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CARDIAC CARE: MANY WAYS TO WIN A PATIENT’S TRUST, AND AWARDS Pan Langseth didn’t know much about TMC’s Cardiovascular Center until she woke up in TMC’s Intensive Care Unit to learn about how the cardiac team saved her life. A quiet evening at home with her family turned into a frantic trip to the Emergency Department. The cardiac team knows time is heart muscle and so the team went to work. And it paid off. Today, Pan is back to playing golf with her friends and enjoying time with her family. Pan will tell you that when you have that dreaded heart attack, you won’t be thinking about a national award at your hospital or fancy words like electrophysiology. You’ll think trust. Trust that no minutes are spared between the ER doorway and the operating suite. Trust that your physicians will use the latest and safest technology. Those same traits helped TMC to earn a Top 50 U.S. cardiac hospital award in the 2011 Thomson Reuters rating, and yes, TMC has skills described with amazing words, but it all boils down to instilling your confidence. Let’s visit just a few cardiac areas that make the case.

Pan Langseth

First, TMC and the community physicians who practice at the hospital have worked as a team to improve quality outcomes and lower costs. The cardiologists, heart surgeons and TMC nurses and administrators collaborate on projects to create a revolutionary system for defining and achieving excellent care. This project is “a rare ray of sunshine in today’s medical care,” said Dr. Gregory Pennock, who is the chairman of the board of directors of the Cardiac Service Line Agreement between physicians and the hospital. “The dialogue may be heated at times, but it promotes positive action, not gridlock. We all have a shared interest in managing the hospital.” The collaboration focuses on those key steps that can be taken to save lives. For example, it’s now much faster to get a patient with an acute heart attack into the Heart Catheterization Laboratory to open a blocked artery. The sooner the artery is opened, the better chance of saving a life. TMC has also seen improvements in quality measurements (metrics) for treating patients with heart attacks and congestive heart failure. “It’s gone from a ‘we vs. them’ mentality to the hospital and cardiologists working well as a team to solve problems of delivering quality care,” Pennock said. “We have different and distinct cardiology groups, each with very different personalities, all at the same table, solving the same problems. It may well be a model for the rest of the country to follow.” Then, consider TMC’s noninvasive cardiology. 4

“TMC approaches cardiac care in a very different way. We focus on patients and improving outcomes, not just on giving medication,” Tirrito said. “TMC does a good job of working with physicians as partners to improve those outcomes.” At the electrophysiology (EP) suite, your physician will be able to fine-tune the dangerous rate of an arrhythmic heart with the latest, and safest, equipment. Guided by Dr. Darren Peress, the relatively new EP division uses remote magnetic navigation to move a tiny device called an ablation catheter toward your heart, while watching its journey on a computer screen. That reduces the need for X-rays, cutting risky radiation exposure from fluouroscopy from as much as 100 minutes to only 5 minutes. Trust the EP staff to use the latest technology: a soft catheter, something like a bit of spaghetti, no more than an eighth of an inch thick. Guided along by a magnet in the tip, the catheter can remove any undesired heart tissue that causes arrhythmia. At rest, your heart beats 60 to 100 times a minute. A nonlethal arrhythmia can speed that up to 180 times or more. “That may not kill you but it could wreck your quality of life,” Dr. Peress said. Happily, cardiac electrophysiology can fix the problem before that happens. At the Chest Pain Clinic, every minute matters. So does every heart. When a new patient arrives, chest pain can signal coronary disease. “Right away we are going to make sure that the chest pain isn’t a life-threatening issue,” says the medical director of the newly accredited center, Dr. Mark Goldberg. “That’s the major concern: the heart.” Simply winning accreditation in 2010 was an organizational feat in itself, taking a year of hard work by TMC on multiple levels, by EMTs, emergency room physicians, cardiologists, nurses, pharmacists and hospital administrators. “This was a concerted effort,” Goldberg says, “and it’s a good reflection on the hospital.” Such accreditation was absolutely essential to win a Top 50 ranking for cardiac services, he adds.


Here you’ll learn what integrative medicine really means. Dr. Salvatore Tirrito, head of cardiac noninvasive services, says his unit spells out lifestyle changes to last a lifetime. His team does all the latest tests, echocardiograms, treadmill and tilt-table stress tests, but they also work on diet and behavior, on your whole environment. “It’s not just prescribing pills and out the door,” Tirrito said. “The patient gets a complete picture of where they stand.”


TUCSON MEDICAL CENTER • Named by Thomson Reuters as one of the nation’s 50 Top Cardiovascular Hospitals for 2011 – the only hospital in Southern Arizona to make the list • OneChart, TMC’s electronic medical record system, is among the 3.2 percent of all U.S. hospitals to reach Stage 6 on the HIMSS Analytics Database, which tracks hospital EMRs from Stages 0-7. • Certification as a Primary Stroke Center by the Healthcare Facilities Accreditation Program • Designation as an Accredited Chest Pain Center by the Society of Chest Pain Centers • Recipient of the IBCLC Care Award from the International Lactation Consultant Association for support of breastfeeding. • TMC for Children is an associate member of the National Association of Children’s Hospital and Related Institutions • TMC Neurosciences holds NeuStrategy designation as a Neuroscience Center of Excellence.

“The whole idea is that our work becomes a standardized process,” Goldberg says. “That way, processes are less likely to break down, our work is less likely to involve mistakes, and we can put out better overall results.” From new models to metrics, TMC keeps adding ways to win the community’s trust in its cardiovascular programs. And, oh yes, they also win awards. 5

TMC Cardiac Care  

Excerpt from TMC's 2010 Report to Our Community