedure areas. We are currently performing more than 1,000 cardiac catheterizations/year, 250 angioplasty procedures and 100 EP procedures/year. With the support of our community, board of trustees, physicians and staff, FMH is able to provide a full-service cardiology program allowing Frederick patients to receive cardiac care in their community.
The FMH Hospitalist Model
FMH has adopted the Hospitalist Physician Care Model. A Hospitalist is defined as "a physician that cares for patients in the hospital in place of the primary care physician" (Wachter, Goldman). A Hospitalist is present in the hospital setting 24 hours a day. Many organizations have embraced this physician coverage because inpatient care is growing in complexity and need. The primary care physicians have other primary responsibilities and therefore cannot be available and present for the inpatients 24 hours each day.
After close evaluation of care, satisfaction and outcomes, FMH decided to take the Hospitalist role to a new level. Our hospital implemented Hospitalist rounds, which means an interdisciplinary team led by the Hospitalist conducts visits daily on their patients with the Physician, Nursing, Clinical Nurse Specialist, Pharmacy, Physical and/or Occupational Therapy, Dietary, Case Management, Stroke Coordinator, and Respiratory.
This work collaborative is used to identify issues and barriers between nursing and the Hospitalist team to improve quality, efficiency, and effective communication that will support superior clinical outcomes.
This initiative will continue to be monitored and evaluated. If the expected outcomes are achieved, Hospitalist rounds will spread throughout the organization on applicable units.
Wachter RM, Goldman L. The emerging role of "hospitalists" in the American healthcare system. N Engl J Med. 1996;335:514-7.