1. OHSU Chest Pain Program
DATE: March 14, 2017
PRESENTED BY: Joaquin Cigarroa, MD Clinical Chief Knight Cardiovascular Institute
Rachel White, MSN, RN, CCRN Chest Pain Coordinator

2. OHSU Chest Pain Program
Mission
To bring together individuals who manage patients with chest pain throughout OHSU and the community and to design the optimal chest pain management program.
Vision
To be a Vizient Top 10 Chest Pain Program nationally and to improve access and quality of care for all Oregonians.

3. OHSU Chest Pain Program
STEMI patients
2017: 89
2016: 103
2015: 65
2014: 64
2013: 89
2012: 135 3

4. OHSU Chest Pain Program
Of the OSH transfers: 31 s/p lytics and 21 direct to CCL 4

5. OHSU Chest Pain Program
KCVI Cardiac Ischemia CQI Committee is a multidisciplinary team that oversees the care of all ischemic heart disease patients at OHSU
Active participation in multiple registries including NCDR, CathPCI, ACTION—GTWG, STS (CABG only) and UHC
KCVI is an integrated center for translational research, clinical care, professional training and outreach in all aspects of heart and vascular disease. 5

6. Rapid Response Team 24/7 Availability
Support inpatients as well as ED and incoming critical care transfers
Stroke and STEMI response team members
Initiate and progress care for STEMI patients after hours/weekends 6

7. Nursing Support of Chest Pain Patients
CVICU
Gold Beacon Award winner x4
Certification: 80% of qualified RNs, and 92% for RRT
Active nursing research (IRB approved) for early warning scoring system, Mock Codes, and CALS
Cardiac Cath Lab
Certification: 67% of eligible RNs
EBP Fellowship Hematoma Project

8. Nursing Support of Chest Pain Patients
CVIMC
Certification of 60% of eligible RNs
Presentation at two nursing conferences on “Fostering a Culture of Safety through Interdisciplinary Improvement Rounds”
Two Good Catch awards
Multiple rose awards
3 Daisy Awards over the past 2 years

9. 2016 ACTION Registry — GWTG Silver Performance Achievement Award
Q4 2014
Q1 2015
Q2 2015
Q3 2015
Q4 2015
Q1 2016
Q2 2016
Q3 2016
Metric 1: Overall AMI performance composite
Metric 2: Overall defect free care
Metric 3: STEMI performance composite
Metric 4: NSTEMI performance composite
Metric 5: Acute AMI performance composite
Metric 6: Discharge AMI performance composite
Metric 9: Beta-blocker at discharge
Metric 10: Statin prescribed at discharge
Metric 12: ACE-I or ARB for LVSD at discharge
Metric 15: Proportion of STEMI patients receiving primary PCI within 90 minutes
Metric 16: Median time in minutes to primary PCI for STEMI patients
Metric 18: Time in minutes from ED arrival at STEMI referral facility to ED discharge from STEMI referral facility for patients transferred for PCI
Metric 19: Time in minutes from ED arrival at STEMI referral facility to Primary PCI at STEMI receiving facility among transferred patients
Metric 22: Door to 1st ECG in minutes
Metrics 40: Pre-hospital ECG
>= 50th %ile
< 50th %ile
> 90th %ile
< 10th %ile

10. OHSU Chest Pain Program
Commitment to Community
ED/EMS STEMI Committee comprised of ED, EMS, and Interventional Cardiology representatives that review STEMI cases quarterly evaluating for quality and process improvement opportunities
Annual EMS Conference
Participant in Accelerator II project with Portland regional hospitals, AHA, and Duke University
Support the annual Oregon ACC Conference 10

11. OHSU Chest Pain Program
Commitment to Community
OHSU Chest Pain Coordinator co-chairs Regional STEMI Coordinator group
Share best practices with community hospitals seeking to develop standard work when providing care to STEMI patients
Provide community providers access to participation in our didactic and case based conferences 11

12. Thank You