HEART Unit Expands
Garnering national interest, St. Anthony’s newly expanded center is one-of-a-kind
When St. Anthony’s Medical Center leaders cut the ribbon Feb. 25 for the newly expanded Lewis Rice HEART (Heart Evaluation and Rapid Treatment) Unit, it came with the distinction as the only one of its kind in the St. Louis metro market, and perhaps the nation.
The HEART Unit provides outpatient care for patients with non-life-threatening cardiac issues, allowing them to undergo needed tests without requiring admission to the hospital.
All 10 private rooms were filled immediately.
“It’s a very unique setup,” said Charles Carey, MD, medical director of the HEART Unit. “We haven’t seen anything quite like it in the nation.”
A nurse practitioner and nurses staff the HEART Unit around the clock, providing necessary lab tests, and continuous EKG monitoring and frequent medication adjustments. Kathleen Martin, RN, is nurse manager of the unit.
“St. Anthony’s wanted to do something for patients who were being admitted for chest discomfort under conditions where the medical staff didn’t feel comfortable sending them home,” said Carey. “We wanted a venue where patients with those conditions could be safely evaluated without requiring admission to the hospital.”
Carey joined St. Anthony’s in January 2011 and helped bring the concept to life when the HEART Unit opened with eight beds in May 2012. In 2013, nearly 2,000 patients were seen at the HEART Unit, eliminating that number of admissions to the hospital. Its popularity prompted the expansion to 10 private rooms, thanks in part to contributions from friends, colleagues and family of the late John K. Pruellage, who served as a “fantastic advocate” for the medical center and sadly, died in 2012, noted Carey.
With a no-hands-tied approach, only with the administrative directive of the patients’ best interests in mind, Carey looked to the Chest Pain Society of Cardiovascular Patient Care for certain criteria for evaluation of chest pain patients on an outpatient basis, consulted with other cardiologists, and reviewed reams of medical literature. He adjusted protocols to better fit technological advances in cardiac care.
“The normal course for a chest pain patient might’ve gone something like this: Arrive in the ER at 10 o’clock in the morning, get to the floor around mid-afternoon, and maybe see a cardiologist that day or the next, and then get a stress test, which all might involve two nights in the hospital,” he said. “That process was something we thought we could definitely improve on, both for patient satisfaction and hospital finances.”
The average length of stay in the HEART Unit for chest pain patients is less than eight hours, and for atrial fibrillation patients with fast heart rates is about 15 hours, said Carey.
“It’s a very quick process, and takes away the element of worry for patients and their families,” said Carey. “For example, a heart patient in the hospital might see a doctor once a day, and have medications adjusted twice a day. In the HEART Unit, an a-fib patient might have their medications adjusted every four hours and quickly get on the doses needed.”
As a result of the HEART Unit’s success, more cardiologists and primary care physicians in St. Louis are referring patients to the center, along with urgent care centers and home health providers. Carey’s fielded calls from competing hospitals and healthcare systems around the country wanting to learn more about the model.
“St. Anthony’s was looking for a way to enhance patient experience and produce better patient outcomes,” said Carey. “We feel like we’ve done that in an expedited, yet evidence-based manner, supported by guidelines and recommendations. Patients are happy with the quick turnaround, knowing they’ve had their heart evaluated before going home and avoided being in the hospital.”